102 BIRTH REGISTRATION 



beginning- in Ohio, and will be taken up in Missouri ; these States 

 have had the model law in force for a much shorter time than 

 Pennsylvania. But in the great majority of States the com- 

 pulsory enforcement of the provisions of the laws for the reg- 

 istration of births by means of the penalties provided for 

 noncompliance is practically a dead letter, and is solely respon- 

 sible for the worthless character of our statistics of births and 

 the utter absence of any reliable figures for infantile mortality. 

 Pennsylvania has pointed the way, and the more progressive 

 States will surely follow. It should be the great opportunity of 

 this Association to aid, to the full extent of its power, in sup- 

 porting the effective official enforcement of registration laws 

 compelling physicians and mid-wives to register ALL births, 

 because, in addition to all the other reasons for such registra- 

 tion, the work of saving the lives of infants and children is 

 seriously impeded by the lack of reliable statistics of infant 

 mortality due to official slovenliness and neglect of duty. 



What this Association should not do, nor should any other 

 organization not familiar with registration work and the prac- 

 tical requirements of effective administration of registration 

 laws undertake to do, is to attempt to introduce changes in 

 methods of registration or to modify the form of the standard 

 blanks used as certificates of birth and death without the most 

 careful consideration and full consultation with the organized 

 registration officials of the United States (Section on Vital Stat- 

 istics of the American Public Health Association), the Amer- 

 ican Medical Association, and the Bureau of the Census, which 

 represents the Government in this matter. Some very unwise 

 changes in State law have been made, such, for example, as 

 reducing the limit of registration of births to 36 hours for rural 

 districts in a State where even the enforcement of the provision 

 for 10 days or 5 days after birth had notoriously failed. It is 

 worse than useless to attempt to secure effective birth regis- 

 tration, not by enforcing the plain provisions of existing law, 

 but by setting a lower, and in the judgment of the most experi- 

 enced registration officials an unreasonably low limit, under 

 which, of course,, there will simply be many more unpunished 

 violations of law. The limit in the model law is, for a State, 

 10 days. It might be possible to enforce a 5-day, or even in 

 time a 3-day, limit over an entire State area, but until a 10-day 

 limit has been thoroughly enforced in practice in one or more 

 States, it is ill advised to advocate a limit that would be even 

 more difficult to enforce, and that the courts might not be dis- 

 posed to sustain as a reasonable requirement. It is, of course, 

 proper to require a very short interval in a city, and one that 



