Can certificate sooth stillborn parents’ pain?

PROVIDENCE — They treated Christopher Michael Silva like any other newborn.

The nurses washed him. They dressed him in a white linen gown. He was wrapped in a blanket, a tiny blue cap on his head. And they put him in his mother’s arms.

But Melissa Silva knew her son was not like the other babies born at Women & Infants Hospital that day. Christopher, a full-term baby that weighed at 7 pounds, 10 ounces, never took a breath outside the womb. His heart did not beat.

Like at least 72 others in Rhode Island in 2004, Christopher Michael Silva was stillborn.

Still, the nurses gave Melissa Silva and her husband a lock of their dead son’s hair. They took photographs of the infant with a digital camera and put them in a special album. They made footprints.

The Silvas, of Bristol, know that Christopher existed. They have the special box painted by nurses that held his clothes, hair and photos. Christopher has a grave that lists his name.

But in the eyes of Rhode Island law, their son was never born. Had he taken even one breath outside the womb, the Silva family would have received a birth certificate, a legal record that Christopher was. But instead, they received a certificate of fetal loss.

“We were told that our son, who we held, dressed, kissed, baptized, buried and most of all loved, never existed because he was never born,” Melissa Silva said before a state Senate committee this week. “I endured labor, delivery and the physical changes and recovery that any other woman who gave birth had gone through and was being told that my son was never born.”

She wants legislators to change Rhode Island law to allow birth certificates for stillborns such as Christopher. Bills to that effect have been introduced by the House and Senate.

But during the brief hearing in the State House, as the Silva family shared their tremendous pain with the Senate Health and Human Services Committee, there was no mention of the national abortion debate spurred by the coordinated effort of an Arizona-based organization to change laws in state houses from Rhode Island to Alaska.

Melody Drnach, of the National Organization for Women, learned about the MISS Foundation about a year ago.

She says NOW is sympathetic to mothers such as Silva, but fears her efforts might help “the extreme right” redefine the point at which life begins.

“There is a larger movement that’s seeking to establish fetal personhood and will unabashedly use any entrée into their goal, which is outlawing safe, legal abortion,” Drnach, NOW’s vice president of action, said from her Washington office yesterday. “This is an ideologically driven movement and it may have started out as a need to help families in grief — I imagine the grief and frustration of being handed a dead child — but very quickly, those who are striving for fetal personhood saw an in for their movement.”

Rhode Island’s proposed law would apply to people such as Melissa Silva, whose son was fully developed. But it would also give a birth certificate to parents of a fetus born at 20 weeks — before the point of viability, according to a nurse at Women & Infants Hospital.

Federal law allows abortions at 20 weeks.

The MISS Foundation’s goal was not to redefine life, according to Joanne Cacciatore, the Arizona mother who started the group 11 years ago after her full-term child died 15 minutes before birth. She lobbied her state legislature for birth certificates for stillbirths after 20 weeks. And she won.

In the years since, the group has urged women across the country to petition their state lawmakers to do the same. The foundation’s Web site includes a template letter for lawmakers, tips for effective communication and talking points.

A question-and-answer section of the site includes such questions as:

“Can you give me a ‘step-by-step generic outline’ to getting this done? Is there such a thing? I work full time — how involved do I really have to be in order to get this done?” and “Everyone who I talk to about this seems to want to bring abortion into this issue — what’s up with that? Why do they do that — and how can I get them to understand that abortion isn’t what it’s all about?”

Reached by phone yesterday, Cacciatore said she’s sick and tired of having her organization dragged into national politics.

“I would like nothing better than for people on both sides of the abortion debate to leave us alone,” she said. “It’s sad that there are people on both sides of the issue trying to use stillborn babies as the poster children for their agenda.”

She said that she’s had no contact with and has received no funds from anti-abortion groups.

Drnach said she’s primarily concerned with each bill’s language. NOW is open to bills that would make birth certificates optional for stillborns. The group opposes mandatory issuance.

Rhode Island’s proposed law would allow a birth certificate only at the request of either individual listed as mother or father.

The sponsors said yesterday that they weren’t aware of the national debate.

“I’m pro-life, but this bill isn’t doing anything about that. This is about a person who loses a baby,” said Rep. Walter Felag, D-Warren. “I didn’t put this in to have either side take advantage of a bad situation. It’s got nothing to do with pro-choice or pro-life.”

One mother held her stillborn baby for 12 hours, recalls Kim McCormick, an assistant nurse manager who has 15 years of experience at Women & Infants Hospital.

“That is the mother’s only opportunity in their life to see that baby or hold that baby,” she said. “It’s the worst experience of their life and we try to make it a little less painful.”

There were 85 fetal deaths at 20 weeks gestation or more in Rhode Island in 2005, the most recent data available from the state Health Department.

The number does not include abortions. Nor does it include nearly 960 other fetal deaths that occurred before 20 weeks, primarily attributed to miscarriages.

McCormick said that some days she sees two or three stillborns. Other days there are none.

The nurses often know when a stillbirth is coming. And they are prepared.

Hospital staffers have hand-painted several memory boxes for their babies’ clothes. They have green and yellow hats — instead of blue and pink — for stillborns so young it’s difficult to determine a sex.

They have special cards for the baby’s footprints, their weight, time of birth and the name.

“We always ask the patients what the baby’s names are — they always have a name,” McCormick said.

And the nurses have a digital camera, photo printer and photo albums. They often snap 15 to 20 pictures of the dead babies.

“Sometimes it takes us two hours to take pictures to position the baby correctly so you can hide some of the flaws,” McCormick said.

Melissa Silva, of Bristol, said she appreciated the hospital staff’s efforts.

“The medical community has come to realize that mothers who give birth to babies resulting in stillbirth love that baby just as any parent loves their living children,” she told lawmakers Wednesday. “These babies will live forever in our hearts and society has realized over time that women who leave the hospital with empty arms after giving birth to a stillborn baby have every right to have that baby’s existence validated.”