Bobbie Hopkinson shows off a framed sonogram photo of her son Nicholas on the mantel in her bedroom.

"I thought he looked just like Jay Leno," she said, laughing and pointing out his chin and the shadows on his head that mimic a hairline. "Jay Leno with a turkey body."

Her home in the Natrona section of Harrison is filled with the few mementos she has of Nicholas: a piece of his hair in a locket around her neck, a set of ink footprints on an index card, a blanket that he was wrapped in at birth on her bed.

In Nicholas' pastel blue baby book, she flips through pages of neatly written memories and photographs until she stops at the blank page that reads "Place Birth Certificate Here."

There's no birth certificate for Nicholas Roland Akam, stillborn on July 14, 2009, because the state of Pennsylvania doesn't issue them in cases such as his.

And Ms. Hopkinson, 32, is among dozens of women across the state lobbying for a bill that would allow them to get birth certificates for their stillborn children.

"It's not a baby book anymore," she said. "It's a book about what we did when he died. That piece of paper would be at least one little happy thing."

Since 2001, 27 states have passed bills allowing for birth certificates for stillborn children. In Pennsylvania, and many of the other states that have considered similar legislation, the bills have proved to be both emotionally and politically touchy, skirting the abortion debate amid fears from abortion rights advocates that the legislation would legitimize the life of an unborn baby.

Though Planned Parenthood of Pennsylvania does not have any opposition to the state's bill, individual legislators have expressed concerns. During Pennsylvania's final legislative session last year, the bill bogged down in the Senate in a dispute over language: Would it refer to "a stillborn child" or "a stillborn fetus?"

In previous sessions, the bill and its earlier incarnations drew concerns from the Pennsylvania Department of Health about the excess cost and workload that would result. Other criticism has come from those worried that the birth certificates could be used for identity theft or terrorism.

The bill's sponsor, Sen. Jake Corman, R-Centre, could not be reached for comment on its status.

Under the legislation, parents would need to request the "Certificate of Birth Resulting in Stillbirth" and would be subject to a fee.

Later this month, a full year will have passed since the bill was introduced. It now is stalled in the Senate's public health and welfare committee.

And it will have been a decade since Tammy Tobac of West Deer started pushing for a stillbirth birth certificate law in Pennsylvania after the death of her son Tanner.

A calligrapher by trade, Ms. Tobac was bothered by a rudimentary birth acknowledgment included in a folder she received at the hospital. Tanner's birth date was written in ballpoint pen with the first letter of his birth month crossed out and rewritten.

After she sought an official document from the state and learned she couldn't receive one, she met former state Rep. Jeff Habay at a church event and complained to him about the issue. Mr. Habay, a Republican from Shaler, repeatedly introduced a birth certificate bill without it becoming law, she said.

"It was an exercise in frustration," she said. "I gave up and decided my time would be better spent ministering to women who had had a loss. People have picked it out and made it their political football and it just shouldn't be that way."

According to the National Center for Health Statistics, about 25,000 babies are stillborn each year in the United States -- roughly 10 times the number that die from Sudden Infant Death Syndrome.

In Ms. Tobac's opinion, the issue also suffers from a lack of public awareness.

"It's not something that people are comfortable talking about and not something that anybody regularly talks about, so it's hard to get people to care about it," she said.

She knows that to people unfamiliar with the issue, the concept of a mother holding and cuddling her dead baby "sounds almost disturbing."

Mothers of stillborn babies often hear comments such as "at least you didn't know him" or "you're young, you can have another child" that minimize their loss, said Dorothy Knappenberger, whose great-grandaughter, Seneca, was stillborn in 2007.

Since then, she has taken the lead role in lobbying the Pennsylvania Legislature to pass the bill.

Mothers of stillborn babies often attach more importance to a birth certificate than do mothers of healthy babies, said Ms. Knappenberger, 73, a retired emergency room nurse.

"To me, my birth certificates of my children were just stored away with important papers, nothing of great sentimental value," she said. "To these moms, it's another thing of the very few things they will have to remember their child."

For 18 years, that's been the case for Shawn Betts, of West Deer, whose stillborn daughter Courtney lacks the birth certificate in her scrapbook that her four sons have in theirs.

"To everyone else it's a piece of paper, but to us it's gold," she said. "I'll wait 25, 30 years if I have to but I am going to do this."

Ms. Knappenberger, of the Allentown suburb of Whitehall, is working with about 40 Pennsylvania women to persuade legislators, she said. A Facebook group that she founded, Pennsylvania Certificate of Birth Resulting in Stillbirth Legislation, has nearly 300 members.

She also is working with the MISS Foundation, a national group dedicated to getting the bills, called "Missing Angels" bills, passed in all 50 states. The group was founded by Joanne Cacciatore, who successfully pushed for passage of the first such bill in Arizona in 2001 after the stillbirth of her daughter.

In some states, the bills have sailed through, said Dr. Cacciatore, a professor at Arizona State University. In others, the process has been "painstakingly painful" due to opposition from advocates on both sides of the abortion issue.

To Ms. Hopkinson, it's the inconsistencies that she perceives in state laws that drive her crazy.

A baby that is more than 20 weeks old gestationally but takes even one breath receives a birth certificate, she said, though her 39-week stillborn baby did not. A person could be charged with manslaughter for taking the life of a baby after killing a woman who was just one week pregnant, she said. And by law, she was mandated to bury or cremate Nicholas after he was born, as would be the case after the death of a living person.

"I don't get politics, and I don't think I want to," she said. "I just know you're supposed to be able to change things that don't make sense."

Ms. Hopkinson was a week from her due date when she went to a routine doctor's appointment to check her baby's progress. Her fiancé, Chris Akam, stayed home with their 4-year-old son Nathan while she went to the doctor.

When the doctor couldn't find a heartbeat, she drove herself to UPMC Mercy, where she was induced into labor that would take 11 hours before she gave birth.

Before Mr. Akam came to the hospital, he cleared the main areas of their house of baby items. They keep the door closed to Nicholas's nursery -- still decorated with its moon-and-star theme, with clothes still in the dresser.

Despite an autopsy, doctors couldn't pinpoint a reason for Nicholas' death, she said.

In the days and weeks that followed, Ms. Hopkinson said she experienced an utter, crushing depression. She walked around her mother's house and then her house wrapped in Nicholas' blanket, unwilling to wash it for fear of losing the stains of his blood.

She has filled nearly a dozen journals with letters to Nicholas. In the midst of discussions over when and whether to try to have another baby, Ms. Hopkinson recently found herself pregnant -- due Oct. 2 and "happy about it but scared to death."

In some ways, the legislative fight over the birth certificate has helped her grieve, she said. She went to Harrisburg over the summer to personally talk to legislative aides. Her sister is organizing an awareness walk and run in South Park on July 17.

"I couldn't dress him, couldn't change him," she said, her voice breaking. "I had the car seat in my car but I couldn't even take him to the funeral because under Pennsylvania law, only the funeral home can transport a dead body. I couldn't do a thing for my son, but I can do this."

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