SOME STATES ISSUING “CERTIFICATES OF BIRTH” FOR STILLBORN CHILDREN
Volume 28, Issue 499 September 17, 2007
Kelly Wilkicki
In 1994, Arizonan Joanne Cacciatore’s daughter died just minutes before birth. Cacciatore’s agonizing grief led her to act; she started lobbying state legislators to recognize that infants who are stillborn have, nevertheless, been born.
Historically, states have simply issued certificates of death to parents of stillborn children and required that their remains be buried or cremated. But Cacciatore began speaking with other parents whose children were stillborn. “So many women wanted and deserved the choice of a birth certificate in addition to the already-issued death certificate,” she said. “After all, they gave birth.”
So Cacciatore and other parents of stillborn children began asking lawmakers to pass bills offering specialized birth certificates to parents of stillborn children. Although the fetus is not alive when delivered, these states are recognizing the families’ loss by offering them “Certificates of Birth, Resulting in Stillbirth.”
In 2001, Arizona became the first state to enact what Cacciatore calls a “MISSing Angels” law (HB 2416). This past June, Rhode Island became the 20th state to offer such documentation, when it enacted H 5086.
Although the majority of stillborn death causes are unknown, they are classified together under the category of sudden antenatal deaths (SAD). Roughly 25,000 children are lost to SAD each year, according to the Centers for Disease Control and Prevention. That’s ten times the number of infants who die of sudden infant death syndrome (SIDS) each year.
“Dignity and compassion need to be extended to women who endure the death and birth of their baby,” Cacciatore said. “Some people want it (the certificate) as something to show their baby existed, that their baby was born like every other baby.”
Reproductive Freedom Issues
The typical “MISSing Angels” bill defines a stillbirth as a naturally occurring death that happens after the 20th week of pregnancy. Delivery may either be induced or occur naturally.
Parents of a stillborn fetus may request a “Certificate of Birth, Resulting in Stillbirth” from the states’ vital records departments and pay a state-levied fee ($15 in Arizona). Funds from the fees are channeled into the state’s general revenues. In Arizona, approximately 700 stillbirths occurred last year; roughly 60 percent of the families requested certificates.
Some reproductive freedom groups have worried that stillborn birth certificates could erode abortion rights by extending certain rights to the fetus. To assuage those concerns, the bills typically refer to “the fetus” instead of “the child,” and they stipulate that certificates will not be issued if a pregnancy is electively terminated.
Most governors have signed “MISSing Angels” bills that passed their legislatures. But earlier this year, New Mexico Governor Bill Richardson vetoed “MISSing Angels” bill (SB 17). According to a press release from the Governor’s office, he was concerned that “having two documents for a single vital event can lead to confusion and potential fraud, and is not sound policy.”
A number of states offer tax deductions to the parents of a stillborn child in the year of the delivery to offset the unexpected costs of a funeral. A 2004 Arizona law revising statutes 43-1023, sponsored by Senator Marilyn Jarrett, extends a $2,300 state income tax deduction to persons who receive a “Certificate of Birth, Resulting in Stillbirth.” Legislative budget analysts estimate the tax break costs the state $34,000 to $51,000 annually.
In addition to lobbying states to offer the certificates, Cacciatore started the M.I.S.S. Foundation, which provides support and long-term aid to families who experience the death of a child, regardless of age.
A chart that lists states that have passed “MISSing Angels” bills is located at: http://www.missingangelsbill.org/stchart.html.
Kelly Wilkicki is an intern with NCSL’s Forum for State Health Policy Leadership
© Copyright 2007, State Health Notes
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