Births and maternity

For more information on the Utah Pregnancy Risk Assessment Monitoring System (PRAMS) visit Utah PRAMS program website.
Improving the well-being of mothers, infants, and children is an important public health goal for
the United States. Their well-being determines the health of the next generation and can help
predict future public health challenges for families, communities, and the health care system. The
objectives of the Maternal, Infant, and Child Health topic area address a wide range of conditions,
health behaviors, and health systems indicators that affect the health, wellness, and quality of
life of women, children, and families.
The risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access to quality preconception (before pregnancy) and interconception (between pregnancies) care.2 Moreover, healthy birth outcomes and early identification and treatment of health conditions among infants can prevent death or disability and enable children to reach their full potential.3,4,5
6,7,8 These differences are likely the result of many factors.
Social determinants of maternal health
These include pre-pregnancy health behaviors and health status,9 which are influenced by a variety of environmental and social factors such as access to health care and chronic stress.10
Physical determinants of maternal health
Common barriers to a healthy pregnancy and birth include lack of access to appropriate health care before and during pregnancy. In addition, environmental factors can shape a woman's overall health status before, during, and after pregnancy by:
Social determinants of infant and child health
The social determinants that influence maternal health also affect pregnancy outcomes and infant health. Racial and ethnic disparities in infant mortality exist, particularly for African American infants.11 Child health status varies by both race and ethnicity, as well as by family income12 and related factors, including educational attainment among household members and health insurance coverage.13
Physical determinants of infant and child health
The cognitive and physical development of infants and children is influenced by the health, nutrition, and behaviors of their mothers during pregnancy and early childhood. Breast milk is widely acknowledged to be the most complete form of nutrition for most infants, with a range of benefits for their health, growth, immunity, and development.14,15 Furthermore, children reared in safe and nurturing families and neighborhoods, free from maltreatment and other social adversities, are more likely to have better outcomes as adults.16,17
Emerging issues in maternal, infant, and child health
Recent efforts to address persistent disparities in maternal, infant, and child health have employed a "life course" perspective to health promotion and disease prevention. At the start of the decade, fewer than half of all pregnancies are planned. Unintended pregnancy is associated with a host of public health concerns. In response, preconception health initiatives have been aimed at improving the health of a woman before she becomes pregnant through a variety of evidence-based interventions.18
The life course perspective also supports the examination of quality of life, including the challenges of male and female fertility. An estimated 7.3 million American women ages 15 to 44 have received infertility services (including counseling and diagnosis) in their lifetime.19 Infertility is an area where health disparities are large, particularly among African American women,20 and may only continue to increase as childbearing practices change over time.
Why it's important
Pregnancy can provide an opportunity to identify existing health risks in women and to prevent future health problems for women and their children. These health risks may include:- Hypertension and heart disease
- Gestational diabetes
- Depression
- Genetic conditions
- Sexually transmitted diseases (STDs)
- Tobacco use and alcohol abuse
- Inadequate nutrition
- Unhealthy weight
The risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access to quality preconception (before pregnancy) and interconception (between pregnancies) care.2 Moreover, healthy birth outcomes and early identification and treatment of health conditions among infants can prevent death or disability and enable children to reach their full potential.3,4,5
Who is at risk
Infant and child health are similarly influenced by sociodemographic factors, such as family income, but are also linked to the physical and mental health of parents and caregivers. There are racial and ethnic disparities in mortality and morbidity for mothers and children, particularly for African Americans. Many factors can affect pregnancy and childbirth, including:- Preconception health status
- Age
- Access to appropriate preconception and interconception health care
- Poverty
6,7,8 These differences are likely the result of many factors.
Social determinants of maternal health
These include pre-pregnancy health behaviors and health status,9 which are influenced by a variety of environmental and social factors such as access to health care and chronic stress.10
Physical determinants of maternal health
Common barriers to a healthy pregnancy and birth include lack of access to appropriate health care before and during pregnancy. In addition, environmental factors can shape a woman's overall health status before, during, and after pregnancy by:
- Affecting her health directly
- Affecting her ability to engage in healthy behaviors
Social determinants of infant and child health
The social determinants that influence maternal health also affect pregnancy outcomes and infant health. Racial and ethnic disparities in infant mortality exist, particularly for African American infants.11 Child health status varies by both race and ethnicity, as well as by family income12 and related factors, including educational attainment among household members and health insurance coverage.13
Physical determinants of infant and child health
The cognitive and physical development of infants and children is influenced by the health, nutrition, and behaviors of their mothers during pregnancy and early childhood. Breast milk is widely acknowledged to be the most complete form of nutrition for most infants, with a range of benefits for their health, growth, immunity, and development.14,15 Furthermore, children reared in safe and nurturing families and neighborhoods, free from maltreatment and other social adversities, are more likely to have better outcomes as adults.16,17
Emerging issues in maternal, infant, and child health
Recent efforts to address persistent disparities in maternal, infant, and child health have employed a "life course" perspective to health promotion and disease prevention. At the start of the decade, fewer than half of all pregnancies are planned. Unintended pregnancy is associated with a host of public health concerns. In response, preconception health initiatives have been aimed at improving the health of a woman before she becomes pregnant through a variety of evidence-based interventions.18
The life course perspective also supports the examination of quality of life, including the challenges of male and female fertility. An estimated 7.3 million American women ages 15 to 44 have received infertility services (including counseling and diagnosis) in their lifetime.19 Infertility is an area where health disparities are large, particularly among African American women,20 and may only continue to increase as childbearing practices change over time.
How it's tracked
Maternal and child health is tracked at the national and state levels primarily through:- Pregnancy Risk Assessment and Monitoring System (PRAMS)
- Birth certificates
- Death certificates
1. Healthy People 2020 Topics and Objectives, Maternal, Infant, and Child Health, accessed on 8/11/2014 from .
2. Centers for Disease Control and Prevention (CDC), Agency for Toxic
Substances and Disease Registry (ATSDR). Recommendations to improve preconception health and
health care-United States: A report of the CDC/ATSDR Preconception Care Work Group and the
Select Panel on Preconception Care. Atlanta: CDC; 2006. 23 p. (MMWR Recomm Rep. 2006;55[RR-06])
3. Centers for Disease Control and Prevention (CDC). Newborn screening for cystic fibrosis: evaluation of benefits and risks and recommendations for state newborn screening programs. Atlanta: CDC; 2004. 37 p. (MMWR Recommen Reps. 2004;53[RR-13]).
4. Centers for Disease Control and Prevention (CDC). Identifying infants with hearing loss-United States, 1999-2007. Atlanta: CDC; 2010. (MMWR. 2010;59[8]:220-3).
5. Watson MS, Mann MY, Lloyd-Puryear MA, et al.; American College of Medical Genetics, Newborn Screening Expert Group. Newborn screening: Toward a uniform screening panel and system [executive summary]. Pediatrics. 2006;117(5 Pt. 2):S296-307.
3. Centers for Disease Control and Prevention (CDC). Newborn screening for cystic fibrosis: evaluation of benefits and risks and recommendations for state newborn screening programs. Atlanta: CDC; 2004. 37 p. (MMWR Recommen Reps. 2004;53[RR-13]).
4. Centers for Disease Control and Prevention (CDC). Identifying infants with hearing loss-United States, 1999-2007. Atlanta: CDC; 2010. (MMWR. 2010;59[8]:220-3).
5. Watson MS, Mann MY, Lloyd-Puryear MA, et al.; American College of Medical Genetics, Newborn Screening Expert Group. Newborn screening: Toward a uniform screening panel and system [executive summary]. Pediatrics. 2006;117(5 Pt. 2):S296-307.
6. Centers for Disease Control and Prevention (CDC). Newborn screening for
cystic fibrosis: evaluation of benefits and risks and recommendations for state newborn
screening programs. Atlanta: CDC; 2004. 37 p. (MMWR Recommen Reps. 2004;53[RR-13]).
7. Tucker MJ, Berg CJ, Callaghan WM, et al. The black-white disparity in pregnancy-related mortality from 5 conditions: Differences in prevalence and case-fatality rates. Am J Public Health. 2007 February 1;97(2):247-51.
8. Williams DR, Collins C. US Socioeconomic and racial differences in health: Patterns and explanations. Ann Rev Soc. 1995;21:349-86.
9. Bryant AS, Worjoloh A, Caughey AB, et al. Racial/ethnic disparities in obstetric outcomes and care: Prevalence and determinants. Am J Obstet Gynecol. 2010 Apr;202(4):335-43.
10. Williams DR, Collins C. US Socioeconomic and racial differences in health: Patterns and explanations. Ann Rev Soc. 1995;21:349-86
11. Centers for Disease Control and Prevention, Division of Vital Statistics; Martin JA, Hamilton BE, Sutton PD, et al. Births: Final data for 2006. Hyattsville, MD: National Center for Health Statistics; 2009 January 7. Report No. 57(7).
12. Larson K, Halfon N. Family income gradients in the health and health care access of US children [Internet]. Matern Child Health J. 2010 Jun 5;14(3):332-42.
13. Larson K, Russ SA, Crall JJ, et al. Influence of multiple social risks on children's health. Pediatrics. 2008 Feb 1;121(2):337-44.
14. US Department of Health and Human Services (HHS), Office on Women's Health. HHS blueprint for action on breastfeeding. Washington: HHS; 2000.
15. Ip S, Chung M, Raman G, et al. Breastfeeding and maternal and infant health outcomes in developed countries. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ); 2007 Apr. (Report/Technology Assessment, No. 153. AHRQ Publication No. 07-E007).
16. National Research Council and Institute of Medicine; Board on Children, Youth, and Families,Commission on Behavioral and Social Sciences and Education. From neurons to neighborhoods: The science of early childhood development. Shonkoff J, Philips D, editors. Washington: National Academy Press; 2000. 612 p.
17. Anda RF, Felitti VJ, Walker J, et al. The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci. 2006 Apr;256(3):174-86.
18. Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry (ATSDR). Recommendations to improve preconception health and health care-United States: A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR 2006;55(RR-6).
19. Centers for Disease Control and Prevention, National Center for Health Statistics; Chandra A, Martinez GM, Mosher WD, et al. Fertility, family planning, and reproductive health of US women: Data from the 2002 National Survey of Family Growth. Vital Health Stat. 2005;23(25):1-160.
20. Wellons MF, Lewis CE, Schwartz SM, et al. Racial differences in self-reported infertility and risk factors for infertility in a cohort of black and white women: The CARDIA Women's Study. Fertil Steril. 2008 Nov;90(5):1640-8.
7. Tucker MJ, Berg CJ, Callaghan WM, et al. The black-white disparity in pregnancy-related mortality from 5 conditions: Differences in prevalence and case-fatality rates. Am J Public Health. 2007 February 1;97(2):247-51.
8. Williams DR, Collins C. US Socioeconomic and racial differences in health: Patterns and explanations. Ann Rev Soc. 1995;21:349-86.
9. Bryant AS, Worjoloh A, Caughey AB, et al. Racial/ethnic disparities in obstetric outcomes and care: Prevalence and determinants. Am J Obstet Gynecol. 2010 Apr;202(4):335-43.
10. Williams DR, Collins C. US Socioeconomic and racial differences in health: Patterns and explanations. Ann Rev Soc. 1995;21:349-86
11. Centers for Disease Control and Prevention, Division of Vital Statistics; Martin JA, Hamilton BE, Sutton PD, et al. Births: Final data for 2006. Hyattsville, MD: National Center for Health Statistics; 2009 January 7. Report No. 57(7).
12. Larson K, Halfon N. Family income gradients in the health and health care access of US children [Internet]. Matern Child Health J. 2010 Jun 5;14(3):332-42.
13. Larson K, Russ SA, Crall JJ, et al. Influence of multiple social risks on children's health. Pediatrics. 2008 Feb 1;121(2):337-44.
14. US Department of Health and Human Services (HHS), Office on Women's Health. HHS blueprint for action on breastfeeding. Washington: HHS; 2000.
15. Ip S, Chung M, Raman G, et al. Breastfeeding and maternal and infant health outcomes in developed countries. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ); 2007 Apr. (Report/Technology Assessment, No. 153. AHRQ Publication No. 07-E007).
16. National Research Council and Institute of Medicine; Board on Children, Youth, and Families,Commission on Behavioral and Social Sciences and Education. From neurons to neighborhoods: The science of early childhood development. Shonkoff J, Philips D, editors. Washington: National Academy Press; 2000. 612 p.
17. Anda RF, Felitti VJ, Walker J, et al. The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci. 2006 Apr;256(3):174-86.
18. Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry (ATSDR). Recommendations to improve preconception health and health care-United States: A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR 2006;55(RR-6).
19. Centers for Disease Control and Prevention, National Center for Health Statistics; Chandra A, Martinez GM, Mosher WD, et al. Fertility, family planning, and reproductive health of US women: Data from the 2002 National Survey of Family Growth. Vital Health Stat. 2005;23(25):1-160.
20. Wellons MF, Lewis CE, Schwartz SM, et al. Racial differences in self-reported infertility and risk factors for infertility in a cohort of black and white women: The CARDIA Women's Study. Fertil Steril. 2008 Nov;90(5):1640-8.
Birth defects
Breastfeeding
Mortality
Pregnancy/maternal measures
- Adolescent births
- Birth rates
- Births from unintended pregnancies
- Diabetes: gestational diabetes
- Domestic violence during pregnancy
- Fertility rate
- Obesity during pregnancy
- Postpartum depression
- Preconception health and healthcare
- Prenatal care
- Severe maternal morbidity among hospital deliveries
- Smoking during 3rd trimester of pregnancy
Birth outcomes
Newborn screening
Births
- Count of births (state, county, and local health districts [LHDs])
- Count of births (state, county, and LHDs by mother's race and Medicaid status)
- Count of births (Utah Small Areas)
- Count of births (Utah Small Areas by mother's race and Medicaid status)
- Birth rate (state, county, and LHDs)
- Birth rate trend analysis (state, county, and LHDs)
- Birth rate (Utah Small Areas)
- Birth rate trend analysis (Utah Small Areas)
Fertility rate (live births per 1,000 female population)
- Fertility rate (state, county, and local health districts [LHDs])
- Fertility rate trend analysis (state, county, and LHDs)
- Fertility rate (Utah Small Areas)
- Fertility rate trend analysis (Utah Small Areas)
General fertility rate (live births per 1,000 females of childbearing age [15-44 years])
- General fertility rate (state, county, and LHDs)
- General fertility rate trend analysis (state, county, and LHDs)
- General fertility rate (Utah Small Areas)
- General fertility rate trend analysis (Utah Small Areas)
Total fertility rate (sum of the age-specific birth rates of women in five-year age groups multiplied by five)
- Total fertility rate (state, county, and LHDs)
- Total fertility rate trend analysis (state, county, and LHDs)
- Total fertility rate (Utah Small Areas)
- Total fertility rate trend analysis (Utah Small Areas)
Girls age 10-14
- Adolescent births, girls age 10-14 (state, county, and local health districts [LHDs])
- Adolescent births trend analysis, girls age 10-14 (state, county, and LHDs)
- Adolescent births, girls age 10-14 (state, county, and LHDs by mother's race and Medicaid status)
- Adolescent births trend analysis, girls age 10-14 (state, county, and LHDs by mother's race and Medicaid status)
- Adolescent births, girls age 10-14 (Utah Small Areas)
- Adolescent births trend analysis, girls age 10-14 (Utah Small Areas)
Girls age 15-17
- Adolescent births, girls age 15-17 (state, county, and LHDs)
- Adolescent births trend analysis, girls age 15-17 (state, county, and LHDs)
- Adolescent births, girls age 15-17 (Utah Small Areas)
- Adolescent births trend analysis, girls age 15-17 (Utah Small Areas)
Girls age 18-19
- Adolescent births, girls age 18-19 (state, county, and LHDs)
- Adolescent births trend analysis, girls age 18-19 (state, county, and LHDs)
- Adolescent births, girls age 18-19 (Utah Small Areas)
- Adolescent births trend analysis, girls age 18-19 (Utah Small Areas)
Girls age 15-19
- Adolescent births, girls age 15-19 (state, county, and LHDs)
- Adolescent births trend analysis, girls age 15-19 (state, county, and LHDs)
- Adolescent births, girls age 15-19 (state, county, and LHDs by mother's race and Medicaid status)
- Adolescent births trend analysis, girls age 15-19 (state, county, and LHDs by mother's race and Medicaid status)
- Adolescent births, girls age 15-19 (Utah Small Areas)
- Adolescent births trend analysis, girls age 15-19 (Utah Small Areas)
- April 2023 Health Status Update: Trends and characteristics of gestational diabetes, 2020
- January 2023 Health Status Update: COVID-19 vaccination during pregnancy, Utah 2021
- November 2022 Health Status Update: Experiences of anxiety during pregnancy in Utah, PRAMS 2016-2020
- October 2022 Health Status Update: Sudden unexpected infant deaths in Utah, 2020
- Influenza vaccination coverage during pregnancy in Utah, PRAMS 2016-2020
- Reduced incidence of congenital cytomegalovirus (CMV) infections during the COVID-19 pandemic
- Newborn hearing screening in underserved populations
- Prenatal Care Experiences During the COVID-19 Pandemic
- COVID-19 Pandemic-related Stressful Events Experienced During Pregnancy
- Breastfeeding Information Sources
- September 2020 Health Status Update: Infant Mortality in Utah by Age at Death, 2015-2017
- August 2020 Health Status Update: Tobacco Smoking Around the Time of Pregnancy, Utah PRAMS 2016-2018
- Women of Childbearing Age Injuries and Deaths, Utah, 2014-2016
- January 2016 Utah Health Status Update: Maternal and Child Health State Priorities, 2016-2020
- August 2015 Utah Health Status Update: Health Status by Race and Ethnicity: 15 Years of Surveillance
Vital Statistics
- Utah Vital Statistics - Births and Deaths 2017
- Utah Vital Statistics: Abortions 2017
- Utah Vital Statistics - Births and Deaths 2016
- Utah Vital Statistics: Abortions 2016
- 2017 Annual Report on the Effectiveness of the Utah Mutual Consent, Voluntary Adoption Registry
- Utah Vital Statistics - Births and Deaths: Utah, 2015
- Utah Vital Statistics: Abortions 2015
- Utah Vital Statistics - Births and Deaths: Utah, 2014
- October 2015 Breaking News: Utah Adoption Registry
- Utah Vital Statistics: Abortions, 2014
Pregnancy-related
- March 2020 Spotlight: Maternal Mental Health Screening through WIC Services
- October 2019 Spotlight: Out-of-hospital Births
- Utah PRAMS Surveillance Report 2016-2017
- July 2019 Utah Health Status Update: New Topics for PRAMS Surveillance
- January 2019 Breaking News: E-cigarette Use Among Pregnant Women
- November 2018 Breaking News: Reducing Preterm Birth
- October 2018 Breaking News: Reasons for Not Having Health Insurance Before Pregnancy
- September 2018 Community Health Spotlight: Oral Health Care and Pregnancy
- Perinatal Mortality Review Update: Maternal Mortality in Utah 2015-2016
- Maternal Mental Health in Utah
- January 2018 Community Health Spotlight: Maternal Anxiety and Depression
- May 2017 Breaking News: Maternal Mortality in Utah
- Special Edition Community Health Spotlight: Pregnancy Intention - Survey Response Options
- Unintended Pregnancy - from Utah State Health Assessment 2016 Report
- May 2016 Community Health Spotlight: Domestic Violence During Pregnancy
- April 2016 Community Health Spotlight: Neighborhood Safety During Pregnancy
- March 2016 Community Health Spotlight: Effects of Perceived Racism during Pregnancy in Utah
- February 2016 Community Health Spotlight: Food Insecurity and Pregnancy Outcomes in Utah
Health Systems/Initiatives
- January 2020 Health Status Update: Early Hearing Detection and Intervention (EHDI) Ten Years of Data: 2007-2016
- November 2019 Spotlight: Utah Levels of Neonatal and Maternal Care
- Special Edition Spotlight: Critical Congenital Heart Disease (CCHD) Screening in Utah
- Special Edition Spotlight: Testing Infants Who Do Not Pass Newborn Hearing Screening(s) for a Congenital Cytomegalovirus (CMV) Infection
- October 2018 Breaking News: Reasons for Not Having Health Insurance Before Pregnancy
- April 2018 Breaking News: Developmental Screening Practices in Utah
- July 2017 Breaking News: Critical Congenital Heart Defect (CCHD) Newborn Screening in Utah
- PRAMS Perspectives: Breastfeeding Friendly Practices in Utah Hospitals
- March 2017 Community Health Spotlight: Program Outputs from "It Takes a Village"
- September 2016 Community Health Spotlight: Safe Haven
- April 2016 Utah Health Status Update: Breastfeeding Friendly Hospitals
- July 2015 Breaking News: Improvement in Collection Time for Newborn Screening Kits
- July 2015 Community Health Spotlight: Perinatal Quality Collaborative: Utah Women and Newborn Quality Collaborative (UWNQC)
- May 2015 Breaking News: Critical Congenital Heart Defect (CCHD) Screening Project
- May 2015 Community Health Spotlight: The Utah Cytomegalovirus (CMV) Education and Testing Initiative: A Pioneering Adventure in Public Health
Birth Outcomes
- November 2023 Spotlight: Mental health outcomes following mistreatment during childbirth: Utah, 2020
- March 2020 Spotlight: Children's Hearing Aid Program (CHAP)
- Neural Tube Defects in Utah, 1995-2015
- January 2019 Community Health Spotlight: Trend in Overall Cesarean Rate
- Special Edition Breaking News: Investigation of an Increased Incidence of Early Onset Group B Streptococcus Infections in Utah
- November 2018 Breaking News: Reducing Preterm Birth
- Perinatal Mortality Review Update: Maternal Mortality in Utah 2015-2016
- Planned Out-of-Hospital Births in Utah, 2013-2015: A Descriptive Review
- April 2018 Utah Health Status Update: It Takes a Village: Addressing Infant Mortality Disparities by Giving Utah Pacific Islander Babies the Best Chance
- Severe Maternal Morbidity, Utah 2013-2015
- December 2017 Breaking News: Chronic Diseases and Birth Outcomes
- July 2017 Utah Health Status Update: Trends and Characteristics of Home Births in Utah 2004-2013
- June 2017 Breaking News: Out of Hospital Birth Transfers
- March 2017 Utah Health Status Update: Zika Virus
- April 2016 Breaking News: Pacific Islander Birth Outcome Intervention Program
- October 2015 Community Health Spotlight: Strategies to Reduce Infant Mortality in Utah
- August 2015 Breaking News: Maternal Transfusion in Utah
- Planned Out-of-Hospital Births in Utah, 2010-2012