WAC 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"




[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.]