Bill 738.

Summary.

The bill defines gestational grief as the psychological suffering a woman experiences when her child dies during pregnancy or childbirth, which may also affect her spouse or cohabiting partner and other family members. It proposes professional support and measures against stigma, while addressing physical and mental recovery. It defines a deceased baby, pregnancy loss, a medical procedure and the Perinatal Grief Scale. It recognizes the woman's rights to express her grief, receive respectful and confidential treatment, learn the causes of death in plain language and obtain timely psychosocial care.

When doctors and nursing staff assist with a loss, care would address the patient's emotional as well as physical condition. The bill calls for a calm setting for her and her family. If her health is not at risk, the doctor would recommend that she consider vaginal delivery. It also provides that sedation be avoided if she requests to remain conscious. Her decisions on delivery and sedation must be recorded in writing in her clinical file. Public hospitals and health centers would provide an isolated recovery room or separate area where she could recover and receive relatives away from other mothers and their children.

The public facility that treated the patient would seek informed consent concerning the final disposition of the deceased child's remains, explain the release procedure and provide a certified copy of the fetal death form. Parents who do not wish to receive the remains would have to say so expressly. Use of the remains for medical or scientific study and research would require their written informed consent, recorded in the patient's clinical file. If the patient is a minor, legally incapacitated or has a mental disorder, the person holding guardianship or curatorship would give the required consent.

The treating medical staff would give the patient a referral to the maternal women's comprehensive health program run by the Ministry of Health (Ministerio de Salud) and the Social Security Fund (Caja de Seguro Social), and record the referral in her file. The bill treats grief as an emotional response warranting specialized care and supervision for the woman and her family. It directs professionals to use the Perinatal Grief Scale for diagnosis and treatment. A mental health professional would also consider, as appropriate, gestational and clinical circumstances, prior psychiatric conditions, the woman's family and social environment, and the care she received.

A female public employee whose pregnancy is interrupted would receive gestational grief leave and additional rest according to her medical certificate and physician's instructions. The bill protects her from dismissal without just cause during that period, grants one year of employment protection and permits attendance at follow-up appointments. Her spouse or cohabiting partner would also receive grief leave if employed in the public service. The bill adds Article 112-A to the Labor Code (Código de Trabajo), granting a female worker and her employed spouse or cohabiting partner five (5) paid working days of leave. That leave is separate from rest prescribed for physical recovery and would not reduce pay, vacation or other employment benefits. It amends Article 83 of Law 9 of 1994 (Ley 9 de 1994) to provide the paid leave in public employment outside the annual limit of eighteen (18) days. Article 18 also states that Article 112 of the Labor Code is amended.

The bill designates October 15 as the Day of Awareness of Pregnancy Loss and Gestational Grief in the Republic of Panama. It assigns annual activities to the Ministry of Health, the Social Security Fund and the Ministry of Women (Ministerio de la Mujer). The latter would incorporate the stated rights into its policies and allocate resources to support organizations. The Executive Branch (Órgano Ejecutivo) would issue regulations, and the law would take effect upon promulgation. The provisions concern those institutions, health facilities, employers, public employees, workers and affected families.