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Some states use a separate form for filing a report of stillbirth. Other states require the birth attendant to file both a birth certificate and a death certificate.

The gestational age that constitutes a stillbirth differs from state to state but is usually around 20 weeks. In some cases, an induced abortion may require registration.

The stillbirth certificate may be the appropriate form even if the child is born alive. Separate birth and death certificates are required usually only if the child is potentially viable and lives for some period. If a fetus of any gestational age shows signs of life such as heartbeat or respiratory effort, it is best to file the appropriate certificates.

A reasonable attempt to determine the cause of death should be made for stillborn infants. Prematurity is usually a result of some underlying medical condition, not the cause itself. Prematurity is obviously not the cause of intrauterine death. Since some causes of stillbirth, such as infection or uterine abnormality, are treatable, the physician who does not establish the cause of a stillbirth may be liable for similar problems in a subsequent pregnancy.

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