1. The Stillbirths and Births (Miscellaneous Amendments) Bill (“the Bill”) was introduced for First Reading in Parliament today.
Naming of Stillborn Children
2. The Registration of Births and Deaths Act 2021 (RBDA 2021) governs the registration of births, deaths, and stillbirths. The Bill will introduce new provisions in the RBDA 2021 to enable parents of a stillborn child to officially register a name for the child within one year after the stillbirth. This is in recognition that stillbirths are similar to the loss of any child, which can be a painful experience for parents, and the official naming of a stillborn child may help some bereaved parents.
3. Pending the new provisions being operationalised, parents who wish to name their stillborn child may apply for a commemorative birth certificate from the Immigration and Checkpoints Authority that reflects the stillborn child’s name, for remembrance purposes, via the ICA’s website.
Definition of “Stillborn Child”
4. The Bill also introduces an amendment to the definition of “stillborn child” in the RBDA 2021.
5. Currently, RBDA 2021 uses a threshold of after the 22nd week of pregnancy in the definition of a “stillborn child”.
6. The previous definition of “stillborn child” in the repealed RBDA 1937 had a threshold of after the 28th week of pregnancy – this was updated to a lower threshold of after the 22nd week of pregnancy in the RBDA 2021, to align with the World Health Organisation’s International Classification of Diseases statistical reporting guidelines. 1
7. Separately, under the Termination of Pregnancy Act 1974 (TOPA 1974), an abortion is allowed for a foetus no more than 24 weeks of pregnancy, after which, an abortion is only allowed due to medical exigencies. This 24-week cut-off is based on medical and scientific evidence of foetal viability outside the womb. 2
8. There has been feedback from the medical community that the stillbirth threshold in the RBDA 2021 may be misinterpreted to be an indication of foetal viability. This may cause confusion for parents facing important and difficult decisions about medical interventions for their unborn child, despite the fact that the definition of a “stillborn child” in the RBDA 2021 was not meant to be an indication of foetal viability outside the womb.
9. There have also been concerns from the medical community that such ambiguities may lead to pressure on medical practitioners to use more liberal treatment for or resuscitation of infants born between 22 and 24 weeks of pregnancy, resulting in potentially severe neurodevelopmental disabilities in infants who survive and higher rates of futile attempts at resuscitation.
10. Given the concerns, notwithstanding that the RBDA 2021 is not meant to indicate foetal viability nor guide medical practice, the Bill amends the threshold in the definition of a stillborn child to after 24 weeks of pregnancy to align with the cut-off for abortions in the TOPA 1974. This will remove any potential confusion regarding foetal viability.
11. Additionally, the Bill will make clear the existing position that an abortion is not considered a stillbirth.
Other Amendments
12. The Bill also makes miscellaneous amendments to the definition of “stillborn child” in the Income Tax Act 1947 to reflect the amendments to the stillbirth threshold in the RBDA 2021, for the purposes of administering tax benefits.
[1] The World Health Organisation’s guidelines are not binding, and countries can choose to align with this recommended threshold for direct comparisons with others, or set their stillbirth thresholds independently based on their domestic context.
[2] Foetal viability is defined as the gestational age at which a premature live born baby has at least 50% chance of survival until discharge from hospital.
