The Certificate of Childbirth Attendance (CeDAP) is the official tool by which the National Health Service collects data on birth events: clinical, demographic and epidemiological information that makes it possible to monitor maternal and child health, plan services and evaluate the quality of care.
With the update of the CeDAP information flow, the birth event detection system in Italy takes a decisive and profoundly significant step: in fact, registration becomes mandatory for all events starting from the 22nd week of gestation(22 + 0).
This is not just a technical change. It is a major cultural, clinical and ethical change.
With the Ministry of Health Decree of May 5, 2025, the new CeDAP is integrated into the New Health Information System (NSIS) and a crucial point is clarified: from January 1, 2026 , the survey covers all deliveries with gestational age of 22 completed weeks or more, in addition to cases with a lower age but with signs of viability.
Beginning to record data from week 22 is a most important change both for those working in the field of perinatal health and for those who have experienced loss since that date.
In past years, fetal deaths and extremely premature births that occurred before 25 weeks and five days gestational age(day 180) were not included in CEDAP records. Late abortion and also extremely premature birth in our country were not collected: an invisibility not only clinical and epidemiological, but also symbolic and social.
The choice to begin collecting data in CeDAP from 22 weeks, in line with the most up-to-date definitions of natimortality and the threshold for potential viability, means recognizing that these events are also a full part of the birth pathway.
Giving recognition and value to the inauspicious events that can punctuate pregnancy means giving value to women, to their health, to their bodies; it means beginning to think of these events as worthy of being measured nationwide, by law. Carefully measuring an adverse event allows us to be able to study it and investigate it, but also to find ways that we can, one day, prevent it. And it is there, to the prevention of preventable events, that a nation that cares about the health of its citizens must aim.
The CeDAP amendment is an important step toward bringing thousands of women with late-term abortion experience out of invisibility.
Recording an event means:
- Make it accountable, thus visible to institutions;
- Allow more accurate analyses of stillbirths, congenital malformations, adverse outcomes;
- Recognize that the loss that occurred at 22, 24, or 28 weeks is not a minor event, either for the clinic or for the people involved.
Lack of data always produces lack of recognition.
The new CeDAP narrows this gap and enables thinking about more appropriate health care planning, more realistic assessment of care needs, and better monitoring of the quality of care in cases of endouterine death and stillbirths with congenital conditions.
What changes with the new CeDAP – in brief
For families
- Loss events occurring from the 22nd week of gestation officially enter health information systems.
- This also means greater institutional recognition of the pregnancy, loss and grief experienced.
- The data collected are used to improve services, continuity of care, and support offered to families.
For health care workers
- Completion of CeDAP also becomes a structural step in cases of stillbirths and late losses;
- A more careful and conscious look is required: not only technical correctness, but also care in the relationship;
- A more comprehensive survey allows for better assessment of quality of care, outcomes and training needs.
For the health system
- More accurate and consistent data nationwide;
- Improved programming of maternal and child services;
- Increased epidemiological visibility of hitherto under-represented or fragmented events;
Collecting all cases of stillbirth or premature birth from the 22nd week of gestation represents a technical advance, an alignment with international standards but also a first concrete step toward the recognition of perinatal grief, in all its forms.
For us at CiaoLapo, who have been fighting for years to ensure that all women affected by abortion and perinatal death are offered the best possible care and treatment, regardless of gestational weeks or survival of the baby, this change is an important milestone.We would like to thank all the people who, through their work in perinatal health, as physicians, researchers, epidemiologists, and through their insistent calls for our country to be brought in line with the most organized and attentive countries, have made it possible to achieve this first, important, change.
