Second Reading of the Stillbirths and Births (Miscellaneous Amendments) Bill – Opening Speech by Ms Sun Xueling, Minister of State, Ministry of Home Affairs and Ministry of Social and Family Development

1. Mr Speaker, on behalf of the Minister for Home Affairs, I beg to move that the Bill be now read a second time.

2. The Registration of Births and Deaths Act 2021, or RBDA, governs the registration of births, deaths, and stillbirths in Singapore. This Bill introduces two main amendments, in relation to stillbirths.

Naming of Stillborn Child

3. First, Clause 9 of the Bill will introduce new sections in the RBDA to allow for the official naming of a stillborn child. The new section 36A will enable the parents of a stillborn child to apply to the Registrar-General of Births and Deaths, or RG for short, for a name to be entered in the stillbirth register, within one year after the stillbirth, should they wish to do so.

4. Speaker, Sir, the MHA has heard the views of bereaved parents. We have heard parents’ deeply felt sentiments that a stillbirth is similar to the loss of any child. For some parents, being able to officially name the child is an important step in the healing process.

5. I would like to especially thank Ms Mandy Too who had advocated for a stillborn child’s name to be entered in the stillbirth register. In her correspondence, she shared, “official documentation for stillborn babies would afford them a level of dignity commensurate with the impact they had on those who grieved for them”, and that it would mean the world to her and her husband if their daughters’ legacy would help future bereaved families. The time her twin girls - Abigail and Lara – spent with us may have been short, but they have left an indelible mark in the journey to help bereaved parents.

6. Others had shared their views in an online petition. “For my sleeping child, WY” said one mum. Another mum said, “Every birth should be recognised and every baby deserves a name. In 2007, I lost a baby boy at 24 weeks and it took me 15 years to finally have another baby.”

7. I would also like to mention Ms Felicia Tan, who lost three children and subsequently set up Angel Hearts, a not-for-profit group which creates angel gowns for babies who sadly do not make it home from the hospital. She shared that it is heart-breaking for parents to go shopping for suitable wear for burial as the babies are so tiny that even the smallest baby clothing would simply be too big for them. She said, “Giving the babies a name and clothing them is our way of saying goodbye and remembering them.” Another parent reached out to me for a commemorative certificate as they were preparing for a memorial for their stillborn child.

8. We hope the amendments to the RBDA to allow for the official registration of a name for a stillborn child will go some way to recognise the birth of the child and support the healing process for bereaved parents.

9. Once Clause 9 comes into force, there will be a facility for parents to apply to the RG to register a name for the child, within one year after the stillbirth. Subsequently, the digital stillbirth certificate for the child, which can be downloaded from the My Legacy website, will reflect the child’s registered name.

10. The official naming of stillborn children will require enhancements to ICA’s systems.  As ICA also has other pressing system enhancements, the enhancement relating to stillbirth naming will take some time. We estimate it to be about two years.

11. The name of a stillborn child will be subject to requirements laid out in the new Section 36B, which mirror the requirements for live births. For instance, the name should not be offensive or obscene.

12. In the interim, parents who wish to name their stillborn child may apply to ICA for a commemorative birth certificate that reflects the child’s name, for remembrance purposes. This can be done through ICA’s website.

Definition of “Stillborn Child”

13. Currently, “stillborn child” is defined in section 2(1) of the RBDA as “a child that issues from the child’s mother after the twenty-second week of pregnancy and does not show any sign of life at any time after being completely expelled or extracted from the mother.” I apologise that this is legal language.

14. Clause 2 of the Bill amends the definition by raising the threshold from 22 weeks of pregnancy, to 24 weeks.

15. To provide context, the RBDA was enacted in 1937, with a definition of stillbirths that used a threshold of 28 weeks of pregnancy. In 2021, when the RBDA was repealed and re-enacted, the definition of “stillborn child” was updated to the current threshold of 22 weeks, to align with the World Health Organisation’s statistical reporting guidelines which recommended using a gestational age of 22 weeks of pregnancy. These guidelines are non-binding on countries and MHA had in 2021 decided to adopt them for the RBDA for consistency with the WHO for the purpose of statistical reporting.

16. Subsequently, MHA received feedback from our local medical community that the threshold of 22 weeks of pregnancy in the RBDA may be misinterpreted to be an indication of foetal viability – which refers to the ability of a foetus to survive outside the womb.

17. Medical practitioners are concerned about this, because local medical and scientific evidence points to 24 weeks of pregnancy as the threshold for foetal viability, and not 22 weeks. Reviews by MOH in 2018 and 2022 involving local experts concluded that the survival rate for premature babies born at 22 weeks is close to zero, while foetal viability at 24 weeks is about 50%.  It is also for this reason that the 24-week threshold is reflected in the Termination of Pregnancy Act 1974, where an abortion is not allowed for a foetus of more than 24 weeks’ duration.

18. Medical practitioners highlighted that if parents mistook the 22-week threshold in the RBDA as an indication of foetal viability, there could be confusion for them on the medical interventions for their unborn child.

19. We have only had one surviving baby born at 22 weeks in Singapore in the last 10 years. The media reported that the child – a baby girl – was born in 2018, and required a slew of life-sustaining treatments and maximum ventilator support. She spent a total of 166 days in the hospital before being discharged. She is a miracle baby who survived despite the odds. Sadly, such cases are extremely rare.

20. The MHA has reviewed the matter with MOH, and will amend the threshold in the definition of stillborn child in the RBDA to 24 weeks of pregnancy. This will align with the cut-off for abortions in the Termination of Pregnancy Act 1974, and remove any potential confusion regarding foetal viability. For absolute clarity, Clause 2 of the Bill states the existing position that a stillbirth does not include an aborted foetus.

21. I would like to assure Members that the amendment to the RBDA to raise the threshold to 24 weeks of pregnancy does not imply or indicate any changes to medical guidelines, practices, or the standard of care for premature babies born before 24 weeks of pregnancy.

22. Clauses 10 and 11 of the Bill make similar amendments to the definition of “stillborn child” in the Income Tax Act 1947. Stillborn children are counted in the child order for the purposes of administering tax benefits.

Other Amendments

23. The Bill also makes other amendments, which I will summarise.

24. Clauses 3 to 8 of the Bill make amendments to the RBDA in relation to registration and re-registration of births. These amendments are meant for clarity, with no changes to existing processes.

25. Clauses 12 to 15 of the Bill make consequential amendments to other Acts, for example, to update the reference to the RBDA 1937, which has been repealed, to the RBDA 2021.

26. Mr Speaker, before I conclude, I would like to share that this journey has not been an easy one. The conversations with bereaved parents, medical practitioners and community partners have been wrought with emotion. Last Friday, as I was settling my younger child to sleep, she suddenly asked if she was a rainbow child. She had watched an episode on “Bluey”, an Australian animated series, on baby loss. She reminded me about this rainbow pendant which was gifted to me by a non-profit organisation - Angel Hearts – last year.

27. I hope that today’s amendments will help bereaved parents in some way and also remind us that as we treasure and honour our babies who have departed, let us also look to the future with hope. Ms Mandy Too is now a mother to Josie and Ms Felicia Tan, a mother to Titus. I wish all our parents the very best.

28. Mr Speaker, Sir, I beg to move.