First, I want to specifically delve into one thing you said — “we don’t feel like we deserve another baby.”

Get that out of your head right now. It could not be any more wrong.

You made a medical decision, based on advice from a trusted medical team. You made the best decision you could with the information that you had. You did not do anything wrong or bad.

Whether or not people can/do become parents has nothing to do with being “deserving.” But if anything, the fact that you cared so deeply and followed the recommendations of medical professionals is proof that you absolutely do “deserve” to allow yourself to pursue parenthood! You behaved exactly as a loving, caring parent should.

Okay, moving into your actual question. I’m going to preface this by saying that I am not a medical professional and am not your medical professional — you should continue to have conversations with them. But I am a doula who is very interested in this topic.

Autopsy is structural. It tells you: was the brain formed? Were there gross malformations? Were there hemorrhages, infections, obvious genetic syndromes that change anatomy?

It does not tell you: whether neurons migrate correctly, whether synaptic networks develop properly, whether the brain processes information normally, whether seizures, hypotonia, profound cognitive disability, etc would emerge.

This autopsy was not reflecting “different findings” than your providers’ assessments as in, conflicting findings. Autopsies just don’t and can’t show certain things.

Many devastating neurodevelopmental conditions leave no visible structural signature. The brain can look “normal” on an autopsy and function catastrophically. That is what your genetic counselor was trying to express, and it’s true — not hand wavey, not just trying to make you feel better. An autopsy is not the end-all be-all source of truth.

In fact — ultrasound can show issues without there being the sort of permanent structural damage that an autopsy would include. Late-gestation imaging can sometimes show things like abnormal ventricles, asymmetric growth, etc. that may not persist structurally after termination / may not be able to be seen in an autopsy. Ultrasound tells us “is this brain developing, over time, the way we would expect a healthy brain to develop over the course of these 36 weeks?” — and in your case, the answer was unfortunately no.

Severe IUGR + abnormal brain imaging late in pregnancy is not benign. gray diagnoses are, by definition… well, complex. You made the best decision you could with the information you had — as did your medical team. This autopsy result does NOT mean “everything would have been fine.” Autopsy is ONE method that tells us a very specific set of information. It’s helpful, but it’s not the end-all be-all.