blood circulation, breath or muscle movements. canada beginning in 1959, "the definition of a stillbirth was revised to conform, in substance, to the definition of fetal death recommended by the world health organization". the definition of "fetal death" promulgated by the world health organization in 1950 is as follows: "fetal death" means death prior to the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy and which is not an induced termination of pregnancy. the death is indicated by the 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. heartbeats are to be distinguished from transient cardiac contractions; respirations are to be distinguished from fleeting respiratory efforts or gasps. germany monument to stillborn babies in germany in germany, a stillbirth is defined as the birth of a child of at least 500g weight without blood circulation or breath. details for burial vary amongst the federal states. republic of ireland at one time, this angels' plot was one of the few burial grounds for stillborn babies that was consecrated by the catholic church in ireland. since 1 january 1995, stillbirths occurring in the republic of ireland must be registered; stillbirths that occurred before that date can also be registered but evidence is required. for the purposes of civil registration, s.1 of the stillbirths registration act 1994 refers to "...a child weighing at least 500 grammes, or having reached a gestational age of at least 24 weeks who shows no signs of life." netherlands in the netherlands, stillbirth is defined differently by the central bureau of statistics (cbs) and the dutch perinatal registry (stichting prn). the birth and mortality numbers from the cbs include all livebirths, regardless of gestational duration, and all stillbirths from 24 weeks of gestation and onwards. in the perinatal registry, gestational duration of both liveborn and stillborn children is available. they register all liveborn and stillborn children from 22, 24 or 28 weeks of gestation and onwards (dependent on the report: fetal, neonatal or perinatal mortality). therefore, data from these institutions on (still)births can not simply be compared one-on-one. united kingdom the registration of stillbirths has been required in england and wales from 1927 and in scotland from 1939 but is not required in northern ireland. sometimes a pregnancy is terminated deliberately during a late phase, for example due to congenital anomaly. uk law requires these procedures to be registered as "stillbirths". england and wales for the purposes of the births and deaths registration act 1926 (as amended), section 12 contains the definition:"still-born" and "still-birth" shall apply to any child which has issued forth from its mother after the twenty fourth week of pregnancy and which did not at any time after being completely expelled from its mother, breathe or show any other signs of life.a similar definition is applied within the births and deaths registration act 1953 (as amended), contained in s.41. the above definitions apply within those acts thus other legislation will not necessarily be in identical terms. s.2 of the 1953 act requires that registration of a birth takes place within 42 days of the birth except where an inquest takes place or the child has been "found exposed" in which latter case the time limit runs from the time of finding. extracts from the register of stillbirths are restricted to those who have obtained consent from the registrar general for england and wales. scotland section 56(1) of the registration of births, deaths and marriages (scotland) act 1965 (as amended) contains the definition:"still-born child" means a child which has issued forth from its mother after the twenty-fourth week of pregnancy and which did not at any time after being completely expelled from its mother breathe or show any other signs of life, and the expression "still-birth" shall be construed accordinglys.21(1) of the same act requires that:except so far as otherwise provided by this section or as may be prescribed, the provisions of this part of this act shall, so far as applicable, apply to still-births in like manner as they apply to births of children born alive.in the general case, s.14 of the act requires that a birth has to be registered within 21 days of the birth or of the child being found. unlike the registers for births, marriages, civil partnerships and deaths, the register of still-births is not open to public access and issue of extracts requires the permission of the registrar general for scotland. northern ireland in northern ireland, the births and deaths registration (northern ireland) order 1976, as amended contains the definition:"still-birth" means the complete expulsion or extraction from its mother after the twenty-fourth week of pregnancy of a child which did not at any time after being completely expelled or extracted breathe or show any other evidence of life.registration of stillbirths can be made by a relative or certain other persons involved with the stillbirth but it is not compulsory to do so. registration takes place with the district registrar for the registration district where the still-birth occurred or for the district in which the mother is resident. a stillbirth certificate will be issued to the registrant with further copies only available to those obtaining official consent for their issue. registration may be made within three months of the still-birth. united states in the united states, there is no standard definition of the term 'stillbirth'. in the u.s., the born-alive infants protection act of 2002 specifies that any breathing, heartbeat, pulsating umbilical cord or confirmed voluntary muscle movement indicate live birth rather than stillbirth. the centers for disease control and prevention collects statistical information on "live births, fetal deaths, and induced termination of pregnancy" from 57 reporting areas in the united states. each reporting area has different guidelines and definitions for what is being reported; many do not use the term "stillbirth" at all. the federal guidelines suggest (at page 1) that fetal death and stillbirth can be interchangeable terms. the cdc definition of "fetal death" is based on the definition promulgated by the world health organization in 1950 (see section above on canada). researchers are learning more about the long term psychiatric sequelae of traumatic birth and believe the effects may be intergenerational the cdc states that, in the us, a stillbirth is typically defined as the loss of a fetus during or after the 20th week of pregnancy. stillbirths can further be classified as early (occurring between week 20 and week 27 of pregnancy), late (occurring between week 28 and week 36 of pregnancy), and term (occurring during or after week 37 of pregnancy). in the us, approximately 21,000 babies are stillborn annually, and stillbirth affects around 1 in 175 births. the federal guidelines recommend reporting those fetal deaths whose birth weight is over 12.5 oz (350 g), or those more than 20 weeks gestation. forty-one areas use a definition very similar to the federal definition, thirteen areas use a shortened definition of fetal death, and three areas have no formal definition of fetal death. only 11 areas specifically use the term 'stillbirth', often synonymously with late fetal death; however, they are split between whether stillbirths are "irrespective of the duration of pregnancy", or whether some age or weight constraint is applied. a movement in the u.s. has changed the way that stillbirths are documented through vital records. previously, only the deaths were reported. however, 27 states have enacted legislation that offers some variation of a birth certificate as an option for parents who choose to pay for one. parents may not claim a tax exemption for stillborn infants, even if a birth certificate is offered. to claim an exemption, the birth must be certified as live, even if the infant only lives for a very brief period.