General Information

Introduction

This handbook describes birth registration in the Texas vital registration system. It provides instructions for completing and filing birth certificates along with related permits.

A birth certificate is a permanent legal record of an individual’s birth. The birth certificate is an individual’s basic claim and proof of citizenship, identification and relationship to his or her parent(s). It serves as the primary document for individuals to enter school, play little league sports, obtain a social security number and account, a driver’s license, a marriage license, a passport, and to prove citizenship to be qualified to work in this country.

In addition to being the primary document of identification for an individual, a birth certificate provides information used in a variety of medical and health-related research efforts. Birth statistics are used to assess the general health of Texas citizens. Birth statistics also help identify adequacy of prenatal care, pregnancy outcome based on birth weight and length of gestation, abnormal conditions of mothers and babies and specific geographic concerns.

Because birth statistics are no more accurate than the information submitted on the birth certificate it is very important that all birth certificates be completed and filed with accuracy and promptness.

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Registration Requirements

A Certificate of Birth (VS-111) must be filled within five (5) days of the date of birth for every live birth in Texas [HSC §192.003 (d)]. The Certificate of Birth should be registered with the State of Texas – Vital Statistics Unit though the Texas Electronic Registration (TER) system. Persons responsible for registering births will need to sign up for TER and will receive a user ID and password. To sign up for TER go to Texasvsu.org

The Texas Administrative Code (TAC) defines a “live birth” as the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy, which, after such separation, breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered live born. [25 TAC §181.1(18)] A Certificate of Birth must be filed for all live births regardless of length of gestation or chance of survival.

Should the infant die after being determined a live birth, a Certificate of Death (VS-112) must also be filed. For instructions on completing a Certificate of Death, see the Handbook on Death Registration.

When a fetal death occurs, then a certificate of birth would not be filed, the Certificate of Fetal Death (VS-113) would be filed. The Texas Administrative Code defines a “fetal death” as death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after such separation, the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles [25 TAC §181.1 (11)]. See the Handbook on Fetal Death Registration for instructions on completing the Certificate of Fetal Death.

The birth certificate must be filed by the attendant at birth. If the birth occurs in a licensed institution (hospital, birthing center), an administrator may file the certificate. If the birth occurs in a non-licensed institution (occurs outside of a licensed institution) and was attended by a registered, certified or documented health care provider (doctor, Midwife, EMT) the birth may be registered by the attendant or by the local registrar after he/she have presented their professional documentation. If the birth occurs in a non-licensed institution and a registered attendant is not present, the birth should be registered by the father or mother of the child or the owner/ householder of the premises where the birth occurred. Documentation is required from the parent(s) before a birth certificate may be filed. Chapter 4 of this handbook provides detailed filing information.

Births must be filed using TER or the forms prescribed by the Department of State Health Services (DSHS), Vital Statistics Unit. The most recent revision of the form must be used.

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Confidentiality / Certified Copies

Requests for information registered in the TER system on Certificates of Birth is considered confidential. Certified copies may be issued only to properly qualified applicants who have submitted proof of their identification and have fully identified the record requested.

The fact of birth (name, date and place) of an individual is public knowledge; however, the birth certificate is not. A birth certificate is a confidential record for the first 75 years after filing and may be released only to a properly qualified applicant. [HSC §191.051 (a); 25 TAC §181.1(2); GC §552.115] A certified copy of a birth certificate includes only the upper “legal” portion down to and including the registrant’s signature.

In addition to the demographic information, information held under the section entitled “Confidential Information for Medical and Public Health Use” are confidential and are not considered open records for the purpose of the open records law. That information, including parents’ signatures and social security numbers, are not included in a certified copy and may not be released or made public on subpoena or otherwise, except for statistical purpose, where no person, patient, or facility is identified. [HSC §192.002 (b)]

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Penalties

It is a Class A misdemeanor if a person knowingly discloses the medical or health information, or knowingly induces or causes another to disclose information. It is a Class C misdemeanor if a person refuses or fails to furnish any correct information in the person’s possession affecting a certificate. It is also a Class C misdemeanor if a person fails, neglects, or refuses to fill out and file a birth certificate with TER, the local registrar or deliver the certificate upon request to the person with the duty to file it. To falsely obtain, use, or alter another person’s Certificate of Birth is a third degree felony.

Licensed Institution Responsibilities

A birth that occurs in a licensed institution (hospital, birthing center) may be registered in TER by the hospital administrator, the birthing center administrator, or a designee of the appropriate administrator in lieu of the physician or midwife in attendance of the birth. [HSC §192.003 (b)]

The responsibilities of the person registering the birth at a licensed institution (hospital, birthing center) in the birth registration process are as follows:

• Obtain information needed for completion of the birth certificate from appropriate sources. Sources include the mother of the child, mother’s physician, infant’s physician, or medical records. Information may be obtained from the immediate family or other sources as needed.
• Complete a Certificate of Birth for each live birth that occurs in the hospital or en route to the hospital.
• If the parents are not married to each other, provide whenever possible an opportunity for the father to acknowledge paternity, including the Acknowledgment of Paternity (AOP) form and the required oral and written notification of rights and responsibilities.
• Inform the parents that they may request an application for child support services by calling the Office of Attorney General at 1-800-252-8014.
• Review the certificate and AOP if applicable, for completeness and accuracy and fax into VSU at 1-888-561-3138.
• Obtain the appropriate parents’ signatures on the Verification of Birth Facts document.
• File the certificate in TER within five (5) days from the date of birth. [HSC §192.003]
• Cooperate with the Vital Statistics Unit (VSU) and local registrars concerning queries on certificate entries.
• Instructions for filing a birth certificate in TER can be found at Texasvsu.org

Contact help-TER [@] dshs.state.tx.us for technical assistance with TER.

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Midwife Responsibilities

A birth that is performed with a Midwife may be registered in TER by the midwife or designated registrant. If the midwife is not a TER participant he/she will need to register the birth as a paper record.

Midwives must be documented each March with the Texas Department of State Health Services (DSHS – formerly TDH). [Title 25 TAC §37.175] The Certificate of Birth should be filed in TER or with each local registrar in whose district he or she intends to deliver births. [Title 25 TAC §81.26 (1)] after his/her health department documents have been provided to the local registrar.

The responsibilities of the midwife in the birth registration process are as follows:

• Midwives must be documented each March with the Texas Department of Health. [Title 25 TAC §37.175]
• Obtain information needed for completion of the birth certificate from appropriate sources. Sources include the mother of the child, mother’s physician, infant’s physician, or medical records. Information may be obtained from the immediate family or other sources as needed.
• Complete a Certificate of Birth for each live birth that the midwife attended.
• If the parents are not married to each other, provide whenever possible an opportunity for the father to acknowledge paternity, including the Acknowledgment of Paternity (AOP) form and the required oral and written notification of rights and responsibilities.
• Inform the parents that they may request an application for child support services by calling the Office of Attorney General at 1-800-252-8014.
• Review the certificate and AOP if applicable, for completeness and accuracy
• If applicable fax AOP into VSU at 1-888-561-3138.
• Obtain the appropriate parents’ signatures on the Verification of Birth Facts document.
• File the certificate in TER within five (5) days from the date of birth. [HSC §192.003]
• Cooperate with the Vital Statistics Unit (VSU) and local registrars concerning queries on certificate entries.
• Instructions for filing a birth certificate in TER can be found at Texasvsu.org

Contact help-TER [@] dshs.state.tx.us for technical assistance with TER.

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Non-Licensed Institution Responsibilities

Non-Institutional Birth Attended By A Registered, Certified Or Documented Health Care Provider.

A birth that occurs in a non- licensed institution (any institution that is not licensed) should be registered by the attendant.

If the birth is attended by a registered, certified or documented health care provider, such as a midwife, doctor, or EMT, the birth may be registered by the attendant after he or she has presented his or her professional documentation to the local registrar.

The responsibilities of the registered, certified or documented health care provider in the birth registration process are as follows:

• Presented his or her professional documentation to the local registrar.
• Obtain information needed for completion of the birth certificate from appropriate sources. Sources include the mother of the child, mother’s physician, infant’s physician, or medical records. Information may be obtained from the immediate family or other sources as needed.
• Complete a Certificate of Birth.
• If the parents are not married to each other, provide whenever possible an opportunity for the father to acknowledge paternity, including the Acknowledgment of Paternity (AOP) form and the required oral and written notification of rights and responsibilities. Inform the parents that they may request an application for child support services by calling the Office of Attorney General at 1-800-252-8014.
• Review the certificate and AOP if applicable, for completeness and accuracy.
• If applicable fax AOP into VSU at 1-888-561-3138.
• Obtain the appropriate parents’ signatures on the birth certificate (VS-111).
• File the certificate in within five (5) days from the date of birth with the local registrar. [HSC §192.003]
• Cooperate with the Vital Statistics Unit (VSU) and local registrars concerning queries on certificate entries.
• Instructions for filing a birth certificate in TER can be found at Texasvsu.org

Contact help-TER [@] dshs.state.tx.us for technical assistance with TER.

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Non-Institutional Birth Not Attended By A Registered, Certified Or Documented Health Care Provider.

If there is no physician, midwife, or person acting as midwife in attendance at a non-institutional birth, documentation is required from the parent(s) before a birth certificate may be filed.

In an effort to control fraudulent filings of birth records and to place control over blank forms, the Texas Vital Statistics Unit (VSU) and Texas Board of Health developed and approved rules for filing birth certificates for children born outside licensed institutions. [25 TAC §181.26] To insure uniform compliance throughout the state, VSU developed the following administrative comments and instructions.

To file a birth certificate with the appropriate local registrar the following proof must be presented to the local registrar by the person in attendance at the birth in the following order of preference:

1. The father or mother of the child; or
2. The owner or householder of the premises where the birth occurs.

The registrar may provide to the person filing the birth record a “Mothers Work Sheet” in order to gather the information to be placed on the birth record.

A birth a birth certificate can be filed only upon personal presentation of the following evidence.

Note: Only one affidavit of personal knowledge of one of the four items should be used.

Proof Of Pregnancy, Presented In Following Order Of Preference;

1. An affidavit (notarized) presented from a licensed, registered, or certified health care provider who is qualified to determine pregnancy as part of the scope of his or her license or registration, or certification; or
2. An affidavit of personal knowledge (notarized) along with photocopy of ID (for example, a driver’s license or government ID, etc.) presented from one person, other than the parents, having knowledge of the pregnancy/birth

Proof That The Infant Was Born Alive;

1. A medical record or a letter from a licensed, registered, or certified health care provider or medical institution; or
2. An affidavit of personal knowledge (notarized) along with photocopy of ID (for example, a driver’s license or government ID, etc.) presented from one person, other than the parents, having knowledge of the pregnancy/birth.

Proof That The Infant Was Born In The Registration District;

• If the birth occurred outside the mother’s primary place of residence, proof shall consist of an affidavit (notarized) along with a photocopy of ID from a person having knowledge of the mother’s presence in the registration district on the date of the birth.
• If the birth occurred in the mother’s primary place of residence, proof of residence in the following order of preference:
  1. A utility bill, telephone, or other bill which includes the mother’s name and address;
  2. A rent receipt which includes the mother’s name, address, and signature of the mother’s landlord;
  3. A driver’s license, or state issued identification card, which includes the mother’s current address on the face of the license or card;
  4. An envelope addressed to the mother at her place of residence, and post marked prior to the date of birth; or
  5. An affidavit of personal knowledge (notarized) attesting to the mother’s place of residence along with a photocopy of ID from a person, other than the father, who was either living with the mother at the time of the alleged birth, or has other knowledge of the mother’s residency.

Proof That The Infant Was Born On The Date Stated.

• A medical record or a letter from a licensed, registered, or certified health care provider or medical institution; or
• An affidavit of personal knowledge (notarized) presented from one person along with photocopy of ID, other than the parents, having knowledge of the pregnancy/birth.

Other Supplemental Information Proving Home Birth

At the discretion of the local registrar, these procedures may be supplemented with any additional requirements needed to verify the circumstances of the birth. Additional requirements may include, but are not limited to, one or more of the following:

• An unannounced visit by a public health nurse, other health professional, registrar staff, or other person including city, county, state, or federal law enforcement officers, prior to registering the birth. This paragraph does not permit nor give authority to enter these premises unless permission is obtained from the occupant at the time of the visit;
• Multiple forms of identifying documents, with or without photographs, when the documents described in this section are unavailable;
• Personal appearance of both parents, either together or separately; or
• Personal appearance of the infant whose birth certificate the parents are attempting to file

Any person who cannot meet the documentation requirements should be referred to the State Registrar and the Fraud Prevention Program. See the information under “Persons and/or Records Not Meeting Requirements for Filing.”

The documentation that has been submitted as proof should be returned to the person filing the record after the birth record is accepted.

Each local registrar must notify the Fraud Prevention Program of any suspicious documents or records submitted or filed with his or her office.

If the individual(s) attempting to file the birth records of a child not born in an institution cannot meet the four essential elements required for filing (proof of pregnancy, proof the infant was born alive, proof the infant was born in the registration district, and proof the infant was born on the date stated), the local registrar will forward the record and all documentation to the State Registrar for his or her determination.

• The local registrar will send a cover letter with the documentation explaining why he or she cannot accept the record for filing.
• The local registrar will give a letter to the parent(s) and/or person trying to file the record telling them why he or she cannot accept the record for filing and that the request and documentation have been sent to Austin for the State Registrar’s determination.