Wash. Admin. Code § 246-491-029

Current through Register Vol. 24-19, October 1, 2024
Section 246-491-029 - Information collected on the confidential section of live birth and fetal death certificates; modifications to the United States standard certificates and report forms
(1) Effective January 1, 2003, the department shall use the 2003 revisions of the United States standard forms of live birth and fetal death as the basis for the state certificates of live birth and fetal death. These forms are developed by the United States Department of Health and Human Services, National Center for Health Statistics.
(2) Copies of these forms may be obtained by contacting the department's center for vital statistics.
(3) Tables 1 and 2 list the statistical information contained in the confidential sections of the birth and fetal death certificates that the board requires the department to collect, and the differences between the state and U.S. standard.

U.S. STANDARD CERTIFICATE OF LIVE BIRTH

TABLE 1:

Confidential Birth Certificate Items

Item Number

Item Name

Difference from U.S. Standard, if any

15

Is mother married to the father?

If no, was mother married to anyone during the pregnancy?

Added

Has the paternity affidavit been signed?

20

Mother's education

Add "Specify": next to box for "8th Grade or less"

21

Mother of Hispanic origin?

22

Mother's race

23

Mother's occupation

Added

24

Mother's kind of business/industry

Added

29

Father's education

Add "Specify": next to box for "8th Grade or less"

30

Father of Hispanic origin?

31

Father's race

32

Father's occupation

Added

33

Father's kind of business/industry

Added

34

Mother's medical record number

35

Mother's prepregnancy weight

36

Mother's weight at delivery

37

Mother's height

38

Did mother get WIC food for herself during pregnancy?

39

Cigarette smoking before and during pregnancy

40a

Number of previous live births

40b

Date of last live birth

41a

Number of other pregnancy outcomes

41b

Date of last other pregnancy outcome

42a

Date of first prenatal care visit

42b

Date of last prenatal care visit

43

Total number of prenatal visits for this pregnancy

44

Date last normal menses began

45

Was mother transferred to higher-level care for maternal medical or fetal indications for delivery?

46

Principal source of payment for this delivery

Add "Indian Health" and "CHAMPUS"

47

Newborn medical record number

48

Birth weight

49

Infant head circumference

Added

50

Obstetric estimate of gestation

51

Apgar score at 5 min; if score is less than 6, score at 10 minutes

52

Plurality

53

If not single birth - born 1st, 2nd, 3rd etc.

54

Was infant transferred within 24 hours of delivery?

55

Is infant living at time of the report?

56

Is infant being breastfed?

57

Risk factors in this pregnancy

Add "Group B streptococcus culture positive"

58

Method of delivery

59

Infections present and/or treated during this pregnancy

Add "HIV infection" and "Other: Specify"

60

Obstetric procedures

61

Abnormal conditions of the newborn

62

Characteristics of labor and delivery

63

Congenital anomalies of the newborn

64

Maternal morbidity

65

Onset of labor

U.S. STANDARD REPORT OF FETAL DEATH

TABLE 2:

Confidential Fetal Death Certificate Items

Item Number

Item Name

Difference from U.S. Standard, if any

38

Weight of fetus

39

Obstetric estimate of gestation

40

Plurality

41

If not single birth - Born 1st, 2nd, 3rd etc.

42

Mother's education

Add "Specify": next to box for "8th Grade or less"

43

Mother of Hispanic origin?

44

Mother's race

45

Mother's occupation

Added

46

Mother's kind of business/industry

Added

47

Mother married?

48

Mother's height

49

Did mother get WIC food for herself during pregnancy?

50

Mother's prepregnancy weight

51

Mother's weight at delivery

52

Date last normal menses began

53

Date of first prenatal care visit

54

Date of last prenatal care visit

55

Total number of prenatal visits for this pregnancy

56a

Number of previous live births

56b

Date of last live birth

57a

Number of other pregnancy outcomes

57b

Date of last other pregnancy outcome

58

Cigarette smoking before and during pregnancy

59

Was mother transferred to higher-level care for maternal medical or fetal indications for delivery?

60

Father's education

Added

61

Father of Hispanic origin?

Added

62

Father's race

Added

63

Father's occupation

Added

64

Father's kind of business/industry

Added

65

Risk factors in this pregnancy

66

Method of delivery

67

Congenital anomalies of the fetus

68

Maternal morbidity

69

Infections present and/or treated during this pregnancy

Add "HIV infection" and "Other:

Specify"

Wash. Admin. Code § 246-491-029

Statutory Authority: RCW 43.70.150, 70.58.055, and chapter 70.58 RCW. 02-20-092, § 246-491-029, filed 10/1/02, effective 11/1/02. Statutory Authority: Chapter 70.58 RCW. 91-20-073 (Order 196B), § 246-491-029, filed 9/26/91, effective 10/27/91. Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as § 246-491-029, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 70.58.200. 88-19-092 (Order 310), § 248-124-010, filed 9/20/88. Statutory Authority: RCW 43.20.050 and 70.58.200. 84-02-004 (Order 270), § 248-124-010, filed 12/23/83; Order, § 248-124-010, filed 9/1/67.