The Cost of Loss: A Secret-Shopper Survey of Mortuary Disposition of Fetal Remains [A182

Abstract

INTRODUCTION: While only a minority of patients facing a pregnancy termination or loss seek burial or cremation of fetal remains, there is little information or awareness around the cost of these services. With an increasing number of states introducing mandatory fetal cremation/burial laws, we investigated the availability and cost of these services. METHODS: This was a cross-sectional “secret shopper” telephone survey of all mortuaries in five Northern California counties identified by the California Cemetery and Funeral Bureau. Two “secret shoppers” presented as clinicians assessing the availability and cost of cremating and/or burying fetal remains for loss in the second trimester. RESULTS: Of the 60 funeral homes contacted, 21% did not accept fetal remains. No mortuaries that accepted fetal remains had policies excluding remains from abortion procedures. The total cost of cremation ranged from USD $0 to $1,800, with a mean of $596.98. This was significantly less than the cost of burial services, mean $853.67 (P=.01), which were also often accompanied by additional cemetery fees and plot expenses up to $3,000. CONCLUSION: Private disposition of fetal remains after an abortion or pregnancy loss is expensive and not available in all mortuary settings. When discussing options for disposition of remains with families, providers must be mindful of the associated costs as a limitation for many families. Legislation requiring private or clinic disposition of fetal remains would add significant cost and financial burden to those seeking or providing abortion care.