The first thing I want to share with you, with a heavy heart, is that we often do not find answers medically as to why a loss has occurred. This blog post will give you ideas for how to pursue those answers, but none of these methods will guarantee you answers. Both the knowns and the unknowns of pregnancy and infant loss can be devastating; be sure to prioritize your mental health and social support as you discern whether or how to seek answers after a loss.
One of the most important steps you can take in pursuing medical answers is assembling a supportive medical team. Some medical care providers are stellar advocates for you in finding the most appropriate tests, figuring out the insurance coverage or cost for your different options, and guiding you regarding what might be most medically useful data to seek. Getting those providers on your team can make a massive difference – in the thoroughness of the testing process and in how supported you and your family are during it.
Once you have your medical team, you may have up to three opportunities to seek medical testing: on Baby, on Mom, and on Dad.
Testing for Baby
If you are planning to seek testing after a loss, one question to consider is whether you want to send your baby’s remains for testing. This is allowed in Church teaching, and there are many reasons why a family may want to pursue medical testing for their child or why they may want to decline it. It is also important to note that in many situations, families may not have the remains of the baby and this question does not apply, or families may not have the choice of whether to pursue testing because it is mandated.
If you do have a choice in this regard, I encourage you to prayerfully consider your options; but as you do, keep in mind that preserving any remains is very important if you do eventually decide to pursue testing. Talk to your medical care team about the best ways to preserve any remains or possible remains in case you want to pursue testing.
Testing for Mom
Common tests for mom include blood tests looking for hormones (for example, progesterone), proteins, diseases, or configurations and numbers of your chromosomes (karyotype test). Other common tests include imaging of the uterus or fallopian tubes (through ultrasound or x ray). In some cases, a biopsy may be useful.
Since many losses, especially early losses, are due to random genetic mutation, certain tests may be more likely to be helpful given the age of your baby and the medical context of their death.
Testing for Dad
The only commonly recommended test for dads, and usually only in situations of repeated miscarriage, is a karyotype test (the blood test that looks at the configuration and number of your chromosomes). Some medical care providers may also recommend a sperm analysis, though the actual role that sperm features play in repeated miscarriage is scientifically unclear. If you have concerns about collecting a sperm sample within the guidelines of Catholic teaching, know that you have options available to you (including using a perforated condom to collect a sample at home).
Access to Testing
Several factors influence your access to testing, including:
- your access to healthcare,
- your insurance coverage (some insurances will only cover testing after a certain gestational age or after a particular number of losses),
- your finances, and
- your medical team.
If you ever have a question about your access, ask. You can ask your medical care team, your insurance representatives, and your community support to help you try to navigate barriers to accessing testing.
Medical Questions Aren’t the Only Questions
If you are looking for other kinds of answers, such as theological answers to the question of why your child has died, I encourage you to reach out to a trusted spiritual advisor or to a bereavement doula. We don’t have those answers for you. But we are ready to struggle with you through the questions.