Dads on the Dotted Line: A Look at the In-Hospital Paternity Establishment Process

pIn 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 perspectivesmdash;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./p