# COMAR Title 10 — Maryland Department of Health

## Subtitle 03 — Health Statistics

### Chapter 01 — Vital Records

#### Regulation .16 Births Outside an Institution.

*COMAR 10.03.01.16*

A. An attending clinician in charge of a birth outside an institution shall:

  (1) Prepare the forms required by the Secretary to register the birth; and

  (2) File the forms.

B. If a birth occurs outside an institution and an attending clinician is not in charge of the birth, the local health officer or designee of the jurisdiction where the birth occurs shall:

  (1) Verify the facts regarding the birth by obtaining the documentation required by §D of this regulation;

  (2) Sign the birth record; and

  (3) File the birth record with the Secretary.

C. If the facts regarding a birth cannot be verified by the local health officer of the jurisdiction where the birth occurs, in order for the Secretary to create a birth record, an individual listed in Health-General Article, §4-208(b), Annotated Code of Maryland, shall obtain an order from a court of competent jurisdiction that:

  (1) Lists the facts about the birth; and

  (2) Authorizes the Secretary to create the birth record according to the facts.

D. The following documentation shall be required to verify a birth outside an institution when an attending clinician is not in charge of the birth:

  (1) A valid, unexpired, government-issued identification document for the child’s mother in the form of a:

    (a) Driver’s license;

    (b) State-issued photo identification card;

    (c) Passport;

    (d) Permanent resident card;

    (e) Military identification card; or

    (f) A signed statement the mother does not have any of the identification documents listed in §D(1)(a)—(e) of this regulation and two of the following documents that contain the applicant’s name and current address:

      (i) Utility bill;

      (ii) Car registration form;

      (iii) Pay stub;

      (iv) Bank statement;

      (v) Income tax return;

      (vi) Income tax W-2 form;

      (vii) Lease or rental agreement; or

      (viii) Letter from a government agency;

  (2) Evidence of pregnancy in the form of:

    (a) A prenatal or postnatal medical record that is consistent with the date of delivery and includes the:

      (i) Mother’s name, date of birth, and date of health exam; and

      (ii) Health care provider’s signature, printed name, signature date, and license number;

    (b) A statement from a physician or certified nurse midwife licensed in the United States, or a direct-entry midwife licensed in Maryland, who has first-hand knowledge of the pregnancy and is willing to attest to the fact of pregnancy;

    (c) Preregistration with the local health department during pregnancy, including a face-to-face interview and physical examination;

    (d) Documentation of a home visit by a public health nurse or other health care provider who has first-hand knowledge of the pregnancy; or

    (e) Other evidence acceptable to the Secretary;

  (3) Evidence of live birth in the form of:

    (a) A statement from a physician, certified nurse midwife, or other licensed health care provider who saw or examined the infant within the first 2 weeks of life;

    (b) An observation of the infant during a home visit by a public health nurse or licensed health care provider during the first 2 weeks of life; or

    (c) Other evidence acceptable to the Secretary; and

  (4) Evidence of place of delivery in the State as follows:

    (a) If the birth occurred in the mother’s place of residence, evidence of place of delivery shall be in the form of:

      (i) A driver’s license or other State-issued identification document that includes the mother’s current Maryland address;

      (ii) A rent receipt, mortgage statement, or deed that includes the mother’s name and Maryland address;

      (iii) A recent pay stub that includes the mother’s name and Maryland address; or

      (iv) Other evidence acceptable to the Secretary;

    (b) If the birth occurred outside the mother’s place of residence and the mother is a resident of Maryland, evidence shall be in the form of:

      (i) An affidavit from the tenant of the premises where the birth occurred stating that the mother was present on those premises at the time of the birth;

      (ii) Evidence of the affiant’s residence similar to that required in §D(4)(a) of this regulation; and

      (iii) Evidence of the mother’s residence in the State similar to that required in §D(4)(a) of this regulation; or

    (c) If the mother is not a resident of Maryland, evidence shall consist of clear and convincing evidence acceptable to the Secretary.