SINGAPORE - Only one baby here born extremely 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 Jan 9, adding that such cases are extremely rare.

Ms Sun did not name the child, but online checks found that she is 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 among 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 of 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) 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.

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.

Mr Louis Ng (Nee Soon GRC) asked if parents who gave birth to a stillborn child before the new provisions are operationalised can apply for their child to be named in the stillbirth certificate once the provisions come into effect.

The answer is yes, if they apply to name their child within a year of the stillbirth after the provisions come into effect, Ms Sun said.

She also added that 51 such commemorative birth certificates have been issued to date since the ICA started issuing them in October 2023.

Workers’ Party MP Jamus Lim (Sengkang GRC), one of three MPs who spoke about the Bill, said the move to allow the naming of the stillborn child in the stillbirth certificate will confer “enormous dignity” to the child and help parents heal from their loss.

His younger brother, Jaaron, was stillborn 33 years ago.

He said: “As I had previously shared with this House, it was one of the few times that I had seen my father – an otherwise traditional man when it came to expressing his feelings – cry. And it left my mother mourning for years after the loss and still leaves a gaping hole in her heart.

“Had this Bill been in place, we would at least have been able to commemorate him in a formal way, and that process would have helped our family find some additional closure.”

Ms Sun, who wore a rainbow pendant given to her by Angel Hearts, a non-profit group that makes gowns for stillborn babies among others, said the Ministry of Home Affairs (MHA) has heard the views of parents. This includes those who signed a petition started in April 2023 by a couple pushing for their stillborn twins’ names to be included in birth certificates.

She added: “When the MHA and the Government look into reviews, we do not look at it cursorily. When we say we will study something, we will commit to it and study it carefully, before committing to policy change and legislative change.”

In 2022, Minister for Home Affairs and Law K. Shanmugam said his ministry would review the feasibility of allowing parents to include their stillborn children’s names in official documents.

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