a mother’s story

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A Mother’s Story Kathleen Moline, BSN, MA Policy Analyst Division of Women’s and Infants’ Health 10/21/2009

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A Mother’s Story. Kathleen Moline, BSN, MA Policy Analyst Division of Women’s and Infants’ Health 10/21/2009. PRAMS. Hospital Discharges. Vital Records. Key VDH Perinatal Health Data Sources. Maternal Mortality Review. How Do WE Listen-PRAMS. - PowerPoint PPT Presentation

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Page 1: A Mother’s Story

A Mother’s Story

Kathleen Moline, BSN, MAPolicy Analyst

Division of Women’s and Infants’ Health

10/21/2009

Page 2: A Mother’s Story

Key VDH Perinatal Health Data Sources

Maternal Mortality Review

PRAMS

VA PRAMS

Vital Records

Hospital Discharges

Page 3: A Mother’s Story
Page 4: A Mother’s Story

How Do WE Listen-PRAMS

• Collects statewide data on maternal attitudes and experiences before, during, and shortly after pregnancy Data not available from any other source

• Provides surveillance data essential for planning, implementing and evaluating MCH policies and programs Identify groups at high risk Monitor changes in health status Measure progress towards goals Plan and review programs and policies

Page 5: A Mother’s Story

Virginia PRAMS Sampling, 2007

102,342 eligible live births

1,245 women selected

683 Low BW selected

562 Normal BWselected

336 LBW completed

323 NBWcompleted

Sampled approx. 100 women per month (50 LBW)

Mail survey with phone follow-up

57% response rate (weighted)

Page 6: A Mother’s Story

Virginia PRAMS Topics

Preconception Pre-pregnancy BMI Multivitamin use Pregnancy intention Health insurance status

During Pregnancy Content and source of

prenatal care Alcohol and tobacco use Attitudes and feelings about

pregnancy Health insurance status

Post-pregnancy Labor and delivery Infant health care Postpartum depression Health insurance status Post pregnancy – infant

health

Page 7: A Mother’s Story

How do we listen- FIMR Fetal and Infant Mortality Reviews Maternal Interview Medical Record Abstraction Case Review Team Analyst Community Action Team

Recommendations

Page 8: A Mother’s Story

Maternal Interview Tells the story from the source Tells of barriers, conflicts,

misunderstandings of information, successes

Points a direction for action Not peer review Must be tempered with the stages of grief

the mother is experiencing

Page 9: A Mother’s Story

SIDS Mother’s Story Stories are real Compiled from actual SIDS cases that

occurred from July 1, 2008-June 30, 2009 Quotes from memory of maternal

interviewer Pictures supplied from CPSC Part of the story told from mothers that

reside in West Central Virginia RPC

Page 10: A Mother’s Story

“She wasn’t sleepy and every time I put her in the crib she cried. I knew I had to get up early for work the next day so I just kept her in the waterbed with me.”

(Photo from CPSC files)

Page 11: A Mother’s Story

About 25% of mothers are co-sleeping with their infant

Source: Virginia Department of Health, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007.

23.325.4

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West Central Virginia

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Page 12: A Mother’s Story

“I wish I would have known more about SIDS. They should have more stuff about it on the radio or TV.”

(Photo from Child Protective Services files)

Page 13: A Mother’s Story
Page 14: A Mother’s Story
Page 15: A Mother’s Story

About 65% of mothers followed the AAP recommendation for back to sleep

Source: Virginia Department of Health, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007.

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West Central Virginia

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Page 16: A Mother’s Story

“I thought crib death only happened in cribs. That is why I didn’t use the crib.”

“I thought crib death only happened to white babies.” (Photo from CPSC files)

Page 17: A Mother’s Story

SIDS Rates 2005-2007

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White Rate Black Rate

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West Central

Virginia

Virginia Department of Health Division of Health Statistics compiled by the Office of Family Health Services Division of Women’s and Infants’ Health, 2005-2007

Page 18: A Mother’s Story

“The baby’s daddy put him down to sleep on his stomach because he always had so much gas and slept better that way.”

“We always had the baby sleep on his back but the babysitter had put him down on his belly in the middle of her bed with a lot of heavy covers.”

Page 19: A Mother’s Story

“How do you most often lay your baby down to sleep now?”

Source: Virginia Department of Health, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007.

16.9

57.1

17.8

8.1

12.7

65.2

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SIDE BACK STOMACH COMBO

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nt West Central

Virginia

Page 20: A Mother’s Story

“I do not believe in Back to Sleep. I worry more babies will die from choking from being on their backs. I believe that if my baby would have been on her back since coming home from the hospital, she would have died sooner.”

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What are we doing about it? CJ Foundation Grant Child Fatality Review focus Division of Injury and Violence Prevention,

Car seat safety pilot “Grandma’s Campaign for Healthy

Grandchildren” program of AARP