Copyright by Dr. Joanne Cacciatore.

My story began 14 years ago. On July 27, 1994, I gave birth to my fourth child. It was my baby girl’s due date. About 15 minutes prior to birth, my beloved child, Cheyenne, died. After a full postmortem evaluation, the pathologist could find “no determinable cause” for her death. I was left with countless questions and few answers. About one week after her death, I received Cheyenne’s death certificate in the mail. What I really wanted, though, was the record of her birth. So I called the vital records office in Arizona to request Cheyenne’s birth certificate. I was told, “You didn’t have a baby. You had a fetus and the fetus died.” I vowed to change this for grieving mothers of the future. For more than one year, I lobbied the Arizona legislature, gathering bipartisan support for the bill that would become the first law enacted in the United States to offer grieving women a Certificate of Birth Resulting in Stillbirth (CBRS) as an option in addition to the death certificate that was already issued. The bill passed the Arizona State Senate with unanimous support during the 2001 legislative session. Shortly thereafter, Governor Jane Dee Hull signed the bill as she said, “I think we all know that this is something that should have happened long ago for women.” In September of 2001, Dr. Catherine Eden of Arizona Department of Health Services presented me with the first CBRS issued in the United States. Since then, we have worked tirelessly to pass the bill in other states. As of June 2008, the bill has passed in 25 other states, and is being considered in seven more. In the states that don’t have CBRS, the registrar of vital records usually issues some type of death certificate or some legal record of death for all stillbirths. This is the only record the family is able to receive at this time. In addition, families are mandated by state and federal law to pay for the final disposition, funeral or cremation, of the baby’s body after a stillbirth. What does the CBRS (in Arizona, it’s called the MISSing Angels Bill) do? It requires the state’s vital records office to offer – though not require – a “Certificate of Birth, Resulting in Stillbirth” for each stillbirth. The stillbirth must meet the medical/legal definition of stillbirth (naturally occurring, intrauterine death that occurs after the 20th week of pregnancy all the way up to birth). In addition, the CBRS is available only as an optional document to parents; parents who don’t want the document do not receive it. There is a fee attached to the document to ensure that there is no cost to state governments. Why is it important to offer CBRS? There are many reasons, but the most important is the psychological benefits to women who endure the death and the birth of their baby. The state’s refusal to validate the birth is an implicit rejection of the woman’s lived experience. The mother of a stillborn baby must still give birth to her dead infant. One 83-year-old woman who applied for and received her baby’s birth certificate 56 years after her baby’s death, said, “I feel like I can finally die in peace.” This legislation has tremendous value to women. There has been opposition in some states, including by the National Organization for Women, Planned Parenthood of California, ACLU, NARAL, California Medical Association, and the California American College of Obstetrics and Gynecology. These groups are concerned that this legislative movement threatens reproductive freedom for women. We disagree. We assert that this movement is all about reproductive freedom. The “vital center” of America clearly exhibits overwhelming support for the CBRS movement, which, boiled down, is simply about human compassion and dignity. It is not only possible, but demonstrable, that CBRS laws can coexist with laws protecting reproductive freedom. In fact, many pro-choice legislators have supported CBRS bills, as have many national organizations that provide aid to grieving families. These include the MISS Foundation, Elisabeth Kubler-Ross Foundation, March of Dimes, Mothering Magazine, National Stillbirth Society, and others. Sharon Kaplan, Chief Executive Officer of Planned Parenthood of Delaware, said: “If this certificate helps ease their (grieving mother’s) pain, then we support it. It does not seem to me to be an anti-choice agenda.” We encourage legislators in all states to do what is right for the citizens they represent. Stillborn babies are not inconsequential, nor are their mothers, and they deserve the dignity of existential recognition. (c) 2008 MISS Foundation. All rights reserved. Reach Joanne Cacciatore through her website

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Monica Novak

Monica Novak became a bereaved mother in 1995 with the stillbirth of her daughter Miranda, learning firsthand the devastation of saying goodbye to a much-loved, much-wanted baby before having the chance to say hello. Three weeks later, she began a journey towards healing when she attended her first Share support group meeting. Along the way, she and six other bereaved mothers formed a close bond that carried them through the grief of miscarriage, stillbirth, and infant death, as well as the challenges of subsequent pregnancy and infertility. Having been at the opposite ends of grief and joy; despair and hope; indifference and compassion; fear and peace-sometimes simultaneously-she has captured these emotions and the story of her journey in a highly-praised new memoir titled The Good Grief Club. Monica writes and speaks on the subject of pregnancy loss and infant death and is involved with local and national organizations that provide support to families and caregivers. She is a member of the Pregnancy Loss and Infant Death Alliance (PLIDA). Her mission is to bring comfort and hope to bereaved parents worldwide and to educate and promote awareness to the physicians, nurses, clergy, counselors, family, and friends of every mother or father who has or ever will be told that their baby has no heartbeat or that nothing more can be done. The mother of three daughters, Monica lives in the Chicago area with her husband, children, and a rat terrier named Sami. For more information, please visit or e-mail Monica at Monica appeared on the radio show “Healing the Grieving Heart” discussing ”Miscarriage and Infant Loss.” To hear Monica being interviewed on this show by Dr. Gloria & Dr. Heidi Horsley, go to the following link:

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