baby registry: Fee-based birth registry skews statistics: doctor

Updated Tue. May. 23 2006 5:34 PM ET

Canadian Press

TORONTO -- Babies born in Ontario to teenaged, poor or foreign mothers are getting caught in a "discriminatory'' fee-based birth registration process that's skewing national statistics, Health Canada's public health division warns.

The fees, which can be as high as $35 depending on where a baby is born, are a deterrent that discourage "disadvantaged'' mothers from registering their new child, the Public Health Agency of Canada says.

That new child is more likely to be stillborn or have a congenital anomaly than infants born to other parents, leading to poor data, said Dr. Arne Ohlsson, a member of the agency's Canadian Perinatal Surveillance System.

That makes it difficult for policy makers to decide what prenatal programs and policies are needed to prevent early deaths or sick babies, he said.

"It's a huge problem; it's appalling,'' Ohlsson said in an interview Tuesday. "If you don't have the baseline data you cannot really compare and see what happened after we introduced a new intervention.''

The difficulty stems from Ontario's practice of charging fees to register a birth, a necessary first step en route to getting a birth certificate and establishing a legal identity for any new baby.

Fees, which are collected by municipalities, vary from city to city. Ottawa charges $33 per child while Hamilton asks for $28.50 and North Bay just $15. In Toronto, the fee is currently $27.50; it goes up to $35 on July 1.

The cost becomes an issue for certain, more disadvantaged citizens, Ohlsson said, pointing to mothers who are in their teens, poor, homeless, illiterate or don't speak English.

Those women are statistically more likely to give birth to stillborns or babies with a host of postnatal conditions, such as low birth weight or severe congenital anomolies.

"They have a very high mortality in that group; therefore, it will affect the statistics of Canada,'' said Ohlsson, who is also a neonatologist in the department of paediatrics at Toronto's Mount Sinai Hospital.

"This is totally discriminatory.''

As the country's most populated province, Ontario has the highest number of newborns in the country. Statistics Canada figures indicate 35 per cent of Canadian babies were born in Ontario in 2003.

It's not the first time the Canadian Prenatal Surveillance System has sounded the alarm.

The system has been pushing various government agencies, including Ontario's Ministry of Health and the registrar general, which issues birth certificates in the province, for almost a decade in hopes of rectifying the problem.

The problem originated in the late-1990s, when then-premier Mike Harris downloaded certain services to municipalities, said Dr. Alexender Allen, chairman of the system's fetal infant study group.

"The municipalities couldn't afford to take it on so they started charging fees,'' he said from his Halifax office.

"The fees are a problem to the disadvantaged part of the population, and it's the disadvantaged part of the population that has more difficulty with infant mortality.''

The provincial government said Tuesday it is aware of the problem, and is looking for ways to improve birth registration rates.

"We agree that fees are a hindrance to registration of births,'' said Paul de Zara, a spokesman for Government Services Minister Gerry Phillips.

"The province is currently exploring ways to fix that problem.''

The intention, de Zara said, is to transfer the responsibility for registration back to the province.

"When the province handles the registration, the fees would not be charged,'' he said.

The sooner the better, said Allen, since one dead baby for every healthy thousand can have a "tremendous effect'' on national statistics.

Said Allen: "Every other province has very good birth registration, not 100 per cent, but very close to it. Ontario is a very serious problem.''