The birth certificate is not only an official, legal document, but also provides critical health planning and research data. This article provides an overview of birth registration in the United States, discusses the functions of the National Center for Health Statistics (NCHS), delineates the role of the CNM in birth certification, presents information regarding the 1989 Revised Standard Birth Certificate, and examines the quality and uses of birth certificate data. The implications of this information about vital statistics for nurse-midwifery practice, research and education are discussed and specific suggestions are made for improving the accuracy of birth registration data provided by CNMs.