Evaluating current knowledge of legislation and practice of obstetricians and gynaecologists in the management of fetal remains in South Africa

Abstract

BACKGROUND. In the clinical setting, the main legislative provisions governing the management and ‘disposal’ of fetal remains in South Africa are the Choice on Termination of Pregnancy Act 92 of 1996 and the Births and Deaths Registration Act 51 of 1992. OBJECTIVES. To determine obstetricians’ and gynaecologists’ current knowledge of this legislation. Current practice with regard to certification of death and methods of disposal of fetal material was also reviewed. METHODS. A questionnaire-based study was conducted. The data collected included demographic details, qualifications, years of experience, working environment (public/private practice), responses to general questions reviewing knowledge of current legislation, and practical experience. RESULTS. Seventy-six questionnaires were returned, with practitioners from the private and public sectors nearly equally represented. It was found that there is a concerning gap in obstetricians’ and gynaecologists’ knowledge of the law, and that some practitioners are acting outside the scope of the law. The study further revealed that patients’ needs are not properly accommodated under the current legislative provisions, because the law prevents certain remains from being respectfully managed. CONCLUSIONS. The study findings suggest that improved training of practitioners, together with possible law reform, are required to better serve the needs of patients.