SINGAPORE – Only one baby here born very prematurely at 22 weeks in the past decade has survived, after a slew of life-sustaining treatments and spending 166 days in hospital.
Minister of State for Home Affairs and Social and Family Development Sun Xueling mentioned this “miracle baby” at the second reading of the Stillbirths and Births (Miscellaneous Amendments) Bill on January 9, adding that such cases are extremely rare.
Ms Sun did not name the child, but online checks found her to be Chelsea Kiew, whose chances of survival were described by her doctors as “close to zero” when she was born in 2018.
One of the two main amendments introduced in the Bill, which was passed in Parliament on Jan 9, is that the definition of stillbirth will refer to the death of a baby born after the 24th week of pregnancy. This is up from after the 22nd week now.
The move comes after doctors expressed concern that the threshold of 22 weeks of pregnancy may be misinterpreted as an indication of foetal viability, and may cause confusion for parents facing difficult and important decisions about medical interventions for their unborn child.
Ms Sun said that local medical and scientific evidence points to 24 weeks of pregnancy as the threshold for foetal viability, which refers to the ability of a baby born prematurely to survive outside the womb.
Reviews by the Ministry of Health in 2018 and 2022 involving local experts concluded that the survival rate for a premature baby born at 22 weeks is close to zero, while the foetal viability of babies born at 24 weeks is about 50 per cent.
She added: “It is also for this reason that the 24 weeks threshold is reflected in the Termination of Pregnancy Act 1974, where an abortion is not allowed for a foetus of more than 24 weeks.”
Raising the threshold in the definition of a stillborn child to 24 weeks of pregnancy will also align it with the cut-off for abortions in the Termination of Pregnancy Act 1974, she added.
She assured MPs that the move to raise the threshold to 24 weeks of pregnancy as the definition of a stillbirth 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.
The other main amendment in the Bill is to allow parents to register the name of their stillborn child, within a year of the stillbirth, if they wish to do so.
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.
Ms Sun added that the ability to officially register the stillborn child’s name will “go some way to recognise the birth of the child and support the healing process for bereaved parents.”
She said: “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 of the healing process.”
However, to enable parents to name their stillborn children, the Immigration and Checkpoints Authority’s (ICA’s) systems have to be enhanced, she said. The system changes required to allow for the official registration of names of stillborn children may be ready in an estimated two years’ time.
In the interim, parents can apply through the ICA’s website for a commemorative birth certificate that reflects their stillborn child’s name for remembrance purposes.