After a dilation and curettage (D&C) procedure following a miscarriage, do healthcare providers typically disclose the gender of the fetus to the patient during the analysis of the fetal tissue?

Gender Disclosure After D&C for Miscarriage

Yes, healthcare providers typically disclose the fetal gender to patients when chromosomal or genetic analysis is performed on tissue obtained from a D&C procedure, though this information is only available if specific genetic testing (such as karyotyping or chromosomal microarray) is ordered—routine pathological examination of tissue does not determine gender.

When Gender Information Becomes Available

Genetic testing must be specifically ordered to determine fetal gender. Standard pathological examination of tissue from a D&C evaluates only for retained products of conception and does not include chromosomal analysis that would reveal gender 1.

• If chromosomal analysis is performed (karyotyping, chromosomal microarray, or cell-free DNA analysis), gender information becomes available as part of the test results 1
• The American College of Medical Genetics and Genomics recommends that when genetic testing identifies findings, families should be referred to qualified genetic counselors to explain results 1
• Results disclosure should occur through appropriate genetic counseling, with clear communication about what the testing revealed 1

Communication Approach for Gender Disclosure

Healthcare providers should use the patient's preferred terminology and demonstrate empathy during any discussion of pregnancy loss and genetic findings. 2

• Use gender-inclusive language when appropriate, particularly for transgender and gender-diverse patients who may have varying comfort levels with gendered terminology 2, 1
• Confirm preferred language and terms before discussing pregnancy-related information, as individuals may experience different degrees of dysphoria around gendered language 2
• Avoid assumptions about how the patient wishes to discuss their pregnancy or fetus based on their gender presentation 2

Documentation Considerations

• Record the patient's preferred name, pronouns, and communication preferences in the medical record to prevent repeated uncomfortable conversations 2, 3
• Information about gender preferences and identity should only be shared with those for whom it is relevant and with patient consent 3
• Medical records should reflect both sex assigned at birth (relevant for medical screening) and current gender identity separately 4, 1

Special Considerations for Transgender and Gender-Diverse Patients

Transgender and gender-diverse patients have low confidence that healthcare workers understand their needs and fear encountering prejudice and discrimination. 3, 2

• Pregnancy can exacerbate gender dysphoria, anxiety, and depression in transgender individuals, making sensitive communication about pregnancy outcomes particularly important 2, 4
• Use the patient's chosen name throughout all interactions—never use legal names that differ from preferred names during clinical encounters 2, 1
• Avoid "outing" transgender patients by calling them by birth names in waiting areas or other public spaces 3

Common Pitfalls to Avoid

• Do not assume the patient wants gender information disclosed—ask first whether they wish to know this detail if genetic testing is being considered 1
• Do not provide genetic results without appropriate counseling support, as the American College of Medical Genetics recommends referral to qualified genetic counselors when pathogenic findings are identified 1
• Do not use gendered language without first confirming the patient's preferred terminology, particularly for patients who may be experiencing gender dysphoria related to pregnancy loss 2, 1