1. Fetal Loss Excellence in Birth Registration Training & Conference April 29, 2011

2. Acknowledge this is hard Loss is hard for everyone The families The visitors The caregivers Other staff

3. What happened last time? First of all, forgive yourself Its human nature to put the past behind us Every situation really is different

4. Semantics Fetal death IUFD – intrauterine fetal demise Stillbirth Miscarriage Spontaneous abortion

5. Your role as birth registrar Collect the data from the delivery and pregnancy Ask the mother if she wants to name the baby and tell her about the Certificate of Birth Resulting in Stillbirth Report the information properly Follow up with MD for cause of death

6. Birth certificates Required for babies who are born alive at any gestation - even Pre-viable Fatal fetal anomalies Neo-natal deaths

7. Fetal death reports Required for fetuses delivered at 20 weeks gestation Required when families want a Certificate of birth Resulting in Stillbirth Optional at < 20 week gestations

8. Paternity documents are not required for fetal deaths. Mom can name the father on the fetal death report regardless of her marital status Mom does not have to name any father What about the dads?

9. Look for a charted time of birth & time of death Signs of life – pulsation of the cord, purposeful movements, heartbeat, respiratory efforts Apgar score at one minute …these indicate live birth Live born or fetal death?

10. Not a birth registration responsibility. Contact MDH Mortuary Science at 651-201-3825 www.health.state.mn.us/divs/hpsc/mortsci Disposition

11. Mothers record – dictated delivery information product of delivery PREFERRED - autopsy results Cause of death terminology is important as several factors may be present, but not be the cause of death. Cause of death

12. Application available from MDH website Two-page application; form & fees Only parents named on fetal death report can purchase Available by mail from MDH Cost $16 Certificate of Birth Resulting in Stillbirth

13. Use MR&C to report this scenario absorbed or vanishing twin is not reported as they are not delivered separately (no time of delivery, no report) Multiple birth follow-on action can be used for twins born on different days Twins; 1 live, 1 stillborn

14. Some funeral homes will offer discounted funeral services and/or disposition for stillbirths Financial relief

15. A birth record and a fetal death report A fetal death report and a death record Never file

16. MDH Mortuary Science – 651-201-3829 for disposition information MDH OSR – 651-201-5961 for information about registration Resources