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Committee advances changes to fetal‑death documentation, aligning state reporting with CDC guidance
Summary
Lawmakers moved HB 1858 forward as a house draft adopting Department of Health and clinician‑recommended language to allow clinicians (physicians, physician assistants, APRNs) to issue documentation for fetal losses under 20 weeks on request, aiming to improve data quality and bereavement support.
The House Committee on Health advanced HB 1858 on Feb. 11 after extended testimony from clinicians and Department of Health representatives who said Hawaii’s fetal death reporting statutes are outdated and hinder accurate data collection.
Dr. Joy Vink, a high‑risk OB–GYN at Kapiolani, told the committee that Native Hawaiians and Pacific Islanders in Hawaii have among the highest fetal‑death rates in the U.S. and that poor state data hinder efforts to design interventions. She said current statutes do not align with CDC reporting recommendations and described multifactorial barriers to accurate facility reporting (testimony at the hearing).
The Department of Health proposed an amendment making physicians and advanced practice registered nurses responsible for issuing documentation of fetal deaths for miscarriages under 20 weeks (or under 350 grams if gestational age is unknown). Dr. Vink agreed with the DOH language and told lawmakers converting permissive language (“may issue”) to mandatory language (“shall issue”) was acceptable to clinicians for specified circumstances to support families seeking documentation.
Committee members asked whether the changes would improve tracking of home births and transfers. Dr. Vink said facility report forms already capture whether a birth occurred at home or in a hospital and pointed to plans to form a fetal‑infant mortality review committee that would analyze cases more deeply.
The committee adopted DOH‑suggested language and moved the bill forward as a house draft for further consideration.
