Objective: To examine the attitudes of neonatologists, obstetricians, midwi
ves, and neonatal nurses toward perinatal autopsy and survey physicians abo
ut whom they perceive influence women's decisions on autopsy consent.
Methods: A postal survey that incorporated a questionnaire of eight fictiti
ous case scenarios and combined three factors (confidence of antemortem dia
gnosis, intention to have future pregnancy, and parental attitude toward au
topsy) in various permutations was sent to various Australian physicians an
d nurses (all consultant neonatologists working in neonatal intensive care
units and a sample of consultant obstetricians, midwives, and neonatal nurs
es in level III maternity hospitals). Respondents were asked to rate how li
kely they were to seek consent for or suggest autopsies on a seven-point Li
kert scale (1 = certainly will not, 7 = certainly will). Interactions betwe
en factors and respondents were measured by analysis of variance, and diffe
rences were compared using Mann-Whitney U, chi (2),and generalized estimati
ng equation tests.
Results: The overall response rate was 70% (neonatologists 57%, obstetricia
ns 62%, midwives 77%, and neonatal nurses 75%). Neonatologists (median scor
e 7, interquartile range 7, 7) were more likely to ask for autopsies than n
eonatal nurses (5; 2, 6) (P <.001), as were obstetricians (7; 7, 7) compare
d with midwives (6; 3, 7) (P <.001). Physicians rated midwives and neonatal
nurses as having some to substantial influence on mothers' decisions about
consent for autopsy.
Conclusion: Physicians are not averse to seeking consent for perinatal auto
psies. Midwives and nurses are influenced by the three factors studied, whi
ch might negatively influence the consent rate for perinatal autopsies. Int
ervention strategies aimed at changing nurses' attitudes should be consider
ed. (Obstet Gynecol 2001;97:994-8. (C) 2001 by The American College of Obst
etricians and Gynecologists.).