West Virginia Perinatal Partnership Working together for healthier mothers and babies Welcome West Virginia Perinatal Partnership Welcome to Your 2014 Summit!

West Virginia Perinatal Partnership Working together for healthier mothers and babies A NEW LOOK FOR THE PARTNERSHIP

West Virginia Perinatal Partnership Working together for healthier mothers and babies State of Perinatal Health total births There were 21,124 WV births in Data Source: WV Health Statistics Center, Vital Statistics System

West Virginia Perinatal Partnership Working together for healthier mothers and babies Locations of WV Birth Facilities Locations of Level I and II obstetric services Level III Perinatal Referral Centers

West Virginia Perinatal Partnership Working together for healthier mothers and babies 2013 WV Births by Hospital Hospital# BirthsHospital# Births Appalachian Regional57Princeton Community Hospital697 Berkeley Medical Center1,101Raleigh General Hospital1,275 Bluefield Regional622Reynolds Memorial Hospital96 Cabell Huntington2,733Ruby Memorial Hospital1,571 Camden Clark1,707St. Mary’s Hospital398 CAMC2,669St. Joe’s (Buckhannon) Hospital295 Davis Memorial331Stonewall Jackson Hospital314 Fairmont General419Summersville Regional Med. Ctr316 Garrett County Memorial280Thomas Memorial Hospital1,085 Grant Memorial263United Hospital Center986 Greenbrier Valley Medical Ctr571Weirton Medical Center571 Jefferson Memorial257Welch Emergency Hospital70 Logan Regional332Wheeling Hospital1,275 Monongalia General1,088Williamson Memorial Hospital100 Ohio Valley Medical Center303Woman Care7 Pleasant Valley146

West Virginia Perinatal Partnership Working together for healthier mothers and babies TheStateofPerinatal Health in West Virginia Low Birth Weight (<2,500 GMS) Among WV Residents % % % 2013 (preliminary) 9.4% Data Source: WV Health Statistics Center, Vital Statistics System

West Virginia Perinatal Partnership Working together for healthier mothers and babies Very Low and Low Birth Weight ByAgeofMother, WV Residents Age Of Mother 2006 % Very Low and Low BW 2012 % Very Low and Low BW 2013* % Very Low and Low BW % 12.5%9.5% % 12.0%10.1% % 10.5%11.3%11.3% % 9.0%9.1% % 8.2%8.9% % 9.0% % 11.2%11.2%11.0%11.0% * Preliminary Data Data Source: WV Health Statistics Center, Vital Statistics System

West Virginia Perinatal Partnership Working together for healthier mothers and babies

West Virginia Perinatal Partnership Working together for healthier mothers and babies WestVirginia OccurrenceBirths by Marital Status of Mother Mother’s Marital Status * Married 61.0%54.3%53.8% Not Married 39.0%45.6%46.2% *Preliminary Data Data Source: WV Health Statistics Center, Vital Statistics System

West Virginia Perinatal Partnership Working together for healthier mothers and babies Percentage of Very Low Birth Weight Infants ( gm) by Place of Birth, Data Source: WV Health Statistics Center, Vital Statistics System

West Virginia Perinatal Partnership Working together for healthier mothers and babies 3 Percent of Singleton Births Induced <39 Weeks Gestation with No Medical Risk Factor or Congenital Anomaly, West Virginia, Data Source: WV Health Statistics Center, Vital Statistics System

West Virginia Perinatal Partnership Working together for healthier mothers and babies Elective Labor Induction, All Births <39 weeks* ** 16.1 %4.4 %4.5 % **Preliminary Data *< 39 Week, with no medical risk factors & no complications of labor /delivery Data Source: WV Health Statistics Center, Vital Statistics System

West Virginia Perinatal Partnership Working together for healthier mothers and babies Percentage of Primary C-Sections and Elective Inductions <41 Weeks among Nulliparous WV Births, Data Source: WV Health Statistics Center, Vital Statistics System

West Virginia Perinatal Partnership Working together for healthier mothers and babies C-Section Rates NumberofVBAC West Virginia Occurrence Births (less unknown) * Total C- Sections 34.4%36.8%36.0%35.9% #VBAC *Preliminary data Data Source: WV Health Statistics Center, Vital Statistics System

West Virginia Perinatal Partnership Working together for healthier mothers and babies WV Initiation of Prenatal Care Data Source: WV Health Statistics Center, Vital Statistics System

West Virginia Perinatal Partnership Working together for healthier mothers and babies WV Smoking Status During Pregnancy Smoking Status During Pregnancy * Smoked 28.1%26.8%25.8% Did Not Smoke 71.9%73.1%73.9% * Preliminary Data Data Source: WV Health Statistics Center, Vital Statistics System

West Virginia Perinatal Partnership Working together for healthier mothers and babies Smoking in Pregnancy by Medicaid Status

West Virginia Perinatal Partnership Working together for healthier mothers and babies Distribution of Birth Scores (High/Low) and Tobacco Use among WV Mothers Tobacco UseNo Tobacco Use High Score1,7061,717 Low Score3,35411,924 Total 5,06013,641 Overall, 27% of all mothers reported using tobacco. Of the infants who had high birth scores, half of them were from mothers who smoke Source: WEST VIRGINIA BIRTH SCORE PROGRAM DEVELOPMENTAL RISK AND NEWBORN HEARING SCREEN INITIATIVE 2012 ANNUAL REPORT

West Virginia Perinatal Partnership Working together for healthier mothers and babies WV Birth Outcome Rankings, 2013 Data Source: National Center for Health Statistics Birth Outcome WVU.S.WV Rank Cesarean Delivery 35.9%32.8%6 th Preterm Births 12.4%11.5%13 th Low Birth Weight 9.2%8.0%7 th Very Low Birth Weight 1.5%1.4%18 th Teen Birth Rate 44.1 per 1, per 1,000 6 th

West Virginia Perinatal Partnership Working together for healthier mothers and babies Infant Mortality Rates Mortality Rates by Cause, *

West Virginia Perinatal Partnership Working together for healthier mothers and babies New Items from 2014 Birth Certificate 16,798 cumulative births as of Maternal Drug Use 5.7% –Known or self-reported maternal non-prescribed / illicit drug use during pregnancy NAS 3.0% –57% of NAS also reported maternal drug use –18.2% of NAS also had a NICU admission

West Virginia Perinatal Partnership Working together for healthier mothers and babies Maternal Risk Screening Prenatal Risk Screens Received by OMCFH 11,08211,57211,355 OMCFH is also working with the Birth Score Office to make the PRSI a web-based document like to birth score form.

West Virginia Perinatal Partnership Working together for healthier mothers and babies Pulse Oximetry Screening2013 High Birth Score2,4385 Low Birth Score13,95616 Total16,394*21 PASSFAIL *During 2013, 21 infants failed the pulse oximetry screening. 7 were diagnosed with critical congenital heart disease.

West Virginia Perinatal Partnership Working together for healthier mothers and babies Hearing Screening Update

West Virginia Perinatal Partnership Working together for healthier mothers and babies WV Breastfeeding Improvements Exclusive BF at 3 Months o 2007 o 2012 o CDC.gov/breastfeeding US Breastfeeding Report Card, Maternity Practices in Infant Nutrition & Care (mPINC) Survey mPINC Scores WV average US average Exclusive BF at 6 months o o o

West Virginia Perinatal Partnership Working together for healthier mothers and babies Breastfeeding in 2015 Continue to help hospitals get moms off to best start possible Increase support to mothers so they can nurse longer Upcoming Mother Baby Summit by West Virginia Breastfeeding Alliance Spring 2015

West Virginia Perinatal Partnership Working together for healthier mothers and babies HB 4335, Child’s Right to Nurse, establishes policy that nursing in a public place is acceptable. Individual leaders, Perinatal Partnership and the WV Breastfeeding Alliance, formed in 2008, spearheaded passage of this bill. PASSED & SIGNED INTO LAW March, 2014 Child’s Right to Nurse ARTICLE 1. STATE PUBLIC HEALTH SYSTEM. § Child’s right to nurse; location where permitted; right protected. (a) The Legislature finds that breast feeding is an important, basic act of nurturing that is protected in the interests of maternal and child health. (b) Notwithstanding any provision of this code to the contrary, a mother may breast feed a child in any location open to the public.

West Virginia Perinatal Partnership Working together for healthier mothers and babies A good year for perinatal & reproductive health in WV 2014 Legislative WINS. WV Pregnant Workers Fairness Act – PASSED Child’s Right to Nurse – PASSED 20 Week Ban on Abortion - VETOED Looking Ahead to 2015 Expedited Partner Therapy – Resume effort on passage Paid Sick and Maternity leave – Initiate efforts on passage Continue to fight against bills that restrict patient/physician relationships, restrict access to comprehensive reproductive options, and criminalize addicted pregnant women.

West Virginia Perinatal Partnership Working together for healthier mothers and babies ONE CALL SYSTEM

West Virginia Perinatal Partnership Working together for healthier mothers and babies Hospital Assessments 2015 Assessments will be based on the newest (7 th ) edition of the Guidelines for Perinatal Care Level IIA & IIB are now simply level II New Level IV facility designation 2015 Assessments to include Tertiary Centers

West Virginia Perinatal Partnership Working together for healthier mothers and babies Differences in Levels Between Perinatal Care Guideline Editions 2007 Nomenclature Old Perinatal Partnership Guidelines 2012 Nomenclature New Guidelines from ACOG AAP Level IOBSTETRIC: Basic NBN: Level I Well Newborn Nursery Level IIA & Level IIBOBSTETRIC: Specialty NBN: Level II Special Care Nursery Level III *Although 2007 AAP ACOG guidelines gave three levels of Level III, the WVPP guidelines committee chose to have one level of Level III OBSTETRIC: Subspecialty NBN: Level III Neonatal Intensive Care Unit Level IV No Level IV in old guidelines OBSTETRIC: Regional subspecialty perinatal health center NBN: Level IV regional neonatal intensive care unit

West Virginia Perinatal Partnership Working together for healthier mothers and babies Perinatal Outreach Education Kangaroo Care Initiative Breastfeeding education for healthcare providers Advanced fetal monitoring New Birth Certificate training CCHD: Neonatal Pulse Oximetry Obstetrical Harm: Preeclampsia and Hemorrhage Progesterone and cervical length screening STABLE Course

West Virginia Perinatal Partnership Working together for healthier mothers and babies Substance Use in Pregnancy Drug Free Mother Baby - 4 Pilot Projects are in years 2 & 3 Neonatal Abstinence Syndrome Screening and Treatment Guidelines Long Acting Reversible Contraception (LARC) Educational Project

St. Joseph's Hospital, Buckhannon Stonewall Jackson Memorial Hospital, Weston Davis Memorial Hospital, Elkins WVU Children’s Hospital Summersville Regional Medical Center, Summersville CAMC Women’s and Children’s Hospital Greenbrier Valley Medical Center, Ronceverte Cabell Huntington Hospital Williamson Memorial Hospital WV Tertiary Perinatal Referral Centers Telemedicine sites WV Obstetric Hospitals Telemedicine sites Prenatal Clinics Telemedicine sites Connect To Care West Virginia Perinatal Telehealth Project Valley Health Systems, Mill Creek Primary Care Systems, Clay Community Health Foundation Of Man, Inc Valley Health Care, Wayne Valley Health Care, Fort incoln P G ri a m y ary Care Center, Inc FamilyCare, Madison Grant Memorial Hospital, Petersburg Roane County Family Health Care Prepared by Ann Dacey (All locations are approximate)

West Virginia Perinatal Partnership Working together for healthier mothers and babies Thank You!

West Virginia Perinatal Partnership Working together for healthier mothers and babies Amy Tolliver, MS Director, WV Perinatal Partnership 1018 Kanawha Boulevard East Charleston, WV (304) ext. 5 Coordinated by the West Virginia Higher Education Policy Commission, Division of Health Sciences