2. Collecting Birth Data: A Team Approach Regional Perinatal Programs of California

3. Quality Birth Data Workshop 2012  Slide 2 Objectives  Improving Data Quality by Learning: -Where to look -Who to ask -What information is “Self Identifying”  Review some Variables and Definitions -Race/Ethnicity -Education -Last Menstrual Period -Date/Month of first and last Prenatal Care Visit -Esimated Gestational Age -Fetal Presentation -Pre-pregnancy Height and Weight and Post Delivery

4. Why Collect Birth Certificate Information?  California Health and Safety Code -Section 102425 http://law.onecle.com/california/health/102425.html Quality Birth Data Workshop 2012  Page 3

5. Quality Birth Data Workshop 2012  Slide 4 It‘s About Presidents and Programs

6. Quality Birth Data Workshop 2012  Slide 5 Protected Information  What information is not shared? -Race -Education -Occupation -Social Security numbers -Address -Any Medical Information or Procedures  Who may access confidential information? -CDPH -County Health Departments -Approved Scientific Inquiry -The child listed on the birth certificate and those parents who have signed – or the mother listed All medical information is confidential and is not released to the public

7. Quality Birth Data Workshop 2012  Slide 6 Can a Parent(s) Refuse to Provide Information? Exceptions:  Race  Education  Occupation  Social Security numbers All information collected is important... The law requires that all information must be collected except:

8. Quality Birth Data Workshop 2012  Slide 7 Race/Ethnicity  Self Identified  Multiples (up to three)  Worksheet

9. Specific Variables Quality Birth Data Workshop 2012  Page 8 Race/Ethnicity 19 22 18 21

10. Race/Ethnicity Worksheet Quality Birth Data Workshop 2012  Page 9

11. How Are We Doing? Quality Birth Data Workshop 2012  Page 10 Mother’s race withheld or unknown (for all California births) National Center for Health Statistics Data

12. Quality Birth Data Workshop 2012  Slide 11 Education  Highest degree or highest year/grade completed  Worksheet  How do you get your families to comply? Copyright: use for educational purposes only http://www.unm.edu/http://www.unm.edu/ Copyright: permission requested http://www.gwu.edu/

13. Education Quality Birth Data Workshop 2012  Page 12 22c 20c

14. Education Worksheet Quality Birth Data Workshop 2012  Page 13

15. Quality Birth Data Workshop 2012  Page 14 Mother’s education withheld or unknown (for all California births) How Are We Doing? National Center for Health Statistics Data

16. Quality Birth Data Workshop 2012  Page 15 LMP Last Menstrual Period Available at: http://www.moondragon.org/pregnancy/calculator.htmlhttp://www.moondragon.org/pregnancy/calculator.html

17. Date Last Normal Menses Began Quality Birth Data Workshop 2012  Page 16 25A

18. Quality Birth Data Workshop 2012  Page 17 How are we doing? Incomplete or unknown date LMP began (for all California births) National Center for Health Statistics Data

19. Quality Birth Data Workshop 2012  Page 18 Date and Month of First and Last Prenatal Care Visit 2009 Prenatal Care Rates in California by County

20. Quality Birth Data Workshop 2012  Page 19 Date and Month of First and Last Prenatal Care Visit 25AADate First Prenatal Care Visit 25BMonth Prenatal Care Began 25BADate Last Prenatal Care Visit 25CNumber of Prenatal Care Visits 25C25BA25B25AA

21. Where To Look? Quality Birth Data Workshop 2012  Page 20

22. Withheld, unknown, or incomplete date and month of first and last prenatal care visit (For all California births) Quality Birth Data Workshop 2012  Page 21 How Are We Doing? National Center for Health Statistics Data

23. Obstetric Estimated Gestational Age (EGA) Quality Birth Data Workshop 2012  Page 22 How many weeks and days elapsed from the first day of the LMP to the day of delivery.... Available at: http://commons.wikimedia.org/wiki/File:Prenatal_development.pnghttp://commons.wikimedia.org/wiki/File:Prenatal_development.png

24. EGA Quality Birth Data Workshop 2012  Page 23 Obstetric Estimation of Gestation at Delivery – Completed Weeks 26A

25. Where To Look? Quality Birth Data Workshop 2012  Page 24 Obstetric Estimate of Gestational Age

26. Quality Birth Data Workshop 2012  Slide 25 Fetal Presentation Presentation of twins in Der Rosengarten ("The Rose Garden"), a standard medical text for midwives published in 1513. Line Item 28AC 20Cephalic 30 Breech 40Other 90Unknown Retrieved from Wikipedia: http://en.wikipedia.org/wiki/Presentation_(obstetrics) Copyright expiredhttp://en.wikipedia.org/wiki/Presentation_(obstetrics)

27. Cephalic Presentation Quality Birth Data Workshop 2012  Page 26 Choice (20) Two of many examples of a cephalic presentation: A. Vertex OA B. Brow Presentation (OP) A B William Smellie: A sett of anatomical tables, with explanations, and an abridgment, of the practice of midwifery, 1792 ; copyright expired, retrieved from: http://www.nlm.nih.gov/exhibition/historicalanatomies/smellie_home.htmlhttp://www.nlm.nih.gov/exhibition/historicalanatomies/smellie_home.html

28. Breech Presentation Quality Birth Data Workshop 2012  Page 27 Choice (30) Breech: any body part below the waist that is the presenting part (feet, foot, buttocks, sacrum) William Smellie: A sett of anatomical tables, with explanations, and an abridgment, of the practice of midwifery, 1792 ; copyright expired, retrieved from: http://www.nlm.nih.gov/exhibition/historicalanatomie s/smellie_home.html http://www.nlm.nih.gov/exhibition/historicalanatomie s/smellie_home.html Footling Breech Presentation, Der Rosengarten ("The Rose Garden"), a standard medical text for midwives published in 1513, Copyright expired

29. Other Presentation Quality Birth Data Workshop 2012  Page 28 Choice (40) William Smellie: A sett of anatomical tables, with explanations, and an abridgment, of the practice of midwifery, 1792 ; copyright expired, retrieved from: http://www.nlm.nih.gov/exhibition/historicalanatomies/smellie_home.htmlhttp://www.nlm.nih.gov/exhibition/historicalanatomies/smellie_home.html

30. Where To Look? Quality Birth Data Workshop 2012  Page 29 Fetal Presentation

31. Quality Birth Data Workshop 2012  Page 30 Unknown fetal presentation (for all California births) How Are We Doing? National Center for Health Statistics Data

32. Quality Birth Data Workshop 2012  Slide 31 Pre-pregnancy Height and Weight and Delivery Weight MWT1Pre-pregnancy Weight MWT2Mother’s Delivery Weight MHTMother’s Height

33. Where To Look? Quality Birth Data Workshop 2012  Page 32 Pre-pregnancy weight and height Delivery weight

34. Quality Birth Data Workshop 2012  Page 33 How Are We Doing? Unknown pre-pregnancy weight, weight at delivery, and height (For all California births) National Center for Health Statistics Data

35. Where Do You Look for Birth Certificate Data information? Quality Birth Data Workshop 2012  Page 34 1.From the medical record? 2.Check with the RN? 3.Use a form or checklist? 4.Review the delivery note or progress note or nursing record? 5.Use the electronic medical record (delivery note)?

36. Quality Birth Data Workshop 2012  Slide 35 Regional Perinatal Programs of California http://www.cdph.ca.gov/programs/rppc/ Pages/default.aspx