Committee passes bill to redefine "stillbirth" and require reporting miscarriages at 12 weeks | Arkansas Blog

Tuesday, January 24, 2017

Committee passes bill to redefine "stillbirth" and require reporting miscarriages at 12 weeks

Posted By on Tue, Jan 24, 2017 at 5:27 PM

click to enlarge MEEKS: Seeks to change "stillbirth" reporting requirement from 20 weeks to 12 weeks
  • MEEKS: Seeks to change "stillbirth" reporting requirement from 20 weeks to 12 weeks
The medical definition of a stillbirth, and the definition used under current Arkansas law, is the death of a fetus after the twentieth week of pregnancy. Some in the legislature would like to redefine it — although this would likely have little practical impact other than reporting requirements for medical providers.

The House Public Health committee today passed a bill sponsored by Rep. David Meeks, which would define "stillbirth" as the unintended death of a fetus any time after 12 weeks.

The bill would require that miscarriages that happened at 12 weeks gestation or more be reported to the division of Vital Records within five days after the event. A similar law was passed in Oklahoma in 2015. Under current law, such fetal deaths must be reported when the fetus weighs more than 350 grams, or at 20 weeks if the weight is unknown. (The reporting requirement falls on medical providers, not on women who miscarry.)

Meeks said that the purpose of his bill was to allow women who had miscarriages to get a fetal death certificate and what's known as a "certificate of birth resulting in stillbirth." He brought a woman to testify for his bill in committee today who had a miscarriage at 23 weeks but said she was unable to get official certificates from the state; the fetal death was not reported because of being below the weight requirement. I spoke with state Health Department attorney Robert Brech, who told me that this was a legitimate issue: sometimes women wish to get the official certificates as part of their grieving process but are unable to because the miscarriage is not reported as a stillbirth under current law.

The elephant in the room here is that the way Meeks has gone about trying to solve this issue has strong anti-abortion symbolism. Redefining the word "stillbirth" and requiring the generation of a fetal death certificate for a fetus starting at 12 weeks (a gestational age nearly three months before the woman who testified miscarried) starts to sound like the sort of move toward "personhood" that legislators have used in various states to attempt to chip away at abortion and reproductive rights. That includes attempts to impose shocking requirements on women who miscarry, such as Texas requiring that fetal remains be buried or cremated (that law was blocked by a court).

The symbolic implications aside, however, it does not appear that Meeks' bill would impose additional burdens on women who miscarry and — although the bill mentions pregnancy terminations in its title — it has no impact whatsoever on abortion reporting requirements. It is already the case under current state law that all abortions at any gestational age must be reported to the division of Vital Records (terminated pregnancies are a different reporting category altogether than fetal deaths).

What would happen under Meeks' bill if a woman miscarries at home at 12 weeks? If she then goes to a medical provider, the provider would have to report the miscarriage as a fetal death to the state. If not, the law is essentially silent — according to Brech, it makes no explicit requirement on the woman herself. Technically, the reporting requirement if there is no medical provider would then fall on a medical examiner or a coroner — but in practice, Brech said, it would simply go unreported.

If the fetal death is reported, it's up to the parents whether they want to receive a fetal death certificate or "certificate of birth resulting in stillbirth."

Brech said that currently, around 200 stillbirths per year are reported in Arkansas. Based upon the experience in Oklahoma, Brech projects that an additional 300 per year will be reported if the new 12-week definition of stillbirth is adopted. Brech said that the Health Department is looking into ways to denote the change so it does not appear that there was a sudden jump in fetal mortality statistics.

I reached out to Meeks but haven't heard back.

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