Distinction between stillbirth and miscarriage-Implications for the external postmortem examination of the corpse An evaluation of the relevant state and federal laws

Background: In the Federal Republic of Germany, as regulated by the Grundgesetz (GG, Constitution), the individual states hold legislative power over statutes governing the verification of death and obligatory external postmortem examination of the corpse (Leichenschau), whereas the Federation holds legislative power over statutes governing the registration of civil status. Civil Status Law is determined by the Civil Status Act (PStG) and the Civil Status Regulations (PStV).Objective: The aim of this study was to investigate if an amendment to 31 PStV, implemented on 1 November 2018, carries implications for the external postmortem examination. The focus was on the distinction between stillbirth and miscarriage and accordingly the implicit obligation to carry out an external postmortem examination, taking federal and state legislations into account.Method: The Burial Acts and respective regulations of the 16 federal states were therefore systematically analyzed in addition to the PStG and the PStV.Results: In 12 of the 16 federal states, the state laws distinguish stillbirths from miscarriages on the basis of a birth weight of at least 500 g. In Hesse, Bremen, and Saarland, however, the laws also include the 24th week of pregnancy as an alternative criterion for this distinction. In the amendment to 31 PStV, the alternative criterion at least the 24th week of pregnancy was added to the statute and now reflects the wording of the statutes in Bremen and Saarland.Conclusion: Independent of whether a stillbirth is to be treated as a deceased in the sense of the Civil Status Law, the obligation to perform an external postmortem examination arises regardless of the Burial Acts in the individual federal states. With respect to the obligatory external postmortem examination, the criteria used by the Civil Status Law should hence define what constitutes a corpse. Accordingly, irrespective of the Burial Acts of the individual states, the alternative criterion of birth at or over the 24th week of pregnancy to distinguish stillbirths from miscarriages should be taken into account in all federal states even if a fetus, born without signs of having lived outside the womb, has a birth weight under 500 g.

Automated summary

In Germany, individual states have legislative power over death verification and postmortem examination of corpses, while the Federation has legislative power over civil status registration. This study investigated the implications of an amendment to the Civil Status Regulations on external postmortem examination, specifically focusing on the distinction between stillbirth and miscarriage.