The burial and cremation of stillborn babies is a complex subject. However, it has become far more complicated because the word stillborn is rarely, if ever, used. They are now included under the more inclusive catch-all term, ‘baby and infant funerals’. The problem with this is that it ignores the relevant legal status of the baby. A stillbirth is a baby born dead after 24 completed weeks of pregnancy. A total of 2512 UK stillbirths were registered in 2019.
The easily missed word here is ‘registered’. A stillbirth has to be registered and is therefore given legal status. However, the catch-all term does not differentiate between stillbirth, fetal remains and the death of an early live birth. The fetal remains, ranging from 12 weeks to 23 weeks, 6 days of pregnancy, make up far higher numbers. These days, they are often called pregnancy remains. They are, in law, clinical waste and cannot be called human remains. This difference forms the basis of my article.
In 1961 as a 15 year old at Shrewsbury Cemetery, I witnessed the stillborns being placed in an excavated adult grave each month, from the local maternity hospital. Each baby was in an individual box and was placed into the grave, on top of previous babies. They were then covered with a little soil before a scruffy tin sheet was placed over the grave. Up to 200 stillbirths were interred in the grave before it was full and was then capped off. A new grave would then be excavated for the next delivery. No service was ever held over the burials or any parent in attendance. All fetal remains were either disposed via a sluice or the hospital incinerator.
This process had gone on since the 1850’s and I gave it little thought. Subsequently, as manager of Wolverhampton Bereavement Services in 1974, I met a woman who had experienced a stillbirth. She was aware that her baby was in a grave with 200 others. She wanted to remove the coffin for interment in a private grave.
I was aware that identifying the coffin was impossible. The babies name had been written on each coffin, in biro and was soon illegible when it came into contact with wet soil. I explained all this to her and she was distraught. The most I could do was to enable her to place a small marker on the grave so that she had a burial location to visit. At that time, the mother of a stillbirth typically remained in hospital for up to 10 days. Consequently, the father made the arrangements for the burial. Often, it was felt that the mother should be kept outside this decision. Few women were allowed to handle the child’s body. Later in life, while undergoing counselling, some of these women had been told to find out what had happened to their baby. Many of the women had separated from the father. Sometimes, the father had refused to tell her where the baby was interred.
I was upset that she was unable to grieve properly because of this archaic practice. Consequently, by 1977, I arranged to inter all stillbirths separately, in their own small grave. I called this area ‘The Babies Memorial Garden’. This meant that any parent seeking to locate their baby, even if returning decades later, could take ownership of the grave for no charge. That meant they could personally mark the grave and grieve for their loss. It also became apparent that mothers could have more than one stillbirth. At least, with an individual grave, the second or more stillborn could be placed in the same grave. This is truly beneficial for the mental health of the parent(s).
This change was not without opposition. Some of my staff were uncomfortable with it and the midwifery hospital refused to discuss the new arrangements. However, it was important that midwives explained that this was individual burial when they spoke to any woman experiencing a stillbirth. The hospital authorities wrote back, clearly annoyed that I had changed ‘time honoured practice’.
To set a standard in the UK, in 1995, I wrote the Charter for the Bereaved and included the statement, ‘It is your right to be offered an individual grave for a baby or infant’. However, in 2010, the Institute of Cemetery and Crematorium Management (ICCM) changed the wording in line with a SANDS (Stillbirth & Neonatal Death Society) statement. Consequently, a stillbirth is not identified as such but included under ‘baby and infant funerals’. Personally, I find the SANDS wording highly confusing. The inclusion of a vast number of fetal remains means that all ‘baby and infant’ bodies cannot be individually buried or cremated. Consequently, individual burial is no longer a standard specific to the stillborn. Indeed, because fetal remains are combined in a single container for burial or cremation, the term shared funerals becomes confusing. As it now stands, a stillbirth can be interred in a shared grave. This must be backfilled immediately or have a lockable cover, but may be used again for further burials. If such a grave is used, the parent(s) must be told how many babies will be ultimately placed in the grave, and reminded that once interred, the body cannot be removed. You can imagine how difficult giving this advice is? This standard is no better than it was prior to 1977?
The weakness in all such discussions is ensuring the parent(s) understand what they are being told. That is why individual burial was always my default position. At least then the parent(s) can take ownership of the grave at any stage.
The parent, of course, has the right to take control of their stillborn baby and arrange a private burial or cremation. If an adult grave is purchased, then the parent’s bodies can join the child when they die. The principal costs can be paid by ‘The Children’s Funeral Fund for England’ (CFF) without any means testing. This includes the burial or cremation fees and the coffin (up to £300). As many funeral directors will arrange and manage stillborn funerals without charge, the entire package will then be free for the parent(s).
As regards cremation, because a stillbirth is registered and of high gestation, cremated remains should be guaranteed. That is not the case with fetal remains, where very little tissue might exist.
The ICCM are due to review The Charter for the Bereaved for all baby and infant funerals.
Resident Author
