SINGAPORE - Parents will be allowed to register the name of their stillborn child, and the definition of a stillborn child will be changed, under a new Bill introduced in Parliament on Tuesday.

Under the Stillbirths and Births (Miscellaneous Amendments) Bill, stillbirth will refer to the death of a baby after the 24th week of pregnancy, up from after the 22nd week now.

Ms Sun Xueling, Minister of State for Home Affairs and Social and Family Development, introduced the Bill, which amends existing laws, in Parliament.

Currently, parents cannot register the name of their stillborn child on the stillbirth certificate under the Registration of Births and Deaths Act 2021. This Act governs the registration of births, deaths and stillbirths. 

But the move to allow the registration of a name comes as the authorities recognise that this may help some grieving parents. 

In a statement on Tuesday, the Ministry of Home Affairs (MHA) said: “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.”

The new Bill will introduce new provisions in the Registration of Births and Deaths Act 2021 to enable parents to officially register a name for their child within a year of the stillbirth.

An MHA spokesman told The Straits Times that it estimates the system changes required to allow for the official registration of names of stillborn children may be ready in about two years’ time.

This is because enhancements to the Immigration and Checkpoints Authority’s (ICA) systems are needed to effect that change, and ICA has other more pressing system enhancements to make, the MHA spokesman said.

In a parliamentary reply in September 2022, Home Affairs Minister K. Shanmugam explained why the current stillbirth certificate does not allow for the name of the stillborn child to be registered.

This is because the names of stillborn children, like in abortions, are not required for the Government to administer public policies and programmes.

Mr Shanmugam said another reason for this is that the registration processes can be fully automated, without the parents having to act to register their stillborn child’s details.

He said: “This is to alleviate any administrative burden while they may still be grieving.”

He was responding to Associate Professor Jamus Lim (Sengkang GRC), who had asked if the new digital birth certificates would allow for the registration of a stillborn child’s name.

Digital birth and death certificates were introduced in 2022, in place of physical hard copies.

To this question, Mr Shanmugam replied that it takes “further process and system changes” to change the current stillbirth registration process to include the name of a stillborn child.

He said MHA recognises that some parents want to name their stillborn children in official documents, and that it will study the feasibility of allowing them to do so during its next review of process and policy.

He added that MHA will also study having alternative options, such as a commemorative birth certificate.

The MHA spokesman said the latest proposed amendments, such as allowing parents to register the name of their stillborn child, are a result of the review.

In its statement, MHA said parents can apply for a commemorative birth certificate on ICA’s website that reflects the stillborn child’s name. 

This certificate is not an official document, but for “remembrance purposes”, until the new provision to register the stillborn child’s name is in operation.

Since Oct 1, ICA has been issuing these commemorative certificates. As at Nov 3, seven such commemorative certificates have been issued.

In 2022, there were 110 stillbirths registered, according to the Report of Registration of Births and Deaths 2022 published by ICA.

Meanwhile, the move to raise the definition of a stillborn child to after 24 weeks of pregnancy, which is expected to take effect in 2024, is to bring it in line with abortion laws here, said the MHA spokesman.  A woman can get an abortion in Singapore up to her 24th week of pregnancy.

In its statement, MHA said the 24th week cut-off threshold for abortion is based on medical and scientific evidence of foetal viability, which refers to the ability of a baby born prematurely to survive outside the womb.

The definition of a stillborn child used to be after the 28th week of pregnancy, but this was lowered to after the 22nd week to align it with the World Health Organisation’s International Classification of Diseases statistical reporting guidelines.

MHA said there has been feedback from the medical community that the threshold of after 22 weeks may be misinterpreted by parents as a sign of foetal viability – even though it is not meant to guide medical practice nor be an indication of foetal viability.

This may cause confusion for parents facing difficult and important decisions about medical interventions for their unborn child, MHA said.

It added that the medical community has also expressed concern that this may lead parents to pressure doctors to use more liberal treatment for or to resuscitate infants born between the 22nd and 24th week of pregnancy.

This may potentially result in the infant suffering severe neurodevelopmental disabilities if they survive, or lead to higher rates of futile attempts to save the infant.

A Ministry of Health (MOH) spokesman told ST that a review it conducted in 2018 showed that about half of babies born prematurely at the 24th week of pregnancy survived, while about 20 per cent of babies born in the 23rd week of pregnancy survived.

Data from two local public hospitals showed that of the 13 premature babies born in the 23rd week of pregnancy in 2019 and 2020, six of them survived to leave the hospital. But all six suffered from severe problems, such as severe chronic lung disease and brain haemorrhage.

The MOH spokesman added: “These neonatal conditions often lead to neurodevelopmental disabilities, poor quality of life requiring lifelong medical treatment and a shortened life expectancy.”

Raising the definition of stillbirths to after the 24th week of pregnancy to align it with the cut-off for abortions under the Termination of Pregnancy Act 1974 removes any potential confusion regarding foetal viability, the MHA statement said.