Birth and Fetal Death Registration Information for Hospital Staff

In Missouri, hospital birth certificate clerks or certifiers are those responsible for collecting and submitting the necessary data elements for the completion of the birth certificate as required by state law. The Missouri Electronic Vital Records (MoEVR) system, operated by the Missouri Department of Health and Senior Services – Bureau of Vital Records, exists to support the electronic registration of vital records, such as birth certificates, in Missouri.

Missouri Birth Record Registration and Filing Timeliness

A certificate of live birth for each birth occurring in Missouri must be filed within five (5) days after the date of birth (Section 193.085, RSMo) with the Missouri Department of Health and Senior Services by state law.

When a birth occurs in an institution or en route to an institution, the person in charge of the institution or such person's designated representative shall obtain the personal data, prepare the certificate, certify that the child was born alive at the place and time and on the date stated either by signature or an electronic process approved by the department, and file the certificate pursuant to this section or as otherwise directed by the state registrar. The physician or other person in attendance shall provide the medical information required by the certificate and certify to the facts of birth within five days after the birth. If the physician or other person in attendance does not certify to the facts of birth within the five-day period, the person in charge of the institution shall complete the certificate.

Live birth is defined by statute as the complete expulsion or extraction from its mother of a child, irrespective of the duration of pregnancy, which after such expulsion or extraction, breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached. The definition is also irrespective of birth weight.

Live birth certificate data is used in estimating population, for evaluation of maternal and perinatal health, for the study of fertility patterns, and to assist public health officials in the conduct and evaluation of programs.

Differences Between a Spontaneous Fetal Death and an Induced Termination of Pregnancy

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.

Recording Births with Mothers in a Same-Sex Marriage

Women in same-sex marriages lawfully entered into in jurisdictions where same-sex marriage is lawful, who give birth in Missouri, may choose to have their spouse listed as the baby’s other parent on the birth certificate. For more information, please contact the Bureau of Vital Records at 573-751-6387, Option 4.

Recording Surrogacy Births

Surrogacy Births

When a surrogate mother is involved in a birth process, please 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.

Training Resources

Hospital Training Guide

National Center for Health Statistics - Training and Instructional Materials

Missouri Electronic Vital Records (MoEVR) Training and Support

Birth Certificate eLearning
The Bureau of Vital Records strongly encourages new birth registrars to take a specially designed one-hour online course before utilizing MoEVR. The course is available online at Applying Best Practices for Reporting Medical and Health Information on Birth Certificates. Clinical and non-clinical providers of medical/health information for the birth certificate or the report of fetal death will find considerable value in the course.

The National Center for Health Statistics (NCHS) at CDC, in partnership with the National Association for Public Health Statistics and Information Systems (NAPHSIS), and several individual jurisdictions designed the course.

The course:

    • Explains the importance of reporting birth record and fetal death information
    • Describes how birth registrars and clinicians can improve maternal and infant health data
    • Identifies resources available to assist birth registrars and clinicians
    • Tests what the individual learned about birth and fetal death registration

Missouri Hospital Data Quality Worksheets

The Bureau of Vital Records has developed Hospital Data Quality Worksheets to provide performance feedback to birth facilities and staff who register births. This two-page reports summarize the timeliness and completeness of selected birth registration items reported by a facility. Aggregate data for all birthing facilities in Missouri is presented for comparison. Facility births registered with missing data are compared to all births in the state and to the National Center Health Statistics quality threshold.

We encourage all birthing hospitals and facilities to utilize these worksheets to review and improve data collection quality. To start receiving these worksheets, please call 573-751-6387, option 4.

National Vital Statistics System

In the United States, the legal authority to register births lies within 57 jurisdictions (50 states, 2 cities, and 5 territories). The 57 jurisdictions share birth record information with the National Vital Statistics System (NVSS) at the Centers for Disease Control and Prevention (CDC). The compiled national natality statistics inform a variety of critical medical and health-related research efforts.

Why Go Electronic?

The benefits of being an electronically registered birth certifier in MoEVR include:

  • Quickly electronically certify a birth certificate anywhere, anytime
  • Real-time prompts, edits, and validations ensure record validity and reduces errors and registration issues.
  • Reduced registration lag times help ensure statutory compliance and decreased possibility of loss, theft, and fraud

Contact Bureau of Vital Records

The Missouri Bureau of Vital Records has field representative staff who travel the state training vital record data providers. Field staff can also arrange for telephone/web conference training calls.

If you are a vital record data provider (local county health agency, funeral home/director, hospital/licensed birthing center, county official, medical certifier, etc.) and would like to request a personalized training session or gain access to MoEVR, please call 573-751-6387, option 4.