Hospital Information

• Registration of births and fetal deaths is completed in the Missouri Electronic Vital Records (MoEVR) system using information from both the Mother’s Worksheet and the Facility Worksheet.
• Names and words on Missouri birth certificates will print in all capital letters. When naming a child and providing related information, any unknowns, extra character spaces, incorrect suffixes, and other specific naming sequences such as adding numbers to names may prevent the automatic issuance of a social security number [known as Enumeration at Birth (EAB)]. For more info, see State Processing Guidelines for Enumeration at Birth.
  • The vital record will still be accepted and registered. However, the Social Security Administration (SSA) may have to be contacted directly and the completion of a Form SS-5 may be necessary to properly register a child for a social security number. In addition, while MoEVR can accept all general special characters and accents (viewable by logging in to MoEVR and clicking on “Accent Characters” in the upper right hand corner of the screen), some versions of birth certificates may not display all special characters and accents.
• The person who gives birth to a child is always listed as the mother and should be the person who completes the Mother’s Worksheet.
• If a mother is unmarried, the birth record should be registered without the father. If a father is to be added, paternity affidavits (mother’s affidavit, father’s affidavit, and if applicable, husband’s denial) must be sent in together to the Bureau of Vital Records after the registration of the birth.
• If sending a correction affidavit, supporting documents must always be included. Preferably the Mother’s Worksheet/Facility Worksheet should be used as supporting documents. If sending one of those worksheets you must send all pages, not just the page that supports the correction. If neither of these are available or they are listed incorrect, call the bureau for further guidance at 573-751-6387 option 4.
• Co-parents (same sex female couples) can only be added if they are married to the mother and if added at the time of birth. Otherwise, a court order is required to add a co-parent after birth registration.
• Verify pre-pregnancy weight -vs- weight at delivery. If one of these fields is unknown, list 999. If you enter 99, it will recognize it as 99lbs and result in a query.
• If a date field is unknown, you must enter a 9 for every required field.
  • Ex: mm/dd/yyy = 99/99/9999 or if one of the fields is unknown such as day of month is should be entered as 05/99/2020
• If height is unknown, enter 99 for feet and 99 for inches. If you enter one 9 in each field, it will recognize it as 9ft 9in and result in a query.
• If number of cigarettes is ½ of a cigarette round up to 1.
• Number of previous cesareans (Risk Factors in Pregnancy): This number should not include the current birth. It should match or be less than the number of children now living and/or dead.
• Ex: Mom has one previous child born via cesarean. This current baby was also born via cesarean. You would enter 1 as the number of previous cesareans, not 2.
• Newborn living at time of report: This question is often misread and marked as no when child is actually living. It will be queried as unlikely based on weight, APGAR, and gestation.

Fetal Death

A fetal death is defined as a non-induced death prior to the complete expulsion or extraction from its mother of a fetus, irrespective of the duration of pregnancy, the death is indicated by fact that after such expulsion or extraction the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles.

Each spontaneous fetal death of twenty (20) completed weeks gestation or more, calculated from the date of last normal menstrual period began to the date of delivery, or a weight of three hundred fifty (350) grams or more which occurs in Missouri shall be reported.

If a spontaneous fetal death occurs, neither a birth certificate nor a death certificate shall be filed or issued—only a report of spontaneous fetal death, and if desired, a certificate of birth resulting in stillbirth certificate are available.

Induced Termination of Pregnancy (ITOP)

An induced termination of pregnancy (ITOP), also known as an abortion, is defined as the intentional destruction of life of an embryo or fetus in his or her mother’s womb or the intentional termination of pregnancy of a mother with an intention other than to increase the probability of a live birth or to remove a dead or dying unborn child.

Information received from the Report of Induced Termination of Pregnancy and the Complication Report for Post-Abortion Care are confidential, only used for statistical purposes, and to preserve maternal health and life by adding to the sum of medical knowledge through the compilation of relevant maternal health and life data and to monitor all abortions performed to assure that they are done only under and in accordance with the provisions of the law.

For more general information regarding these terms, visit the National Center for Health Statistics.

Surrogacy Births

When a surrogate mother is involved in a birth process, note the following regarding filing of the birth certificate:

• The hospital will list the surrogate as the mother.
• If surrogate is not married and wishes to list the father on the record, paternity affidavits shall be completed. If father is not listed at this time, the father can be added later via surrogacy court order documents as applicable.
• The surrogate should complete the mother's worksheet.
• The surrogacy court order documents must be sent to the Amendment Unit for the mother (and father if not listed through paternity affidavits prior to court order) to be changed. Before sending documents, it is recommended parents contact the Bureau of Vital Records – Amendment Unit at 573-751-6387, option 2.

• Women in same-sex marriages, lawfully entered into in jurisdictions where same-sex marriage legal, who give birth in Missouri, may choose to have their spouse listed as the baby’s co-parent on the birth certificate.
• The person who gives birth to a child is always listed as the mother. In instances, where the mother wishes to list the biological dad on the birth certificate, she can list the father in lieu of the female spouse. The female spouse does not sign a Husband’s Denial of Paternity. In this case, the birth record is registered with only the mother on the record. Information for the “co-parent” is not added and the mother and father will need to complete paternity affidavits to add the father to the birth record after the record is registered.
• A mother in a same-sex marriage who refuses to provide her spouse’s information on the record at the time of birth will require a court order to add the co-parent later.
• Men in same sex relationships or marriages (using a donor egg/surrogate) will have the person who gives birth to the child listed as the mother. Paternity affidavits are then needed to add the biological father. If the couple choose to mix sperm, either father may be listed. Finally, a court order is then needed to remove the mother and add the father’s spouse/co-parent.
• Unmarried same sex female couple using donor sperm.
  The person who gives birth to a child is listed as the mother. No father is listed on the birth certificate. A court order is required to add co-parent.
• If a same sex female couple is not married, the person who gives birth to a child is listed as the mother, and then a court order is needed to list her partner.

For more information or guidance on additional scenarios, contact the Bureau of Vital Records at 573-751-6387, Option 4.