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'0 , S - U S. DEPARTMENT OF LABOR CHILDREN’S BUREAU J U L I A C . L A T H R O P . Chid AN OUTLINE FOR A BIRTH-REGISTRATION TEST <55 MISCELLANEOUS SERIES No. 12 Bureau Publication No. 54 W ASHINGTON GOVERNM ENT PRINTING OFFICE 1919 U- S' Digitized » trfor + FRASER https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis F 3* 5 4 AN OUTLINE FOR A BIRTH-REGISTRATION TEST. Who are you ? What is your name ? How old are you ? Are you a citizen of the United States ? Anyone can answer these questions, but some persons may find it rather .difficult to prove the truth of their answers. Only the person whose birth has been registered can easily establish his age and identity. Since birth registration is by no means general in the United States, many men and women may, and indeed do, suffer inconvenience and loss because they can not prove that they are as old as they say they are or even, sometimes, that they are who they say they are. The drafting of thousands of men for military service has given special emphasis to the need for more complete birth registration in the United States. Young citizens have been confronted, many of them for the first time, with the necessity of furnishing proof of age and citizenship and have found proof lacking them on account of faulty laws governing birth registration or imperfect enforcement of such laws as are in existence. The right to have a record of his birth in the public archives of the town or city or county in which he makes his first appearance should be considered one of the inalienable rights to which a child is born, for upon such a record many of his future rights and privi leges may depend. The record will stand as legal proof whenever his age or parentage or citizenship' is questioned. It will afford testimony that he is old enough to go to school, to leave school, to go to work, to vote, to marry. It will corroborate his statement regarding his age if he desires to take out life insurance papers. It will give proof of his parentage in case his title to inherited property is contested and of his citizenship in case his right to hold office or to receive passports for foreign travel is questioned. A birth record is important not only to the individual but to society as a whole. Vital statistics based on complete and accurate records of births and deaths are the only satisfactory index to the health of the community. They point the way to public measures for the protection of life and health. Registration of births is especially important as a prerequisite to welfare work for mothers and babies. The public-health nurse, with the birth record as a guide, can find those persons in need of advice and aid during the first few critical days of the child’s life. 10222a0—19 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis ' 4 O U T L IN E E O R B I R T H -R E G I S T R A T I O N TEST. Upon the prompt filing of the birth certificate depends in large measure the work done in many cities for the prevention of blind ness among newborn infants. In spite of the importance of the birth record, the parent's of the United States do not generally realize the necessity for seeing that the authorities are promptly notified of the birth of a child. The question “ Is your child registered?” that was asked by Children’s Year workers in connection with the nation-wide weighing and measuring test carried on by the Children’s Bureau and the Woman’s Committee of the Council of National Defense has revealed not only that many births are not recorded but that parents are frequently ignorant of the meaning of the term “ birth registration. In one town where 616 children were tested, 192 children were reported as registered; 123 were definitely said not to be registered, and the mothers of 3G1 children did not know whether their babies’ births had been recorded or not. In another town where 95 children were examined, only 17 births had been reported to the authorities. Although most modern European countries have very complete systems of birth registration, the United States lags behind. Only 20 States and the District of Columbia, embracing a little over half of the total population of the country, according to the latest avail able information from the Bureau of the Census, are included in what is called the “ birth-registration area.” To this area the United States Bureau of the Censu,s admits any State which shows by actual test that over 90 per cent of the births are being registered and which has regis tration laws giving promise of still more complete registration. Yet even in the birth-registration area, registration is oftentimes incom plete. Although the Bureau of the Census makes periodic tests of the communities admitted to the area, it is obviously impossible for it to maintain a staff of workers sufficient to check the records of hundreds of communities at frequent intervals to find out whether places once admitted to the area should be permitted to remain in it. Children’s Year workers have found that in many communities sup posedly within the area the births of numbers of children go unre corded. The experience of the Children’s Bureau has been similar. In choosing cities in which to make its studies of infant mortality it chose chiefly those in the birth-registration area, so that the birth records might be taken as a starting point for the investigation. In a number of cases, however, the bureau’s agents have found registra tion by no means complete. In one of the cities in which the bureau made an investigation it was found that over half the unrecorded live births were of the chil dren of Lithuanian mothers, who lived in an isolated foreign colony. Workers for Children’s Year, likewise, have found that in many instances the babies whoso parents were born in the United States https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis O U T L IN E F O R B I R T H -R E G I S T R A T I O N TEST. 5 were better protected by birth registration than the babies of foreignborn parents, or that the babies of the well-to-do were registered while those of the poor were not. In a southern State it was found that only 38.4 per cent of the colored babies examined in a certain county had been registered, while 76.8 per cent of the white children had their names entered in the county archives. Such discoveries as these have led to campaigns for better birth registration as one of the “ follow-up” measures for the weighing and measuring test. Many Children’s Year committees are planning to conduct birth-registration tests, with the twofold purpose of discov ering the extent of birth registration in their communities and of awakening the public to the need for making local records complete. There are many ways of conducting a birth-registration test. A list of baby brothers and sisters under a year old may be obtained from school children. Such lists may be supplemented by records secured from hospitals, physicians, and midwives, or from the bap tismal records, cradle rolls, and death records of churches. I f these lists are checked with the official records, some idea may be gained of the extent of birth registration among the babies covered by the investigation, ahd a great deal of local interest may be awakened. Such tests, however, can have to do with only a limited number of children. If a complete and accurate test is desired, it can best be accomplished by means, of a house-to-house canvass, in the course of which information is obtained from mothers concerning all babies born within a certain period—say, the 12 months preceding the month in which the investigation is made. Though such a canvass will in volve considerable work, the definite findings to be obtained from it will prove invaluable in a campaign for better birth registration. A BIRTH-REGISTRATION CANVASS, STEP BY STEP. The following outline has been prepared by the Children’s Bureau for the use of organizations desiring to conduct a house-to-house investigation of birth registration: I. The organization undertaking the canvass appoints an executive chairman to take charge of the work. II. The executive chairman names an executive committee to assist her. III. The executive chairman delegates a member of her com mittee— A. To discover whether or not the community is in the birthregistration area. 1. If so, when was it admitted ? Has any local test of birth registration been made since its admission ? ‘2. If not, has any local test ever been made of birth regis tration ? When ? With what results % https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 6 O U T L IN E B. F O E B I R T H -R E G I S T R A T I O N TEST. To investigate and report upon the law with regard to birth registration in the community, with especial view to ascertaining— r 1. Who is responsible for giving notification of birth. 2. How long a period may elapse between birth and notification. 3. What provisions have been made for enforcement. (а) Penalties. (б) Inducements. 4. What local officer is responsible for enforcement. 5. What local officer serves as registrar of vital statistics. 6. Whether the law distinguishes between live births and stillbirths. IY. The executive chairman visits the local registrar of births— A. To explain the object of the canvass. 1. It should be made clear that the birth-registration can vass is in nowise a reflection upon the registrar or upon his method of conducting his office, but is an attempt to cooperate with him to secure adequate registration by putting at his service a force of volunteer assistants and by awakening public interest in the value of his work. B. To secure the cooperation of the registrar. 1.' The registrar can tell where registration is especially weak and can make valuable suggestions. C. To ascertain from the registrar’s report or from figures fur nished by the registrar— 1. Total number of births registered during the period to be covered by the canvass. 2. Whether the local records are kept in card files, a separate card for each birth. If so, (а) Are they filed alphabetically by the child’s family name? ^ (б) Are they filed by date according to date of birth, or (c) Are they filed by date according to the date on which the birth was registered ? V* The executive committee names a definite period such as “ BirthKegistration Day” or *‘ Birth-Registration Week,” within which the canvass must be completed. If a canvass is dragged out over an indefinite length of time— A. Both workers and public lose interest. B. Families may move from one part of the city to another with the result that 1. They are subject to the annoyance of being canvassed twice. 2., Duplicate records will be made and the work of the test will thus be unduly complicated. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis O U T L IN E F O R B I R T H -R E G I S T R A T I O N 7 TEST. VI. A publicity manager or subcommittee is appointed by the executive chairman to make public the purpose and methods of the canvass, by means of— A. Articles sent to newspapers— 1. To announce the canvass. 2. To explain the need for birth registration. 3. To give news of the progress of the work. B. Posters and handbills—• 1. To announce the time chosen for the canvass. 2. To explain the purpose of the canvass. C. “ Four minute” speeches in churches and theaters— 1. To explain the need for birth registration. 2. To urge the cooperation of the community for the canvass. D. Talks to school children, poster contests, prizes for essays on birth registration, etc. VII. The executive chairman names a subcommittee to draft and order blanks upon which the results of the investigation may be entered by the canvassers. A. A card 4 by 6 inches in size will be found convenient to handle. B. About 25 cards should be ordered for each 1,000 of the com munity’s total population. C. The following diagram for a record card shows the style of card that may be used and indicates the subjects to be covered by the investigation. D IAGRAM OF CARD FOR BIRTH-REGISTRATION CANVASS. [Face.] Birth-Registration T est........... ............ C i ty ..........................State. ............................ 2.............................................. (Fam ily nam e.) 3......... (Date of birth: Day,'¿ ¿ ¿ t h , year.) (Child’s given nam e.) 4. Living at canvasser’s visit (Yes, No). 5. If dead, give date of death......................... 6. Parent’s residence at time of child’s birth...................................... (N um ber, street, city, county, State.) 7. Parent’s present address: .................................................... 8. Father’s full name: .......................................... 9. R a c e :.......... ...................................... (W hite or colored.) 10. Birthplace: (United States, France, etc.) 11. Mother’s maiden name: ................................ ........ 12. R a c e :------ - - - - - .......... ...... ........................ (W hite or colored.) 13. Birthplace: (United States, France, etc.) 14. Attendant at birth: (physician, midwife, other)............... 15. Informant: . . . . . Remarks: Canvasser’s name........... .......................................................... X>ate 0f visit [Canvasser m ust not write below this line.] Birth registered (Yes, No). https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Birth-registration number, Serial number " 8 O U T L IN E F O R B I R T H -R E G I S T R A T I O N TEST. [Reverse.] INSTRUCTIONS TO CANVASSERS. f Obtain information concerning all babies live born between (here insert dates designating the 12 months preceding the month in which the canvass is held), in cluding those babies that have died. If possible, information should be obtained from one of the parents. Always write on the line. Be sure your writing is plain and that you have answered every question. Whenever an answer to an inquiry can not be obtained enter “ N . R .” (no report) in the proper place. Inq. 1. Try to obtain the correct spelling of the child’s family name. In foreign districts a baptismal certificate, or some other document, may solve the problem of spelling. Inq. 5. If the child is alive enter a dash after this inquiry. Inq. 14. Be sure to indicate clearly the attendant at birth, i. e., physician,” “ midwife,” “ father,” “ grandmother,” “ neighbor,” etc. Inq. 15. Enter the relation to the child of the person who gives the information, i. e., mother, father, aunt, etc. Remarks: Enter here such information as: “ Italian interpreter needed to secure information;” “ Child adopted— no information obtainable;” “ Parents refused any information, ” etc. A ll items below the heavy line will be filled in by the person who compares this card with the original birth record. (The Children’s Bureau offers the above form as a suggestion. It will be necessary for committees undertaking the test to have the card printed themselves, as the bureau has not issued any for free distribution.) VIII. The community is organized for the canvass. A. The executive chairman appoints ward or school district chair men who assume the responsibility for the work in their respective districts. B. The ward or district chairmen appoint block chairmen who assume the responsibility for the work on their respective blocks. In rural districts a neighborhood chairman will take the place of a block chairman. C. The block chairmen appoint canvassers to visit each house on the block and secure from the mothers the necessary information. 1. In foreign districts, thé block chairmen endeavor to secure canvassers who understand the language most commonly spoken. 2. If such canvassers are not to be procured and an adult interpreter is not available a child may be secured to act as interpreter. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis O U T L IN E 2T0B B I E T H -E E G I S T E A T I O N TEST. 9 IX . The executive chairman calls a meeting of all workers. A. To explain methods of investigation, making it clear that—■ 1. No inother is under any obligation to answer the questions asked. 2. That mothers are usually willing to give information— (a) If it is made plain that the information to be secured is absolutely confidential. (b) If the advantage of the inquiry to their children is made clear. (c) If the person asking for information is courteous and considerate. B. To explain methods of filling in the cards, emphasizing the value of—1 1. Neatness and legibility. 2. Accuracy. 3. Completeness. X . After the canvass has been made, the'cards are delivered by the block chairmen to the district chairmen and by the district chairmen, when all returns are in, to the central office. A. Both block chairmen and district chairmen should look over the cards before passing them on to see that they are legible and completely and accurately filled in. Cards that are not correct should be returned to the canvasser for correc tion. X I. A subcommittee is appointed to compare the cards with the official records. A. Cards for children not born in the locality are eliminated. B. The cards are arranged to conform with the system under which birth certificates are filed in the registrar’s office, i. e., by date, alphabetically, etc. 1. Cardboard file boxes which hold 1,000 cards each may be obtained for a very small sum. The cards should be filed in these and separated by dividers which bear the letters of the alphabet or the months of the year, according to the method of filing. C. The registrar is interviewed to find— 1. The most convenient time to consult his records. 2. The number of workers he can accommodate. (a) To avoid confusion the work of comparison should be intrusted to the supervision of a person experienced in the use of files or in office work, who can be trusted to leave the registrar’s records as she found them. (b) Not more than two or three persons should be appointed to work under the direction of the supervisor. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 10 O U T L IN E F O R B I R T H -R E G I S T R A T I O N TEST. X II. The executive chairman appoints a subcommittee to count the answers to the questions indicated on the .cards with a view to learning—■ A. Total number of babies born in community during period covered by investigation. B. Total number of registered births. C. Total number of unregistered births. D. Total number of babies of white parents.1 1. Number of these registered—not registered. E. Total number of babies of colored parents. 1. Number of these registered—not registered. F. Total number of babies whose mothers were attended by— 1. Physician. (a) Number of these registered— not registered. 2. Midwife. (a) Number of these registered—not registered. 3. Other. (a) Number of these registered—not registered. G. Total number of children born during period covered by investigation and living at time of investigation. 1. Number of these registered—not registered. H. Total number of children bom during period covered by the investigation and not living at time of investigation. 1. Number of these registered—not registered. ' I. If the information under any of these heads is lacking, that fact should be noted in a “ no report” group under each head. J. The total for each of the following groups added together, with the “ no reports” for each group, should be equal to the total number of births: T. B and C. 2. D and E. 3. D - l and E -l. 4. F -l, 2, and 3. 5. G and H. * In communities w ith a large foreign population a classification b y native and foreign parentage may be included. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis O U T L IN E F O E B I R T H -R E G I S T R A T I O N 11 TEST. iXIII. In a community of 100,000 population or less, results are counted as follows: A. Cards should be sorted to make sure that none that should have been eliminated have been included. B. To obtain total number of children born during period cov ered by investigation, cards should be numbered consecu tively in space after “ serial number” in lower right-hand corner of card. 1. In large communities an automatic numbering machine will be found useful. Such a machine may be bor rowed from a local stationer or may be purchased for $3 or $4. C. To obtain other totals. 1. Cards are sorted according to classification of desired total, arranged in piles of 50 or 100, and the bundles counted. D. All counting is done independently by two different persons and groups and the results verified to insure their cor rectness. [Specimen form for tabulation of results of birth-registration canvass.] .,7 9 . . find Test o f birth registration for births occurring between............. 1 9 ... Color.1 Total births. Live births. Stillbirths. White. Colored. Not reported. Num Per Num Per Num Per Num Per Num Per Num Per ber. cent. ber. cent. ber. cent. ber. cent. ber. cent. ber. cent. Total.................. 125 100.0 109 100.0 16 100.0 72 100.0 51 100.0 2 100.0 Registered................... Unregistered.............. 48 77 38.4 61.6 40 69 36.7 63.3 8 8 50.0 50.0 30 ■ 42 41.7 58.3 16 35 31.4 68.6. 2 100.0 Attendant at birth. Physician. Midwife. Other. Children living at time of investigaNot reported. tion. Num- Per Num- Per Num- Per Num- Per Num- Per ber. cent. ber. cent. ber. cent. ber. cent. ber. cent. Total.................. Registered................... Unregistered..................................... 73 100.0 45 100.0 34 39 46.6 53.4 14 31 31.1 68.9 3 3 100.0 100.0 4 4 100.0 104 100.0 100.0 39 65 37 5 62^5 1In communities with a large foreign population a classification by native and foreign parentage may be substituted for or added to the classification by color. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 12 O U T L IN E F O R B I R T H -R E G I S T R A T I O N TEST. X IV . In order to compare the adequacy of registration in different groups of the population, the percentage of unregistered births in the community as a whole and in each group should be determined. A. For example, to find what percentage of the births included in the canvass are registered, add two ciphers to the total number registered and divided by the total number of births. The percentage of those unregistered may be obtained similarly by adding two ciphers to the total number of unregistered births and dividing by the total number of births. The sum of the two percentages thus arrived at should equal 100. Similar reckonings should be made for each of the groups indicated. B. The results of the test can be shown truthfully only by percentages. It may easily be seen, for instance, that a comparison of registration among births attended by physicians and births attended by midwives, based on numbers and not on percentages would be misleading and unsound. HOW TO USE THE RESULTS OF THE BIRTH-REGISTRATION CANVASS. A birth-registration canvass is a necessary part of a community’s auditing, and citizens should take pride in having it done frequently and carefully. The canvass should be made the occasion for put ting before the public the value of birth registration and the need for making the local records complete. In many communities the canvass has been followed by a mass meeting at which the results of the investigation have been made public. At such a mass meeting graphic charts and posters should be used to illustrate the findings, and the problem of birth registration should be briefly discussed from different angles by competent speakers. A local lawyer may be willing to talk on the legal value of the birth certificate. A doc tor may speak on birth registration from the physician’s point of view. A social worker may discuss the relation of birth registration to the problems of inf ant-welfare work. A member of the school board may show how the birth certificate aids in the enforcement of the compulsory education laws. A speaker may be obtained who will point out the evils attendant upon the entry of young children in industry, and show how birth registration protects children from being put to work before the legal age. At the mass meeting the significance of the figures obtained through the canvass should be explained. If they sliow, for instance, that children of colored parents are not as frequently pro tected by birth registration as are the children of white parents, attention should be drawn to the need of a special campaign to https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis O U T L IN E F O R B I R T H -R E G I S T R A T I O N TEST. 13 acquaint the colored population with the advantages of birth regis tration. If the canvas has revealed that midwives are especially lax about reporting births, that fact should be emphasized, in order to arouse the attention of the midwives to the necessity for register ing all births which they attend. The names of individual doctors and midwives who have been lax about reporting births should not, of course, be made public, though in every case the attention of the offending person should be privately drawn to the law which demands a report of births. A copy of a model birth-registration law may be obtained from the United States Bureau of the Census, and if the State law does not seem, upon comparison with this law, to be adequate, that fact should be made public and an attempt should be made to arouse sentiment in favor of a new law. If the law is adequate but not properly enforced, parents should be urged to aid in its enforcement by insisting that the doctors and midwives report all births as the law requires. The number of babies who died during the year covered by the investigation may be used to draw attention to the need for infant-welfare work, and may, indeed, serve as a basis for a later study of infant mortality. In connection with the mass meeting and following it, as much newspaper publicity as possible should be obtained. In order not to permit the interest aroused by the canvass to lapse, certain “ follow-up” measures should be undertaken. In some commun ities, the names of registered babies are published in the newspapers daily or weekly. Parents read these lists, and if their children do not appear on them are led to ask the reason. In other communities the parents of each child whose birth has been registered are sent a birth certificate printed in such form as to make it desirable for preservation. In still other communities each mother whose baby’s birth is registered receives pamphlets on the care of the baby. All of these' methods are effective in keeping the importance of birth registration in the minds of the public. Some one of them should be adopted in every community where the canvass is held in order that the effort spent may result in permanent good. o https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis