Factors Associated With the Absence of Fetal Autopsy: Perception of Healthcare Professionals From a French Cross‐Sectional Survey
Camille Reyl, Sophie Martin‐Berenguer, Fanny Sauveste, Mélie SarreauABSTRACT
Objective
Despite recent recommendations highlighting the importance of fetal autopsy for genetic counseling and recurrence prevention, its uptake has declined. This study aimed to identify factors associated with absence of fetal autopsy from the perception of healthcare professionals (HP).
Methods
National cross‐sectional online survey among French HPs involved in the management of fetal loss was conducted. An anonymous questionnaire explored demographic characteristics, perceived medical, emotional, organizational and educational barriers to fetal autopsy, as well as potential strategies to improve uptake. Data were analyzed descriptively.
Results
A total of 125 HP completed the survey. Opinions about estimated rate of fetal autopsy refusal in stillbirth cases ranged from 30% to 40% across institutions. Refusal rates varied according to the clinical context or reaching over 75% in terminations of pregnancy with known genetic diagnosis. Identified barriers were multifactorial, including emotional distress related to grief, religious beliefs, fetal bodily integrity. Organizational issues constraints also played a significant role. Additionally, many respondents reported that insufficient training influenced the absence of fetal autopsy.
Conclusion
Fetal autopsy refusal is driven by emotional, cultural, informational, and organizational factors according to practitioners' perceptions. The development of less invasive alternatives and improved training in communication and bereavement care may enhance acceptance and support for bereaved couples.