Proving U.S. Citizenship for a Child Born Outside of a Hospital

If you were born outside of a hospital or don't have your birth certificate, the Department of State will likely need additional evidence of citizenship to issue a U.S. passport.

By , Attorney · University of Arizona College of Law

A person born in the U.S. typically needs only to present a birth certificate and government-issued photo I.D. to prove U.S. citizenship and obtain a U.S. passport. Still, every year the Department of State (DOS) initially denies thousands of U.S. passport applications because the applicant has a "non-institutional birth," despite the fact that the applicant has a valid U.S. birth certificate. A "non-institutional birth" occurs when the applicant was born outside of a traditional hospital, usually with the assistance of a midwife.

Today, many hospital births are attended by midwives and these individuals do not typically have difficulty proving U.S. citizenship.

Non-Institutional Births and Midwife Birth Certificate Fraud in the U.S.

When a baby is born in a hospital, the hospital usually files the birth registration directly with the state registrar. When a baby is born outside of a hospital with a midwife, however, the midwife will typically file the birth registration and sign the birth certificate, affirming the details.

The overwhelming majority of U.S. birth certificates signed by midwives, who delivered babies outside of hospitals, are completely legitimate. Still, over 75 midwives were implicated in schemes where the midwife fraudulently claimed to deliver children in the U.S. who were actually born in Mexico. These children (mostly now adults) have birth certificates that are "real" but were fraudulently issued.

Many of these same midwives who committed fraud also legitimately delivered hundreds of babies in the U.S. and it is nearly impossible to tell whether a birth certificate is one that was fraudulently registered just by looking at it. Again, the birth certificate itself is a real state-issued document. This is why the DOS might ask for secondary evidence of U.S. citizenship, in addition to your U.S. birth certificate.

While most of this fraud occurred in Texas border towns, passport applicants born outside of a hospital in all parts of the U.S. report that the Department of State requested additional citizenship evidence with the passport application.

How to Gather Secondary Evidence for Proving U.S. Citizenship

If you had a non-institutional birth or no longer have your original birth certificate, the DOS might ask you to provide additional proof of U.S. citizenship. If this is the case, you will receive a letter requesting secondary evidence such as:

  • immigration status of your parents at the time of your birth
  • travel history of your parents
  • all the schools you attended and the dates of attendance
  • your residence history
  • siblings' birth details
  • details of your mother's prenatal care
  • affidavits from anyone present at the time of your birth
  • baptismal details, and
  • documents that substantiate the above details.

You will have only 90 days in which to send in additional documentation after receiving a letter from DOS. If you don't meet the deadline, expect your U.S. passport to be denied.

DOS Might Request Additional Evidence Even If You Already Had a U.S. Passport

If you were born outside of a hospital and had previous U.S. passports, that does not mean you will never be asked to provide secondary evidence of citizenship. If a passport adjudicator receives your application for renewal but cannot verify that the previous adjudicator properly scrutinized your application, you might be asked to provide secondary evidence of citizenship, even for a renewal application.

The good news is that the supporting documents you submit will be scanned into your passport file, so once your passport is issued, you should not encounter delays with future renewals.

If Your U.S. Passport Is Denied, Consider Seeking Legal Advice

There are hundreds of people every year who discover they were not born in the United States at all, after submitting a passport application. In many of these cases, the applicant's parents never told the applicant about the lie or fraud, and the applicant was unaware of the parent's actions.

There are also many passport applications that are denied because the applicant cannot provide sufficient secondary evidence of a U.S. birth. The DOS has been involved in extensive litigation over this issue and it continues to be a contentious issue for the department.

If you provide secondary evidence of U.S. citizenship and your passport is nevertheless denied, you might want to discuss your situation with an immigration attorney who specializes in this particular issue.

It is also important that you not leave the United States until your citizenship determination is completely resolved, as you might have difficulty re-entering or be denied entry altogether. Many attorneys who work outside the Texas border area are unfamiliar with this area of the law and the stakes are high, because your U.S. citizenship is now being questioned.

Be sure the attorney you are working with is familiar with the legal issues of midwife-generated birth certificates or at least willing to consult with a specialist in this field.

Talk to a Lawyer

Need a lawyer? Start here.

How it Works

  1. Briefly tell us about your case
  2. Provide your contact information
  3. Choose attorneys to contact you

Talk to an Immigration attorney.

We've helped 85 clients find attorneys today.

How It Works

  1. Briefly tell us about your case
  2. Provide your contact information
  3. Choose attorneys to contact you