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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 2013.
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
# Births
Hospital
# Births
Appalachian Regional
57
Princeton Community Hospital
697
Berkeley Medical Center
1,101
Raleigh General Hospital
1,275
Bluefield Regional
622
Reynolds Memorial Hospital
96
Cabell Huntington
2,733
Ruby Memorial Hospital
1,571
Camden Clark
1,707
St. Mary’s Hospital
398
CAMC
2,669
St. Joe’s (Buckhannon) Hospital
295
Davis Memorial
331
Stonewall Jackson Hospital
314
Fairmont General
419
Summersville Regional Med. Ctr
316
Garrett County Memorial
280
Thomas Memorial Hospital
1,085
Grant Memorial
263
United Hospital Center
986
Greenbrier Valley Medical Ctr
571
Weirton Medical Center
571
Jefferson Memorial
257
Welch Emergency Hospital
70
Logan Regional
332
Wheeling Hospital
1,275
Monongalia General
1,088
Williamson Memorial Hospital
100
Ohio Valley Medical Center
303
Pleasant Valley
146
Woman Care
Working together for 7
healthier mothers and
babies
West Virginia Perinatal Partnership
The State of Perinatal Health
in West Virginia 2006-2013
Low Birth Weight (<2,500 GMS)
Among WV Residents
2006
2011
2012
2013
9.8%
9.6%
9.2%
(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
By Age of Mother, WV Residents
Age
Of Mother
10-14
15-17
18-19
20-24
25-29
30-34
35+
2006
% Very Low
and Low BW
18.2%
12.5%
11.3%
10.7%
8.9%
9.1%
8.6%
2013*
% Very Low
and Low BW
2012
% Very Low
and Low BW
12.5%
12.0%
10.5%
9.0%
8.2%
9.0%
11.2%
9.5%
10.1%
11.3%
9.1%
8.9%
9.0%
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
West Virginia Occurrence Births by
Marital Status of Mother
Mother’s
Marital
Status
Married
Not
Married
2006
2012
2013*
61.0%
54.3%
53.8%
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
(450-1499 gm) by Place of Birth, 2000-2009
90
80
70
60
50
40
30
20
10
0
80.7
19.3
Tertiary Hospitals
Non-Tertiary Hospitals
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 CongenitalAnomaly,
West Virginia, 2008-2013
25
20
19.3
15
9.4
10
7.3
5
3.6
4.5
4.6
2012
2013
0
2008
2009
2010
2011
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, 2008-2013
35
31.4
31.5
32.1
31.9
31.9
30.8
30
25
24.4
19.1
20
18.1
15
12.0
14.1
14.3
C-Sections
Inductions
10
5
0
2008
2009
2010
2011
2012
2013
Data Source: WV Health Statistics Center, Vital Statistics System
West Virginia Perinatal Partnership
Working together for
healthier mothers and
babies
C-Section Rates 2006-2013
Number of VBAC
West Virginia Occurrence Births (less unknown)
2006
Total C- 34.4%
Sections
#VBAC
139
2011
2012
2013*
36.8%
36.0%
35.9%
155
150
135
*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
Trimester Care Began
2006
2012
2013*
1st
2nd
82.5%
83.0%
80.3%
14.3%
13.2%
15.1%
3rd
2.6%
2.5%
3.0%
No Care
0.7%
0.5%
0.7%
*Preliminary Data
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
2006
2012
2013 *
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
Percentage of West Virginia Women Who Smoked During Pregnancy*
100
90
Percentage (%)
80
70
60
50
41.5
Medicaid Smokers
40
30
20
25.9
Unknown Coverage Smokers
12.3
39.5
19.0
10.2
Non-Medicaid Smokers
10
0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Data Source: WV Health Statistics Center, Vital Statistics System
West Virginia Perinatal Partnership
Working together for
healthier mothers and
babies
Distribution of Birth Scores (High/Low) and
Tobacco Use among WV Mothers
Tobacco Use
No Tobacco Use
High Score
1,706
1,717
Low Score
3,354
5,060
11,924
13,641
Total
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
Birth
Outcome
WV
U.S.
WV Rank
Cesarean
Delivery
35.9%
32.8%
6th
Preterm
Births
12.4%
11.5%
13th
Low Birth
Weight
9.2%
8.0%
7th
Very Low
Birth Weight
1.5%
1.4%
18th
44.1 per
1,000
29.4 per
1,000
6th
Teen Birth
Rate
Data Source: National Center for Health Statistics
West Virginia Perinatal Partnership
Working together for
healthier mothers and
babies
Infant Mortality Rates
Mortality Rates by Cause,* 2008-2010
1000.0
900.0
800.0
Infant Deaths per 100,000
700.0
48%
26%
44%
600.0
47%
42%
Other Perinatal Conditions
42%
40%
500.0
Preterm-related
36%
17%
Congenital Anomalies
SUID
400.0
8%
11%
13%
300.0
18%
15%
17%
13%
12%
18%
19%
200.0
13%
Infection
13%
18%
20%
14%
15%
Region III
Total
U.S. Total
Injury
All other Causes
26%
15%
100.0
19%
12%
13%
13%
15%
PA
VA
0.0
DC
DE
MD
West Virginia Perinatal Partnership
WV
Working together for
healthier mothers and
babies
New Items from
2014 Birth Certificate
16,798 cumulative births as of 10-29-14
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
2011
2012
2013
11,082
11,572
11,355
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 Screening 2013
PASS
FAIL
High Birth Score
2,438
5
Low Birth Score
13,956
16
16,394
*21
Total
*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
2013 WV Infant Hearing Screen Results
Passed
West Virginia Perinatal Partnership
Failed
Not Recorded
Working together for
healthier mothers and
babies
WV Breastfeeding Improvements
mPINC Scores
WV average US average
2007
54
63
2013
69
75
Exclusive BF at 3 Months
21.3
o 2007
23.3
o 2012
28.3
o 2014
Exclusive BF at 6 months
o 2007
5.2
o 2013
9.1
o 2014
12.2
CDC.gov/breastfeeding US Breastfeeding Report Card,
Maternity Practices in Infant Nutrition & Care
(mPINC) Survey 2007-2013
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
Child’s Right to Nurse
HB 4335, Child’s Right to Nurse,
establishes policy that nursing in a
public place is acceptable.
ARTICLE 1. STATE PUBLIC
HEALTH SYSTEM.
§16-1-19. Child’s right to nurse;
location where permitted; right
protected.
Individual leaders, Perinatal
Partnership and the WV
Breastfeeding Alliance, formed in
2008, spearheaded passage of
this bill.
PASSED & SIGNED INTO LAW
March, 2014
West Virginia Perinatal Partnership
(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.
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
West Virginia Perinatal Partnership
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.
Working together for
healthier mothers and
babies
ONE CALL SYSTEM
1-866-893-7266
West Virginia Perinatal Partnership
Working together for
healthier mothers and
babies
Hospital Assessments
2015 Assessments will be based on the
newest (7th) 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 2007 2012 Perinatal
Care Guideline Editions
2007
Nomenclature
Old Perinatal Partnership Guidelines
2012
Nomenclature
New Guidelines from ACOG AAP
Level I
OBSTETRIC: Basic
NBN: Level I Well Newborn Nursery
Level IIA & Level IIB
OBSTETRIC: 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
together
for intensive care
NBN: Level IVWorking
regional
neonatal
healthier mothers and
unit
West Virginia Perinatal Partnership
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
West Virginia Perinatal Partnership
Working together for
healthier mothers and
babies
Connect To Care
West Virginia Perinatal Telehealth Project
Primary Care Systems, Clay
WVU Children’s Hospital
CAMC Women’s
and Children’s Hospital
Roane County Family Health Care
Grant Memorial Hospital, Petersburg
Cabell Huntington Hospital
Valley Health Care,
Wayne
Valley Health Care, Fort
incoln PG
ria
myary Care Center, Inc
FamilyCare, Madison
Davis Memorial Hospital , Elkins
Valley Health Systems, Mill Creek
St. Joseph's Hospital, Buckhannon
Stonewall Jackson Memorial Hospital, Weston
Summersville Regional Medical Center, Summersville
Greenbrier Valley Medical Center, Ronceverte
Williamson Memorial Hospital
Community Health Foundation
Of Man, Inc
WV Tertiary Perinatal Referral Centers
Telemedicine sites
WV Obstetric Hospitals Telemedicine sites
Prepared by Ann Dacey
(All locations are approximate)
Prenatal Clinics Telemedicine sites
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 25301
(304) 558-0530 ext. 5
[email protected]
www.wvperinatal.org
Coordinated by the West Virginia Higher Education
Policy Commission, Division of Health Sciences
West Virginia Perinatal Partnership
Working together for
healthier mothers and
babies

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