The Politics of Stillbirth

Thirteen years ago, Joanne Cacciatore delivered a stillborn fetus, a trauma that was compounded by the fact that she received a death certificate in the mail but no birth certificate -- a tangible memento she said would have helped her grieve.

Motivated by her loss, she mounted a grassroots campaign in her home state of Arizona to get the government to give parents who deliver stillborn fetuses the option of receiving a "certificate for stillborn birth" -- and in so doing unintentionally waded into the turbulent waters of abortion politics.

Although reproductive rights advocates say they sympathize with Cacciatore, they also fear her effort -- which has since ballooned into a nationwide campaign -- could aid anti-choice groups as they attempt to chip away at or eliminate abortion rights. "There's no question in my mind that the anti-abortion crowd will look for some way to use this," Kim Gandy, president of the National Organization for Women, has said. At issue is the question of "personhood," or when human life begins; the answer lies at the heart of the debate over abortion.

Opponents of abortion rights contend that life begins at the moment of conception, and they have sought to define embryos and fetuses as human beings with a right to life. Under their logic, abortion is murder and should be illegal. Supporters of abortion rights do not equate embryos and fetuses with full human beings. Granting "personhood" to embryos and fetuses before they are born raises their legal status and jeopardizes women's right to abortion, they say.

Abortion-rights opponents have not taken up the cause of stillborn birth certificates en masse, Cacciatore said. But pro-choice groups worry that Cacciatore's movement to enact what she calls "Missing Angels" laws, which would grant fetuses that die before they are born certificates of stillbirth, will push anti-choice groups one step further in their quest to make abortion tantamount to murder.

On average, there are more than 25,000 stillbirths a year, according to the National Center for Health Statistics in Atlanta, Ga.

NOW has not taken an official stand on the issue. But Gandy said the organization has urged local women's rights activists to oppose legislation that doesn't include language guaranteeing that certificates of stillborn birth will only be issued to fetuses that die as a result of a naturally occurring intrauterine death after the 20th week of pregnancy. NOW also stipulates that certificates must only be issued only to parents who request them.

Otherwise, aborted fetuses could be eligible for the certificates -- a sign that would confer greater status, she said. And if outside parties could request the certificates, anti-choice groups might inundate states with requests for aborted fetuses, she said.

Cacciatore says the "Missing Angels" bills should not be muddied up in the contentious debate over reproductive rights. "The bottom line is, if these women want it, it should be their choice," she said.

But pro-choice activists have reason for caution: Efforts to improve the legal status of embryos and fetuses have gained considerable ground in recent years.

In 2002, the Bush administration expanded the State Children's Health Insurance Program to include embryos and fetuses, a move that for the first time made them separate beneficiaries of a government program, according to NARAL Pro-Choice America, a leading abortion rights advocacy group.

And in 2004, Congress passed and Bush signed the "Unborn Victims of Violence Act," a law that made it a separate federal crime to harm an embryo or fetus, giving them rights apart from the mothers. The law passed in the wake of the 2002 death of Laci Peterson, a California woman who was 8 months pregnant when she was murdered by her husband.

Cacciatore's campaign, pro-choice advocates fear, could further the personhood movement.

That is why Planned Parenthood of New Mexico recently objected to a "Missing Angels" bill even though it passed the state legislature with near unanimous support. "We're always concerned about measures that elevate the legal status of the fetus," said Martha Edmands, director of public affairs of Planned Parenthood of New Mexico.

New Mexico Gov. Bill Richardson, a Democrat running for his party's presidential nomination, vetoed the bill on April 6. In a letter of explanation, Richardson did not cite reasons related to abortion but said the bill would cause logistical problems because it would issue two certificates -- one for stillbirth and one for death -- for the same event. "Having two documents for a single vital event can lead to confusion and potential fraud and is not sound policy," he wrote.

Richard Olsen, a member of the National Stillbirth Society in Phoenix, Ariz., blamed Richardson for kowtowing to political pressure from reproductive rights groups. "This was just political opposition by a governor who wanted to show the women of America that he was pro-choice," Olsen said. Cacciatore agreed, adding that 20 states have already passed similar laws and none have encountered logistical problems.

"Missing Angels" bills have faced opposition elsewhere from state chapters of national groups that back abortion rights, including NOW, NARAL Pro-Choice America, the Planned Parenthood Federation of America, the American Civil Liberties Union, and the American College of Obstetricians and Gynecologists, Cacciatore said.

In California, where a "Missing Angels" bill is pending in the state legislature, Planned Parenthood of California, the California Medical Association, and the California American College of Obstetrics and Gynecology have tried to block the bill.

But Cacciatore doesn't expect opposition to spread. This year, in fact, has been the most active yet, she said: "We're gaining momentum."

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