In the U.S., two out of five children are born to unmarried parents. These children do not have a legal father until paternity is established, a process completed by most families in the hospital at the time of the birth. Over the last 30 years, the percentage of unmarried parents voluntarily establishing paternity in the hospital has climbed considerably, driven in large part by a series of policy changes aimed at easing and incentivizing the process. Despite the apparent success of these policies, few have examined the mechanics of the paternity establishment process itself to understand whether it is functioning optimally for parents and hospitals. Further, few have sought an understanding of why parents do or do not establish paternity. Drawing on original data collected through two separate studies, this paper presents a descriptive portrait of the paternity establishment process from two perspectives—that of unmarried parents and that of birth registrars, the certified hospital staff who administer the process. Data come from the Paternity Establishment Study (PES), a longitudinal birth cohort study of approximately 800 Texas mothers who gave birth outside of marriage in 2013, and the Nonmarital Birth and Registration (NBAR) study, an online survey of 555 hospital staff members certified to register births in Texas conducted in January of 2014. In addition, we incorporate data from a roundtable discussion with staff from the Child Support Division who oversee the in-hospital paternity establishment program. We find that despite heavy workloads, high turnover, relatively low wages, and varying levels of support from hospital management, birth registrars are largely effective in their execution of the in-hospital paternity establishment process, guiding a remarkable 90 percent of parents who are both at the hospital to establish paternity. Despite these successes, birth registrars continue to confront issues that lie outside of their training, experience, and legal knowledge; third-party AOPs, disputed paternity, and family violence cases deserve special consideration, and underscore the need to recognize circumstances in which it may be preferable for a father to establish paternity through alternate means. Our findings call for a more nuanced perspective on the objectives of paternity establishment, and highlight the need for clear and consistent protocols to address the more complex circumstances that birth registrars face.
Key Take Away Points
- Despite heavy workloads, high turnover, relatively low wages, and varying levels of support from hospital management, birth registrars successfully guide nearly 90 percent of unmarried parents who are both at the hospital to establish paternity.
- Birth registrars show a deep understanding of the parents they serve, but continue to confront a range of issues that lie outside of their training, experience, and legal knowledge—especially with regard to third party AOPs, uncertain paternity, and family violence.
- Policymakers should consider articulating more nuanced objectives for the in-hospital paternity establishment process, including directives for addressing complex circumstances in which it may be preferable to establish paternity through alternate means.
Dr. Osborne is an Associate Professor at the LBJ School of Public Affairs at The University of Texas at Austin. She is also the Director of the Child and Family Research Partnership (CFRP) at the LBJ School of Public Affairs, where she has extensive experience conducting evaluations of state and national programs aimed at strengthening families and increasing fathers’ emotional and financial contributions to their children. In this capacity, Dr. Osborne has launched several studies into the dynamics of nonmarital childbearing, paternity establishment, and child support. She has also led evaluation work on the Texas Home Visiting Program and the Project on Education Effectiveness and Quality (PEEQ). Dr. Osborne joined the faculty of the LBJ School of Public Affairs in 2005 after completing a post-doctoral research fellowship at the Center for Research on Child Wellbeing at Princeton University. Her teaching and research interests are in the areas of social policy, poverty and inequality, family and child well-being, family demography, teacher quality, and school entry among disadvantaged children. Dr. Osborne holds a Ph.D. in Demography and Public Affairs from Princeton University, a Master’s in Public Policy from Harvard’s Kennedy School of Government, and Masters of Arts in Education. Previously, Dr. Osborne taught middle school in a low-income community in California.
Daniel Dillon is a Senior Research Associate at the Child and Family Research Partnership (CFRP) in Austin TX, where he studies nonmarital childbearing, paternity establishment, father involvement, child support, and asset building. Dillon holds a Master's of Public Affairs from the Lyndon B. Johnson School of Public Affairs, and a BA in Sociology, from The University of Texas at Austin. Prior to his time with CFRP, Dillon worked at The Century Foundation, a New York-based think tank, where he researched issues related to income inequality and criminal justice.
The authors would like to thank the many Texas parents, hospital staff, and Child Support Division personnel who generously shared their perspectives and time to make this research possible. This research was also greatly supported by the insights and editing contributions of other research staff, including Nora Ankrum and Robert Brill. Finally, we thank the Texas Office of the Attorney General, whose interest and encouragement of research related to Texas families has been a valuable source of support.
Osborne, Cynthia and Dillon, Daniel
"Dads on the Dotted Line: A Look at the In-Hospital Paternity Establishment Process,"
Journal of Applied Research on Children: Informing Policy for Children at Risk: Vol. 5
, Article 10.
Available at: https://digitalcommons.library.tmc.edu/childrenatrisk/vol5/iss2/10