PURPOSE: This rule establishes the content of the report of fetal death to be filed with the Department of Health for each fetal death in this state.

1. (1) The report of fetal death shall include the following items: registration district number; registrar’s number; fetus name; city, town or location of delivery; county of delivery; date of delivery; sex of fetus; place of delivery; if residence (home) delivery, was it planned that way—yes or no; facility name; mother’s name, maiden surname, date of birth, residence (state, county, city, town or location), zip code, street and number, inside city limits—yes or no, years living at present address; father’s name, date of birth; immediate and underlying cause of death and specify if cause is fetal or maternal; other significant conditions; fetus died before labor, during labor or delivery or unknown (specify); attendant’s name and title, Missouri license number; name and title of person completing report; burial, cremation, other (specify); cemetery or crematory, location (city or town, state); date; name and address of facility; informant; registrar’s signature; date received by local registrar; mother of Hispanic origin—no or yes; father of Hispanic origin— no or yes; mother’s race; father’s race; mother’s education; father’s education; mother participated during pregnancy (check all that apply); live births—now living; live births—now dead; date of last live birth; other terminations, date of last other termination; was mother married to father—yes or no; date last normal menses began (month, day, year); month pregnancy prenatal care began (specify); prenatal visits (total number); birth weight; crown heel length; clinical estimate of gestation (weeks); plurality (specify); if not single birth—born first, second, third, etc. (specify); mother transferred from another facility or physician’s office prior to delivery—yes or no and if yes enter name of facility; medical risk factors for this pregnancy (check all that apply); other risk factors for this pregnancy (complete all items); obstetric procedures (check all that apply); complications of labor or delivery or both (check all that apply); method of delivery (check all that apply); congenital anomalies of child (check all that apply).

AUTHORITY: section 193.165, RSMo 1986.* This rule was previously filed as 13 CSR 50-150.060 and 19 CSR 30-10.060. Original rule filed Nov. 4, 1977, effective Feb. 11, 1978. Rescinded and readopted: Filed Sept. 12, 1988, effective Jan. 1, 1989. Changed to 19 CSR 10-10.060 July 30, 1998.

*Original authority: 193.165, RSMo 1984.