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A precious piece of paper

There are no words to describe the raw emotion a parent must feel after they lose an infant at stillbirth.

Thanks to the grassroots movement by a South Whitehall Township woman, the memories of those infants who die in childbirth will live on.Recently, Gov. Tom Corbettt signed a bill to allow parents to claim a birth certificate for their infants who die at childbirth. That makes Pennsylvania the 31st state in the country to direct health departments to issue birth certificates for stillbirths in the event a parent requests one.For Palmerton native Dorothy Knappenberger, 74, the signing of the bill marked the end of a four-year-plus odyssey she embarked on to remember her great granddaughter, Seneca.On Jan. 4, 2007, Seneca, was stillborn. A retired Registered Nurse who worked locally for 42 years, the last 20 of which were as an Emergency Room nurse, Knappenberger said even she wasn't prepared for the situation."I certainly saw stillborns, but I never realized the impact of it," said Knappenberger. "Until it affects you personally is when it really sinks in about how tragic this is."Knappenberger said her granddaughter, Mandy Mancini, was full-term, and was told to go to the physician's office, where it was discovered there was no heartbeat. An ultrasound was done and it was determined Seneca was dead.That moment will forever remain etched in Knappenberger's mind."I always think of that song, The Sounds of Silence", she said. "She was beautiful, had a full head of hair, curly hair, we all held her, hugged her, kissed her, and passed her around."Knappenberger had no idea the emotional time would launch her four-plus-year journey, which featured many peaks and valleys.As the family made arrangements with a funeral director, Knappenberger said she learned that all states had always required that a death certificate be made out and filed in our state capitol. But, while a baby is mandated to be buried and cremated, they weren't mandated to have a birth certificate."I made up my mind I was going to do whatever I could to see that these babies, including my great-granddaughter, were going to get a birth certificate," Knappenberger said. "To me, it was just a matter of common sense."While she wasn't thinking in political terms, Knappenberger said that's exactly what she encountered."It was nothing but political debating; this isn't Rowe vs. Wade," she said. "We are not debating when life begins or anything; this is just a common sense fact, a baby was born, but the baby happened to die before birth, so how can legislators argue forever and ever, session after session."About a week after her great-granddaughter passed away, Knappenberger began her quest. At the time, there were only 14 states that allowed parents to claim a birth certificate for infants who die in childbirth."Luckily, I'm computer literate, so I began searching the Internet for stillborns," she said. "I became connected with a doctor from Arizona State University. She herself had a full-term stillborn daughter in the year 2001, and she lobbied the state of Arizona for the first certificate of birth resulting in stillbirths."Knappenberger said the woman also started a nonprofit organization called the MISS Foundation (Mothers In Sympathy and Support), for parents who have lost a child of any age. Once she got the bill passed in Arizona, her goal was to get it passed in all 50 states.As a result, Knappenberger became very involved and began making regular trips to Harrisburg.She said Sen., Pat Browne was a co-sponsor of bill, while state Sen. Jake Corman, was the prime sponsor."I became connected to (Corman's) constituents, and I found out one out of 115 are stillborn births," Knappenberger said. "As I became the MISS Foundation PA contact person, I started getting referrals."Moms were referred to her, and sent her their stories."I cried, and I became very emotionally attached to these mothers all over Pennsylvania; Pittsburgh, Philly, Delaware County, plus locally," she said. "So, then I also became connected with these parents of these stillbirths in Lancaster County, and I discovered they were actively pursuing this law."They began to take trips to Harrisburg to speak with Dept. of Health officials, whom Knappenberger said were opposed to the legislation for years."They had all kinds of crazy excuses, such as insufficient funds to initiate if this bill would pass, insufficient staff, abortion, partial abortion, identity theft," she said. "Then they were claiming they were afraid of terrorism."In 2007, Knappenberger said Rep. Kathy Watson from Bucks County became her advocate and sponsored a House of Representatives duplicate bill. She said Corman's bill that passed went to the governor's desk on July 7. Corbett signed it on July 27, in what Knappenberger called a "beautiful ceremonial signing of the bill.""It just brings tears to my eyes to be able to think about it," she said. "I was just honored to be able to sit at the side of the governor."Knappenberger said the day was "just marvelous.""I'm still in a dream world and can't believe I actually had something to do with changing a law in Pennsylvania," she said. "It was tough, but it came about, and certainly it wasn't just I; I had just some wonderful mothers, a father, and it was an amazing experience."However, had she have known beforehand all that would be involved in the process, Knappenberger isn't sure she would have undertaken the journey."There's been this misunderstanding for so many generations, that I believe stillbirth was swept under the carpet," Knappenberger said. "I think maybe it was almost thought of as a stigma in generations past ... that there was something wrong with the mother or the baby."Knappenberger said statistics have shown that with 50 percent of stillborns, there is never a cause of death determined."There is a great need that maybe funds will start coming in for research and to causes of stillbirth," she said. "Even with modern technology, as fast as they can set up for a C-section, it's too late."While losing a child of any age is traumatic, Knappenberger believes losing one at stillbirth is especially devastating."The sad part with stillborns is that people do not understand, so they don't know what to say," she said. "They say, 'Well, at least you didn't get to know them', but that mother, for nine months, had this baby."Knappenberger, who herself had a miscarriage at two months, said that wasn't even quite the same as having a stillborn."This is a full-term baby that looks like a sleeping baby, has been named, has a nursery waiting for it at home, a baby shower, you talk to the baby, pat the baby on the stomach, this was this person's child," she said. "Unfortunately, people will say things like 'Oh well, you're young, you can always have another child'; this child was unique, and will always to the day the parents die, will always be in their heart."The law actually goes into effect on Sept. 5. But, since that marks Labor Day, it won't actually go into effect until the next day."Probably one of the best things is that so many true friendships were formed among all these mothers," Knappenberger said. "They all look upon me as their mother/grandmother figure."It's moments such as those where Knappenberger said she can understand the phrase '15 minutes of fame.'"I was so overwhelmed with emotions; I guess I had my 15 minutes of fame," she said. "My heart if filled with joy, and I am so happy this bill has finally become a law in Pennsylvania."While the certificate certainly can't bring back those infants who were lost, Knappenberger said she's hopeful they will help ease their loss somewhat."I don't believe in the word closure, but I hope that it does give maybe a little bit of healing to them, and it certainly is something that all these mothers have wanted for many, many years," she said. "It's not going to take away their pain; it is a piece of paper. But to them, it is a precious, precious piece of paper."

SUSAN BRYANT/Special to the TIMES NEWS Dorothy Knappenberger, left, of South Whitehall Township admires a shadow box, plaster cast of her great-granddaughter's feet and other memory items her granddaughter Mandy Mancini, right, saved to remember her daughter Seneca, who was born stillborn in 2007 as a portrait painting of her sits on the back of the sofa.