( J8 BIRTH REGISTRATION 



throughout the greater part of this nation, in depriving the chil- 

 dren and citizens of the most fundamental of all vital and in- 

 dustrial statistics, the record of births. 



"In New York city some years ago, Dr. Ernst J. Lederle, the 

 Health Commissioner, introduced a simple device for forcing 

 doctors to record births. Whenever a child's death certificate 

 was filed, the birth records were searched for its birth certificate. 

 If the child's birth had not been recorded, the family was ques- 

 tioned as to the doctor or mid-wife, and a warning sent to the 

 offender that the next failure to record a birth would be fol- 

 lowed by publicity and prosecution. Immediately the [apparent] 

 birth rate rose not because more children were born, but be- 

 cause a simple workable device was installed for compelling 

 registration." 



Your committee has emphasized certain passages in this state- 

 ment because they go to the heart of the question of effective 

 registration of births, which would enable dependable ratios of 

 infantile mortality to be computed for the special service of this 

 Association, as well as of all the official public health agencies, 

 in the work of saving the lives of our American-born babies. 

 Our native-born children of native parents are as worthy of 

 protection as the children of any other country, and the children 

 born to foreign-born parents in this country should have the 

 same safeguards about their cradles as if they had been born 

 in a foreign land. America should not mean barbarity in its 

 relation to infant life. The aegis of protective civilization should 

 rest upon the infant of American birth, and a proper record be 

 made of the vital events of his life for his personal protection, 

 legal use, and for the most important sanitary information which 

 can alone be obtained from such records. 



Not even the records in New York city, the second largest 

 city in the world in the magnitude of its population, are yet 

 complete. In the last report of the Department of Health it is 

 stated that "the returns of births in this city are not complete," 

 there being "still many that are not recorded by reason of the 

 neglect of the medical attendants and mid-wives;" while as to 

 comparisons with previous years or periods so that it can be 

 ascertained what the course of infantile mortality has been, 

 "the absence of anything like complete returns of births in this 

 city in previous years prevents the preparation of a table pos- 

 sessing rates" suitable for that purpose. A disgraceful condition 

 in the history of American sanitary progress at the end of the 

 first decade of the Twentieth Century! And when questions of 

 public health have come so largely into the public eye some- 

 times even to the extent of constituting fads! Yet New York 



