Birth Registration and Birth Certificates: Report

2. Birth notification

Current law

2.1 The Births, Deaths and Marriages Registration Act 1996 (Vic) (the Act) and the Births, Deaths and Marriages Registration Regulations 2008 (Vic) (the Regulations)^[1] provide the statutory basis for the registration of births in Victoria. The Act requires that the Registry be notified of all births occurring in the State of Victoria.^[2] In addition to the requirement to notify the Registry, other legislation requires notification of a birth to other agencies: see [2.7]–[2.13].

2.2 Part 3 of the Act concerns the registration of births,^[3] and includes the requirement to give notice of a birth to the Registrar.^[4] The notice of the birth differs from the registration of birth. The requirement to register the birth and submit a birth registration statement is covered in Chapter 3.

2.3 The Act requires that a responsible person must give notice of any live birth to the Registrar within 21 days of the birth.^[5] The responsible person is:

• the chief executive officer of the hospital (where a child is born in a hospital or brought to hospital within 24 hours after birth)^[6]

• a doctor or midwife responsible for the care of the mother ^[7]

• where no medical practitioner was present, any other person in attendance at the birth.^[8]

2.4 There is provision in the Act for the Registrar to specify what particulars must be provided by a responsible person when giving notice of a birth.^[9] Information provided at the birth notification stage is basic, including details such as date of birth, mother’s name and address, sex of the baby, whether it was a multiple birth and whether the child was live

or stillborn.^[10]

2.5 In the case of a stillbirth, the Act requires that the Registrar be notified within 48 hours of the birth.^[11] When notice of a stillbirth is given, the person responsible must also give the Registrar a doctor’s certificate, in a form approved by the Registrar, certifying the cause of foetal death.^[12] The doctor’s certificate must be completed by the doctor responsible for the professional care of the mother or the doctor who examined the body of the stillborn child after birth.^[13]

2.6 The penalty for the failure to give notice of a birth is 10 penalty units.^[14]

Other legislative requirements for notification of a birth

2.7 In addition to the requirement to notify the Registrar under the Act,^[15] other legislation requires notification of a birth for other purposes.

2.8 The Child Wellbeing and Safety Act 2005 (Vic)^[16] requires notification of births to local councils for the purpose of the continuum of care with local maternal and child health services (MCH).^[17]

2.9 If a child is born in Victoria, but the mother resides outside Victoria, the Secretary to

the Department of Education and Early Childhood Development must be notified of

the birth.^[18]

2.10 The penalty for failure to provide notification under the Child Wellbeing and Safety Act is not more than one penalty unit.^[19]

2.11 The definition of a responsible person for the purpose of birth notification in the Child Wellbeing and Safety Act is the same as the definition in the Births, Deaths and Marriages Registration Act, as outlined in [2.3].^[20]

2.12 The Public Health and Wellbeing Act 2008 (Vic) requires that the Consultative Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM) be notified of a birth by the proprietor of a health service where the birth occurred or the attending midwife or medical practitioner, or other responsible person.^[21] The notification must be in an approved form^[22] and made within the prescribed period of 90 days.^[23] The CCOPMM data repository is held by the Victorian Perinatal Data Collection (VPDC) within the Department of Health, and contains a wide range of pre-partum and post-partum birth indicators for babies from 20 weeks gestation to 28 days post partum. The penalty for failing to notify CCOPMM is 10 penalty units.

2.13 The information required by each Act differs, and the methods of notification vary. Whether data is submitted by hospitals to the Registry and other agencies electronically or manually will depend largely on the size of the facility and its resources.

Requirement to notify CCOPMM of peri-natal death

2.14 If the Registrar is notified of a stillbirth, the Registrar has an obligation to notify CCOPMM and forward to CCOPMM any medical certificate in his or her possession or under his or her control relating to the stillbirth.^[24] In addition, the Public Health and Wellbeing Act also requires the Registrar to inform CCOPMM, and provide a certificate of death in the case of a neonatal death,^[25] child death,^[26] and maternal death.^[27]

2.15 The Registrar may also forward, or make available, any medical certificate in his or her possession, or under his or her control, relating to any peri-natal death to the Commonwealth statistician or to the secretary of the Department of Health.^[28] A peri-natal death means the death of a live-born child within 28 days after the birth or a stillbirth.^[29]

Historical notification of births, stillbirths and peri-natal deaths

2.16 Under the Registration (Births, Deaths and Marriages) Act 1853 (Imp), the father or mother of any child born, or the occupier of every house or tenement in which the birth occurred, was required to give notice of the birth to the deputy registrar of the district within 60 days of the birth.^[30]

2.17 If a newborn child was found abandoned, the chief or other constable of the district was required to give notice and information of the child found and of the place where the child was found to the chief registrar or to the deputy registrar of the district.^[31]

2.18 A person who failed or neglected to give the notice and information, without reasonable cause, was, for every such offence, liable for a sum not exceeding £10.^[32] The father or mother of every child born, or in the case of the death, absence or inability of the parents, the occupier of the house or tenement in which the child was born, was required, within 60 days of the birth, to provide the information to the deputy registrar according to the best of his or her knowledge and belief of the several particulars required to be known and registered.^[33]

2.19 The prescribed information included the child’s date and place of birth, name, and gender.^[34] The father’s full name and occupation, and the mother’s name and maiden name were also required to be notified.^[35] Further, the informant’s signature, relation to the child (if any), and residence was included.^[36]

2.20 If they refused or, without reasonable cause, neglected to give this information, they were liable to pay a penalty of not more than £10.^[37]

2.21 The Births Notification Act 1930 (Vic) provided additional requirements for the notification of stillbirths, ‘in the case of every birth of a child … whether the child is born alive or dead and whether prematurely or at full time, but shall not apply in the case of the delivery of a non-viable foetus’.^[38]

2.22 Under the Births Notification Act, the municipal clerk of the municipality in which the mother ordinarily resided was to be notified of the birth, in a form prescribed in a schedule to that Act.^[39] The form required the notifier to indicate whether the child was male or female, and whether she/he was delivered alive, dead, at full term or prematurely.^[40] On receipt of the notice, the municipal clerk was required to send a copy of the notice to the nurse whose duty it was to visit the house to which the notice related.^[41]

2.23 There was a penalty for failing to notify,^[42] and the Births Notification Act specified that the notification was in addition to, and not a substitute for, any requirements for registration of the birth.^[43]

Current practice

2.24 When a child is born in a hospital or birth centre, or the birth is attended by a qualified medical practitioner or midwife, a birth report^[44] must be completed. Information about the birth is also entered on the relevant hospital patient database. Many Victorian hospitals use a facility called the Birthing Outcomes System (BOS) to collate and extract data.^[45]

2.25 On admission to hospital, all patients are issued with a universal record number. This number stays with the patient to enable easy identification and tracking within, and between, hospital systems. Patient details are entered into a Patient Administration System (PAS) of which there are several types used in Victoria.^[46] The BOS system can be pre-populated with information from the relevant hospital PAS or data can be entered directly into the BOS.^[47]

2.26 The hospital or birthing centre where the birth occurs (or private practitioner in cases of home births) is responsible for sending birth data to different bodies under the statutory reporting requirements discussed in the section above. For the purposes of satisfying the requirement to notify the Registry, information is extracted from the hospital patient database and sent directly to the Registrar either manually or via an electronic transfer of data or secure data exchange.

2.27 The CCOPMM, which has statutory responsibility for the administration of the VPDC, must also be notified.^[48] The VPDC receives birth reports either electronically or manually from sites (generally hospitals) or independent midwives who attend home births. This notice is generally provided 30–90 days post partum.^[49]

2.28 In addition to the Registrar and the CCOPMM, the local municipal authority must be notified of a child’s birth.^[50] The local authority is responsible for running MCH centres in its municipality and will notify the centre closest to the address where the child lives.^[51] The maternal and child health nurse will then contact the mother in the first instance and offer a health visit within the child’s first week at home. In the case of a stillbirth, or a child who has yet to be discharged from hospital, a note to this effect may accompany the notification to ensure contact with the child’s parents is appropriate and does not cause further distress.^[52]

2.29 It is also current practice that the mother’s nominated general practitioner (if there is one) or shared maternity care affiliate (in shared care arrangements) will also be notified. The notification to the general practitioner will usually occur within 48 hours of discharge and be accompanied by a hospital discharge form.

2.30 The Commission was advised during consultation with health care professionals that no universal system of birth notification exists. Some sites submit information manually and some electronically, through a secure data exchange.^[53] The system used is largely determined by the size of the hospital, its available resources, and the sophistication of the hospital’s data collection systems.

2.31 Information is extracted from the birth report and/or hospital patient databases under different reporting requirements and only to the extent authorised by the relevant legislation. For example, the VPDC requires detailed birth data on labour and birth events, obstetric conditions, procedures and outcomes, neonatal morbidity and birth defects. The majority of data items, of which there are over 100, comply with the Perinatal National Minimum Data Set^[54] and are sent to the National Perinatal Statistics Unit (at the Australian Institute of Health and Welfare) for the Australia’s Mothers and Babies annual report.^[55]

2.32 Maternal and child health services provided by the local council collect a limited range of indicators such as: the mother’s name, address and telephone number; gestational period and gender of child; what complications, if any, mother or child experienced; whether there was an admission to a special care nursery; mother’s Indigenous status; and whether an interpreter may be required.

2.33 The Registry currently requires notification of basic information only (as outlined earlier in this chapter). Once a birth registration statement is submitted by one or both parents or another suitably qualified informant, the information is matched to the earlier notification provided by the responsible person. The matching of the notification to the birth registration statement completes the registration process.

2.34 All Australian states and territories have largely consistent birth notification, registration and birth certificate legislation.^[56] The National Parliamentary Counsel’s Committee refers to this type of uniform legislation as mirror model provisions.^[57] Appendix E outlines birth registration and birth certificate law and practice in other Australian jurisdictions.

2.35 For comparative purposes Appendix F discusses differences in practice in three international jurisdictions—England and Wales, New Zealand and Ontario, Canada.

Births that are not notified

2.36 In 2009, over 99 per cent of babies born in Victoria were born in a hospital or birth centre. 0.4 per cent of births were registered as home births attended by a midwife in private practice.^[58] 0.4 per cent of babies were registered as unplanned out-of-hospital births.^[59] These births may not be notified to authorities in the first instance because they may have occurred without an attendant medical practitioner.

2.37 While the legislation accounts for mothers and babies who present at a hospital within 24 hours following birth, the process for notification where babies are not admitted to hospital at all, or not until after the 24-hour mandatory notification period, is unclear.

2.38 Under the Act, this responsibility falls to a person present at the birth. The Commission is unaware of any person being penalised in practice for failing to notify the appropriate authorities of a birth. In most cases where a child is not born in a hospital or birth centre, the attendant medical practitioner (generally the midwife) will notify the closest hospital or centre of the birth shortly after it occurs.^[60]

2.39 The number of births that are not notified to the Registry is not known, but is likely to be very small. Most births occur in a hospital, birth centre or at home with a midwife in attendance. In these circumstances there are formal notification processes in place.

Community responses

Particulars required by the Registrar

2.40 In the consultation paper, the Commission asked what particulars should be required at the birth notification stage by the Registrar from the responsible person. As noted in the previous section, only basic information is currently required.

2.41 Some consultation participants felt that it would assist with statistical collection and highlight anomalies in registration if the Registry required more particulars from hospitals about the mother and child’s ethnicity at birth. This could include whether the mother identified as an Indigenous person.^[61] It was also suggested that indicators of other ethnicities could be collected.^[62] Respondents acknowledged the sensitivity of raising Indigenous status.^[63]

2.42 Others felt that additional particulars required should include the mobile phone number of the mother as well as the next-of-kin details, and/or father’s details if known/present at birth.^[64] It was suggested that this information could help the Registry when attempting to follow up a birth that had not been registered within the 60-day timeframe.^[65]

2.43 The Commission was advised that the advantage of obtaining a mobile phone number was that a residential address will often change, especially in the case of disadvantaged persons who may be in temporary accommodation at the time of the child’s birth.^[66] It was noted that a phone number, particularly a mobile phone number, has often been found to be the most reliable form of contact, by nurses and other health care professionals.^[67]

2.44 One concern raised in the Commission’s preliminary consultations was that additional reporting requirements may be unreasonably onerous on health care providers. However, the Commission heard in consultations with hospital staff that hospitals already routinely collect a range of patient information on admission (including Indigenous status, mobile phone number and next-of-kin details) and that this information is already available in most hospital online systems.^[68]

Commission’s view

2.45 The Act currently provides discretion to the Registrar to determine what particulars are required in the birth notification form from the ‘responsible person’.^[69]

2.46 Providing additional particulars to the Registrar at notification stage would increase the data available about births at the birth event stage rather than waiting for registration, and so capture more detail about those births which are not registered. This data may help in identifying particular groups who are not registering the birth of their child, and who may need additional assistance or targeted programs.

2.47 Including a mobile phone number, and details of the father and next of kin, could help the Registry to follow up late registrations.

2.48 The Commission would not want the collection of additional particulars to be onerous for health care providers. However, as discussed above at [2.44], much of this information is already routinely collected and could be easily extracted without requiring any changes to hospital admission procedures or existing forms.

2.49 The Commission notes that the provision of additional information should be identified as optional, allowing health care providers to leave blank those details which they do not currently collect or that their client has not provided, rather than placing an obligation on the provider to collect additional information.

2.50 The Commission notes that in some jurisdictions the particulars required at notification and registration are included in regulations, for example, New South Wales^[70] and the Northern Territory.^[71] The Commission does not consider that an obligation to include additional particulars within regulation is warranted at this stage.

Recommendation

1 The Registrar should request the following information in the

birth notification:

• details of the father

• the Indigenous status of the mother and father

• details of the next of kin (if known)

• a contact telephone number (mobile or landline).

Provision of this information should be optional.

Use of notification particulars in the birth registration statement

2.51 Several consultation participants suggested that the particulars provided to the Registrar at the time of notification could be used to pre-populate fields in the birth registration statement.^[72] It was suggested that this would help parents in registering the birth of their child and avoid the need for them to provide the same details to both the hospital and the Registrar. Supporters of this approach envisaged a larger range of particulars being extracted from the hospital system, and supplied to the Registrar, in the first instance.

2.52 The Commission notes the views expressed during consultations. However, the Commission is of the view that the inclusion of notification particulars to pre-populate fields in the birth registration statement would require significant changes to the way in which the notification and registration system and responsibilities currently operate. As such, the Commission does not make recommendations to this effect.

Verification of the birth for the purpose of registration

2.53 During consultations the Commission heard that hospitals are asked to check hospital records by parents, and on occasion the Registry is asked to confirm whether a child was born in the facility. These requests usually relate to births that are known to have occurred some time ago, possibly several years prior, at the hospital but that have not subsequently been registered.^[73]

2.54 Staff of the Royal Women’s Hospital informed the Commission that they have received calls from parents seeking confirmation of the birth of their child at the hospital for the purpose of obtaining a birth certificate for school enrolment. In these cases, the hospital staff regenerate birth information from the database and supply this to the parents to enable them to complete the birth registration statement.^[74]

Birth notification under other legislative schemes and in other jurisdictions

2.55 Concerns were raised in some submissions and during consultations about the requirement to notify the local authority of a birth under the Child Wellbeing and

Safety Act.^[75] These concerns related to both the particulars required under the legislation and the process for notification. As the Child Wellbeing and Safety Act is not within the terms of reference for this review, the Commission is unable to comment further on the issues raised.

1. These regulations came into effect on 28 September 2008 and replaced the previous 1997 regulations.

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2. Births, Deaths and Marriages Registration Act 1996 (Vic) s 12(1).

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3. Ibid pt 3.

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4. Ibid div 1, s 12.

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5. Ibid ss 12(1), (3)(a).

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6. Ibid s 12(6)(a).

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7. Ibid s 12(6)(b)(i).

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8. Ibid s 12(6)(b)(ii).

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9. Ibid s 12(1).

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10. Letter from Erin Keleher, Victorian Registrar of Births, Deaths and Marriages to the Hon P.D. Cummins, Chair, Victorian Law Reform Commission, 21 February 2013.

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11. Births, Deaths and Marriages Registration Act 1996 (Vic) s 12(3)(b).

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12. Ibid s 12(4).

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13. Ibid s 12(5).

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14. Ibid s 12(1). Penalty units are prescribed by the Monetary Units Act 2004 (Vic) s 5(3). They are CPI-indexed and for the 2012–13 financial year (until 30 June 2013) are $140.84 per unit: Office of the Chief Parliamentary Counsel, Penalty and Fee Units (19 April 2013)
    
    <http://www.ocpc.vic.gov.au>.

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15. Child Wellbeing and Safety Act 2005 (Vic) s 42(2).

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16. Ibid s 43(1).

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17. Department of Human Services (Victoria), Continuity of Care Protocol: A Communication Protocol for Victorian Public Maternity Services and the Maternal Child Health Service (2004). Maternal and child health (MCH) was moved from the Department of Human Services (DHS) to the Department of Education and Early Childhood Development (DEECD) in 2007. From 27 August 2007 documents published by DHS with regards to MCH policy and services fall within the remit of DEECD. The Continuity of Care Protocol is currently under review: Department of Education and Early Childhood Development (Victoria), Policy and Reports (4 February 2013) <http://www.education.vic.gov.au>.

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18. Child Wellbeing and Safety Act 2005 (Vic) ss 43(1)(c), 45.

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19. Ibid s 46(1).

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20. Ibid s 43(3).

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21. Public Health and Wellbeing Act 2008 (Vic) s 48.

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22. Ibid. The Consultative Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM) is the advisory body to the Minister for Health on maternal, peri-natal and paediatric morbidity and mortality.

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23. Public Health and Wellbeing Regulations 2009 (Vic) reg 11.

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24. Births, Deaths and Marriages Registration Act 1996 (Vic) s 49B(1)(a).

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25. Ibid s 49B(1)(b).

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26. Ibid s 49B(1)(c).

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27. Ibid s 49B(1)(d).

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28. Ibid s 21.

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29. Ibid s 4.

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30. Registration (Births, Deaths and Marriages) Act 1853 (Imp) s VIII.

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31. Ibid.

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32. Ibid.

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33. Ibid s IX.

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34. Ibid sch A.

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35. Ibid.

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36. Ibid.

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37. Ibid s IX.

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38. Births Notification Act 1930 (Vic) ss 3(1)–(2). ‘Non-viable foetus’ was not defined.

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39. Ibid s 4(1).

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40. Ibid sch.

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41. Ibid s 4(2)(b).

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42. Ibid s 4(3).

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43. Ibid s 5.

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44. A birth report is designed to collect information in relation to the health of the mother and baby. It contains information on obstetric conditions, procedures and outcomes, neonatal morbidity and birth defects relating to every birth in Victoria of 20 weeks gestation or more, or 400 grams or more birth weight. The birth report is used for peri-natal data collection and is completed by all hospitals, birth centres and midwives in private practice, manually or electronically, and submitted via the HealthCollect secure web-based interface at Department of Health (Victoria), HealthCollect Portal (6 July 2011) <https://www.healthcollect.vic.gov.au> or Consultative Council on Obstetric and Paediatric Mortality and Morbidity, Forms (18 March 2013) <http://www.health.vic.gov.au>.

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45. The Birthing Outcomes System (BOS) is a clinical management information system designed to capture comprehensive details about mother and baby during a pregnancy. One of the main objectives of the system is to ‘meet the statutory reporting requirements associated with Birth Registration, Statutory and Perinatal reporting and clinical audit’. BOS has been used by hospitals, midwives and clinicians in conjunction with day-to-day clinical practice since 1990: Management Consultants and Technology Services, About Us
    
    <http://www.mcats.com.au/>.

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46. Consultation 22 (MCH Team Meeting, Traralgon).

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47. Ibid.

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48. Public Health and Wellbeing Act 2008 (Vic) s 48. The VPDC was established as a population-based surveillance system to collect and analyse information on, and in relation to, the health of mothers and babies, in order to contribute to improvements in their health.

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49. Public Health and Wellbeing Regulations 2009 (Vic) reg 11.

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50. Child Wellbeing and Safety Act 2005 (Vic) s 43.

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51. Ibid s 45(a). See also Municipal Association of Victoria, Maternal and Child Health <http://www.mav.asn.au>.

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52. Consultation 32 (Mercy Hospital for Women).

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53. Electronic transfer of birth data commenced in 2009, with 80 per cent of health services currently using this mechanism. Birth data is securely submitted to the VPDC either via a computerised hospital system using a secure data exchange portal or via the hard-copy birth report form.

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54. The Perinatal National Minimum Data Set is a nationally agreed framework for mandatory collection and reporting at a national level. These core data elements are agreed to by the Statistical Information Management Committee and endorsed by the National Health Information Management Principal Committee. See further information published by the Australian Institute of Health and Welfare on its website <http://www.aihw.gov.au>.

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55. Australian Institute of Health and Welfare, Australia’s Mothers and Babies 2010 (2012).

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56. Births, Deaths and Marriages Registration Act 1995 (NSW); Births, Deaths and Marriages Registration Act 1996 (SA); Births, Deaths and Marriages Registration Act 1996 (Vic); Births, Deaths and Marriages Registration Act 1997 (ACT); Births, Deaths and Marriages Registration Act 1998 (WA); Births, Deaths and Marriages Registration Act 1999 (Tas); Births, Deaths and Marriages Registration Act 2003 (Qld); Births, Deaths and Marriages Registration Act 1996 (NT).

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57. Parliamentary Counsel’s Committee, Protocol on Drafting National Uniform Legislation (3rd ed, July 2008).

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58. Consultative Council on Obstetric and Paediatric Mortality and Morbidity, Annual Report for the Year 2009 (2012) 55.

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59. Ibid.

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60. Consultation 22 (MCH Team Meeting, Traralgon).

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61. Consultations 10 (MCH Team Meeting, Flemington); 21 (MCH Team Meeting, Warragul).

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62. Consultations 10 (MCH Team Meeting, Flemington); 26 (Gippsland East Aboriginal Driver Education Program).

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63. Consultation 21 (MCH Team Meeting, Warragul).

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64. Consultations 21 (MCH Team Meeting, Warragul); 26 (Gippsland East Aboriginal Driver Education Program).

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65. Consultation 23 (MCH Team Meeting, Bairnsdale).

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66. Consultations 5 (MCH Team Meeting, Shepparton); 22 (MCH Team Meeting, Traralgon).

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67. Consultation 21 (MCH Team Meeting, Warragul).

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68. Consultations 10 (MCH Team Meeting, Flemington); 22 (MCH Team Meeting Traralgon).

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69. Births, Deaths and Marriages Registration Act 1996 (Vic) s 12(1).

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70. Births, Deaths and Marriages Registration Regulation 2011 (NSW) regs 4, 5.

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71. Births, Deaths and Marriages Registration Regulations 1996 (NT) regs 2, 3.

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72. Consultations 18 (New Parents Group, Dandenong North); 21 (MCH Team Meeting, Warragul).

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73. Consultations 14 (Mildura Base Hospital); 31 (The Royal Women’s Hospital).

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74. Consultation 31 (The Royal Women’s Hospital).

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75. Submission 1 (Cathy Arndt).

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