Decisions to consent for autopsy after stillbirth: Aboriginal and Torres Strait Islander women’s experiences

Kilcullen, Meegan, Kandasamy, Yogavijayan, Waston, David, and Cadet-James, Yvonne (2020) Decisions to consent for autopsy after stillbirth: Aboriginal and Torres Strait Islander women’s experiences. Australian and New Zealand Journal of Obstetrics and Gynaecology, 60 (3). pp. 350-354.

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Abstract Background: The stillbirth rate for Australian Aboriginal and Torres Strait Islander infants is twice that for non-Indigenous infants. Autopsy is the gold standard for fetal investigation, however, parental consent is low. There is little research investigating the drivers of parents’ decision-making for autopsy after stillbirth. Aims: The current study explored the reasons why Aboriginal and Torres Strait Islander women did or did not give permission to autopsy after stillbirth. Materials and Methods: Five Aboriginal and/or Torres Strait Islander women participated in semi-structured interviews. Thematic analysis was conducted within a phenomenological framework. Results: Five themes were identified as reasons for giving permission – to find out why baby died; confirm diagnosis; understand future risk; help others; and doubt about maternal causes. Four themes were identified as reasons for declining permission – not asked in a sensitive manner; not enough time to think; distress about the autopsy procedure; and unwilling to agree. There was a lack of acceptability of the lengthy timeframe for the availability of autopsy results as families usually wait between three and nine months. This lengthy waiting period negatively impacted upon families’ health and wellbeing. Conclusions: It is important for health professionals to understand the factors that parents consider when giving permission for autopsy after stillbirth. It is hoped that an increase in autopsy rate will enhance the understanding of the causes of stillbirth and ultimately decrease the stillbirth rate for Aboriginal and Torres Strait Islander families.

Item ID: 59164
Item Type: Article (Research - C1)
ISSN: 1479-828X
Keywords: autopsy, stillbirth, Aboriginal, Torres Strait Islander, consent, Indigenous
Copyright Information: © 2019 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. In accordance with the publisher's policies, the Author Accepted Manuscript of this publication is available Open Access from ResearchOnline@JCU from 8 October 2020.
Projects and Grants: THHS SERTA grant
Date Deposited: 19 Aug 2019 00:21
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3215 Reproductive medicine > 321501 Foetal development and medicine @ 100%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes @ 100%
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