I am the home-schooling mother of two wonderful young children nobody thought we could have had. All of my pregnancies, until these last two, ended in the death — in utero — of the baby. The very first miscarriage was of twins. Then came a stillborn boy. Then another miscarriage. Already approaching forty, I was told to stop trying to become pregnant since every pregnancy I have had (successful or not) has required medical intervention, before and after birth.

The miscarriages of which you have written are more accurately called “missed abortions,” the word “miscarriage” being slang rather than a medical term. Even the women who have suffered the more common “miscarriage” — that is, one that did not require surgical removal — have the word “abortion” on their medical records. Even though I know that is simply the proper wording for a naturally occuring event, I instinctively flinch at the word “abortion” for obvious reasons.

Surgical removal of the remains of my children who have died in “missed abortions” is something I have had to suffer entirely too often. The agony is indescribable. As an actively pro-life person in my diocese, I made more than one doctor prove to me that the children were, in fact, dead before even considering removal of the bodies. Even then, the idea of surgical removal was horrifying. I knew that removal (D&C and D&E) meant dismemberment. I recoiled at the notion of such treatment of human remains. I shrank from being the one to request that it be done at all, let alone to my own children. I know about what you are debating, and far more than I want to admit.

We enquired about being allowed the remains for proper burial, but encountered another element that has to be factored into a decision in this matter: the state comes between the family and its deceased loved ones to determine what it will allow the family to do with the remains. Also, if there is, by the law of your state, a “deadline” of fetal development to differentiate between when a baby is “miscarried” vs. stillborn, this also will determine whether you will be allowed a funeral. Our miscarried infants were not allowed a funeral; our stillborn son was. Both were surgically removed after they had died naturally in utero. These legal and procedural elements need to be corrected, I think, before we can disentangle for what the mother and doctor are truly responsible.

Why did I choose to have my children surgically removed rather than wait? Among the reasons is the fact that, even in utero, the deceased fetuses had begun decomposition and would not have been recognizably human upon completion of the miscarriage, surgical removal or not. Also, since the removal occured in the hospital, regulations required that the remains be treated as waste and not allowed to be handled by us; the matter was outside of our control once I opted to prevent infection by surgery. The knowledge that our twins and other children had their remains deposited in the common hospital waste bin for disposal will haunt us until the day we die. We do not know how to develop a plan for hospitals to allow access to human remains, intact or not, for proper funerals. On this matter, I would LOVE some input.

Should I have allowed the miscarriage to occur naturally? Medically speaking, in my case at least, while it was POSSIBLE, it was not advisable: it had been two or more weeks since the death of the children and there was no indication of anything other than an impending infection. There was no sign I ever WOULD have miscarried in the usual sense of the term. Some women simply do not. Not all deceased children in utero result in a natural expulsion of the remains. As long as this remains true, the surgical removal of those remains continues to be a genuine option, in my opinion.

In short, I did not seek the consignment of my children to the trash heap; I sought to save my health and life, and the current procedures of hospital and state unwittingly pitted my health against the proper respect due my children’s mortal remains.

The mother’s health and the welfare of her children — in life or in death — have too long been set against each other as mutually exclusive. That, I think, is the false dichotomy with which we need to contend. The removal of a dead body from close proximity to the living is normal, and always has been. What you DO with that retreived body is the matter at hand. Normally, such removal does not entail dismemberment; there are occasions in which it does.

Surgical removal does normally dismember the body of the deceased. This also happens with the retrieval of bodies from wrecks and bomb sites. Such dismemberment does not stem from disrespect of the body; it speaks to the opposite in fact. Far from disrespect, the bodies of the diseased are so held in reverence that we risk our lives to retrieve them, and do so even if the only way reclaim all of the body from the wreckage is to to do so, quite literally, piecemeal.

The important thing to keep in mind is that the surgical removal of the deceased is, in either case, a retrieval — a sort of posthumous rescue. Not being allowed by law or by medical custom to COMPLETE the rescue with a proper burial is the cruel, unjust, and uncharitable thing about which we CAN do something, I think. It only compounds the cruety, injustice and uncharitability then to turn to the mother and ask her, “Are you sure YOU did the right thing?” As a mother, I know I will always ask MYSELF that question. Always. Even when that question is really nothing more that the fertile ground for temptation to despair and scruples.

But I never will doubt that the posthumous retrieval of the dead — from anywhere — is the right thing, in and of itself. Knowing this fact can, and does, clear my head, although it does not answer the question of whether the dismemberment involves culpabilty.

How can we finish the job? — that is the question we can and must answer, I think, fairly easily. What would be the proper way to allow for the safe and respectful collection of the rescued remains, even if such be not intact? My father was in the Coast Guard and was one of the founding fathers of Paramedics in my home state. When he and his fellows dealt with retrieving the “remains of the remains” of a person, THEY had a way to manage the respectful collection of them for burial. There is really nothing to keep us from doing so with miscarriages which require, or strongly suggest surgical removal, even when such removal has the cost of involving some measure of our own permission and willingness in a kind of violence.

Philosophically and theologically, I suppose the question must then be, is the cost of surgical removal allowable as long as the possibility of “letting nature take its course” is an option? To me, that is like asking, “Do we go after the body or simply wait for it to wash ashore?” Since my dander is up, I’ll say “Well, gee, they’re both risky. Examine each as an allowable possiblity.”

In either case, it is WHY you made the choice you did, as well as what you DO with the body once it is there. Right now, the only option that clearly allows burial and is absent of obvious culpability is that of “waiting for the body to wash ashore”. I say, let us work VERY hard to find a way to allow for proper burial no matter what retrieval is either chosen or foisted upon you. This would allow for fewer “what ifs” to plague our consciences — and scruples. It would more readily allow for forgiveness and healing if and when transgressions DO happen. I would allow what every funeral and gravesite allows — the opportunity to keep the proper perspective from the moment the death is discovered until long after it has been faced.

From where I sit — from what I have gleaned from the Catechism, Scripture, and my theology degree, from what I have been through in trying to apply it to our own choices — if the surgical removal is removal for disposal, then it is not correct; if the surgical removal is retrieval for burial, however violent that retrieval, it is not essentially different from any other rescue of remains, and should be treated as such. I know that, if we are aware of the possibility of an evil and proceed anyway, we are, in fact, wishing that evil to occur, however indirectly. We are willing participants in the POSSIBILITY. Intentional, willing dismemberment of the dead is evil. Is the surgical removal of a dead body within a living body willing dismemberment? This is the question which determines the culpability of mother and doctor. As I mentioned above, some willing, intentional dismemberment of the dead may not be culpably evil, as with cases involving the removal of remains from wreckage. After a massive earthquake, removal of remains quickly is imperative to maintain the health of the living. I think similar considerations should be taken into account in the decisions of women to have or not have their deceased children surgically removed.

As for women like me who WISHED that the retrieval COULD HAVE resulted at least in the proper burial of their now twice-harmed children, I see it this way: we are left, like mothers who have lost children to shipwreck. We have lost them twice — once to death, and once to something outside of our control which has taken even their bodies from our desire to offer them our last respects.

We did not wish the shipwreck. We do not control the sea. There may not be much we can retrieve from the waters. Despair comes from the temptation to believe that, somehow, we SHOULD or COULD have, “if we really cared.” Perhaps with a little support, and a few changes in laws and policy, we can at least retrieve from that figurative sea what IS left for us to bury.

Here, in an erratic listing, is what I have learned so far: We need to know, is there a way to surgically remove the child’s body intact, but without risk to the mother? If so, that would solve much. Whatever outreach is to be developed, it can NEVER be based on “what ifs” or “should-haves”, but on “where to from here” as a way to deal with “how we got here in the first place.” Whatever is to be done with the bodies of our loved ones, we can do nothing until we actually have the body accessible to do anything for them at all. Whatever we do in charity for the dead cannot pose unreasonable risk to the living. For those of our children we have not been allowed to bury, we keep their names in our fammily Bible, pray for them, and keep our own memorial, just as do the parents of lost sailors or soldiers. Yes, my choice for one good (keeping my health) allowed for an evil (the dismemberment and disposal of my deceased children). Self-defense, unfortunately, can do this sort of thing, even if we are defending ourselves against unintended harm from a loved one (ask someone who has had to cope with severe, dangerous mental illness from a family member, for instance). It is counter-productive to let the mother beat herself up with guilt when all she meant to choose was not to let an infection or dangerous bleeding beat her up. Emotions, however valid, are not allowable for reasoning out what to do, either before or after the miscarriage; however, emotions have to be dealt with in an outreach to those of us hurting from our double loss. For whatever evil we may be responsible, God is bigger than any sin we could ever commit, and so,therefore, are his mercy and forgiveness; we can face whatever we have done for what it is; and if we treat our sins as too big for God to forgive, we are committing a form of idolatry. These things I HAVE learned, for whatever they may be worth to anyone else out there.

This is just a jumbled rant. My apologies for the length and randomness.

Peace of Christ to all out there — mothers, fathers, and grandparents — trying to come to terms with this matter. May the Mother of God help us all — she knows what it is like to have a troubled pregnancy,the loss of a son, and continued concern about the welfare of the rest of her kids — us.

TM Koch