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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'

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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


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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


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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 %

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B.

F O E B I R T H -R E G I S T R A T I O N

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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.

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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).


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Birth-registration number,

Serial number

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[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.


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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.

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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.


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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.


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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


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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


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