Birth certificates for stillbirth?

Some argue stillborn babies don't deserve a death certificate.

Published April 12, 2007 10:45PM (EDT)

Call me callous, cruel and totally unmaternal but I just don't get the controversy surrounding the issuing of birth certificates to stillborn babies. According to a story in the San Francisco Chronicle, however, it is a matter of "wrenching politics" that has grieving mothers pitted against abortion rights advocates. According to the article, 18 states have passed laws to issue birth certificates to stillborn babies, and seven more have bills pending, with California's bill hitting the Senate floor this week.

Before you search for a sharp object to hurl in the direction of your screen, let me say I do get the grief -- grief that I'm sure gets far less support than that which follows the death of other children. But apparently, some women who have stillborn babies regard the practice of issuing a death certificate but not a birth certificate as a matter of adding insult to injury. Joanne Cacciatore, who founded the MISS Foundation, which is dedicated to supporting families after the death of a child, and organized the first National Stillbirth campaign in Arizona, explained it this way: "No one has been talking about this, and frankly I got tired of it. Seventy percent of women seriously consider ending their lives after stillbirths. This needs serious compassion and attention."

This I get. Pain, feeling misunderstood, even suicidal thoughts, I get. But what does an official document that "the child was born" -- albeit dead -- do for parents who have lost a baby? According to the National Stillbirth Society it provides "closure for bereaved parents" and "validates" the grieving woman's "motherhood."

But should we also give certificates of miscarriage? And how will a birth certificate ward off one iota of sorrow? One mother interviewed by the Chronicle seems to suggest it won't: "Having a birth certificate doesn't take away any of the pain, but it is just an acknowledgment that you did carry him for nine months and his memory does live on."

I'm sorry but I have trouble understanding how official documents alone help "memories live," especially since the memories of a baby who arrived on earth already dead are first and foremost the private matter of the family. Maybe it's one of those things that mean so much more when you're denied them. For the women who didn't get a record of their child's birth, it's an official negation of their grief. Though I can't imagine the parents in states like Arizona, Utah, Indiana and Massachusetts, where they do issue birth certificates, feeling anything approaching gratitude upon receiving an official reminder that they are going home empty-handed.

If it makes some grieving parents feel better, why not offer them a certificate? Pro-choice advocates fear the national movement for certificates of stillbirth is a slippery slope toward treating fetuses like people. Upon reading the Chronicle story, the pro-choice perspective seemed a bit paranoid and even heartless. As long as it's defined as a natural stillbirth, why not let parents get birth certificates? Unfortunately, according to the Centers for Disease Control and Prevention, there is no single medical definition of stillbirth in the United States and some definitions could overlap with definitions applied to late-term abortions. Of course, state by state the legislation could be written carefully to avoid such ambiguities, but therein lies the slippery slope.

So sure, I understand debate around the certificate of stillbirth, but something about it bothers me. It's all about symbols: birth certificates that offer a symbolic token from the state that the mother really did give birth, a symbolic token in an argument that women are killing their babies when opting for abortion. Symbols are easy things to argue about -- but they can also distract us from grappling with much tougher struggles. They can't bring back a stillborn child, nor do they keep abortion accessible.

By Carol Lloyd

Carol Lloyd is currently at work on a book about the gentrification wars in San Francisco's Mission District.

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