Антропология
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When Does the Fetus Become a Person? A French Retrospective Study and Review of the Literature of Rituals Related to Medical Interruptions of Pregnancies, in-utero Fetal Death, and Late Miscarriages

Philippe Charlier,  Agathe Roth Le Gentil , Luc Brun, Christian Hervé

Background: To best accompany bereaved couples facing a dead fetus, as a midwife or a physician, and understand more precisely what they live, it seems important to ask us on what represents for the mother, parents, this little being whom they had to separate. This brings us to the question: what represents this fetus lost for parents? How is he regarded by contemporary society? Do parents feel respect or revulsion to the body of the deceased children? What is the place of these “babies” in our society.

Objective: The objective of our study was to determine, in relation to the term, the beginning of “humanity” for the parents of a dead fetus. We wanted to determine a term (in the medical sense), if it exists, which can be considered the body as “sacred” (not just an inert entity) from the point of view of the parents.

Material and Methods: The study was retrospective and single site: it was carried out at the hospital Necker (Paris 5). Anonymous data collection was carried out from September 2011 to March 2012. Inclusion criteria were: medical interruption of pregnancy, in-utero fetal death, and late miscarriage. In order to define some “humanity” of the fetus from the point of view of the parents, from the 9 binary variables collected, four independent qualitative scores were constructed: “Announcement”, “Vision”, “Investment” and “Offering”.

Results: The study population included 310 cases, corresponding to fetus expulsed between September 2010 and November 2011. On all of those fetal deaths, we distinguished three different modes: 233 medical interruptions of pregnancy (75.16%), 57 in-utero fetal deaths (18.39%), 20 late miscarriages (6.45%). After a statistical analysis, the average term of “humanity” was determined as around 180 days (95%CI [167;192]).

Discussion: Facing this term, we try to answer some questions: is the fetus a patient like any other? What is the place of the fetus in the society? Is there a special work of mourning for fetal deaths? Does-it change anything to see and feel the child? What is the place and importance of the fetus for the main religions? Practically, does-it change anything to the legal status of the fetus in France and elsewhere?