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Births/Maternity

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 objective of the Maternal, Infant, and Child Health topic area is to 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.
Pregnancy provides 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
  • Diabetes
  • Depression
  • Genetic conditions
  • Sexually transmitted infections (STIs)
  • Tobacco use and alcohol abuse
  • Inadequate nutrition
  • Unhealthy weight
  • Intimate partner violence

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. Additionally, 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.
Conditions in the places where people live, learn, work, and play affect a wide range of health risks and outcomes. Environmental and social factors influence maternal health behaviors and health status. These factors include access to health care and subsequent developmental screening/early intervention services, education, employment, economic opportunities, social support, and availability of resources to meet daily needs.

The factors that influence maternal health also affect pregnancy outcomes and infant and child health. Racial and ethnic disparities exist in maternal, infant and child mortality and can be partly attributed to disparities in social determinants of health. Children's health status varies by both race and ethnicity, as well as by family income and related factors, including educational attainment among household members and health insurance coverage. Other factors related to child health status include access to high-quality health care and medical home as well as maternity care practices that promote breastfeeding and safe sleep environments.

The cognitive and physical development of infants and children are influenced by the health, nutrition, and behaviors of their mothers during pregnancy and early childhood. Consumption of recommended amounts of folic acid before and during pregnancy reduce the risk for neural tube defects. 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. Also, children reared in safe and nurturing families and neighborhoods, free from maltreatment and other adverse childhood experiences, are more likely to have better outcomes as adults.
Many factors affect pregnancy and childbirth, including:
  • Preconception health status
  • Maternal age
  • Access to appropriate preconception and interconception health care
  • Poverty

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. These differences are likely the result of many factors.

Social Determinants of Maternal Health
These include pre-pregnancy health behaviors and health status, which are influenced by a variety of environmental and social factors such as access to health care and chronic stress.

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. Child health status varies by both race and ethnicity, as well as by family income and related factors, including educational attainment among household members and health insurance coverage.

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. Also, 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.

Emerging Issues in Maternal, Infant, and Child Health
Recent efforts to address persistent disparities in maternal, infant, and child health use a "life course" perspective to health promotion and disease prevention. Fewer than half of all pregnancies are planned. Unintended pregnancy is associated with a host of public health concerns. In response, preconception health initiatives focus on improving the health of a woman before she becomes pregnant through a variety of evidence-based interventions.

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 received infertility services (including counseling and diagnosis) in their lifetime. Infertility is an area where health disparities are large and may only continue to increase as childbearing practices change over time.
The risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access to quality care preconception (before pregnancy), during pregnancy, after the baby arrives, and interconception (between pregnancies).
  • Preconception health care is the medical care a woman or man receives from their doctor or other health professionals that focuses on aspects of health shown to increase the chance of having a healthy baby. Preconception health care is different for every person, depending on his or her unique needs. Based on a person's individual health, the doctor or other health care professional will suggest a course of treatment or follow-up care as needed.
  • During pregnancy-women need regular prenatal care to monitor their health and the growth and development of the fetus. Health care providers can provide needed vaccinations, order blood tests, monitor blood pressure and blood sugar to check for gestational diabetes, screen for HIV and other services to assure optimal health for mother and baby. Mothers can support their pregnancies by taking folic acid, eating a healthy diet, getting enough exercise, controlling their weight gain, avoiding exposure to certain chemicals and radiation, and abstaining from tobacco, alcohol and other drugs.
  • After the baby arrives-mothers and babies need continued medical care to screen for and manage postpartum conditions in both mother and child. These can include newborn screening for treatable diseases, jaundice, hearing loss, vaccinations and care for postpartum depression. Practices such as breastfeeding, sleep positioning, and use of child safety seats are just some of the important ways parents can safeguard their baby's health.
Maternal and Child Health is tracked at the national and state levels primarily through:
  • National Survey of Children's Health (NSCH)
  • Behavioral Risk Factor and Surveillance System (BRFSS)
  • Pregnancy Risk Assessment and Monitoring System (PRAMS)
  • Birth certificates
  • Death certificates

Hawaii IBIS Indicator Reports

Hawaii Health Matters Indicator Dashboards (Note: leaving IBIS site)

Births


Deaths


Pregnancy Risk Assessment Monitoring System (PRAMS) - Health Insurance Coverage


Pregnancy Risk Assessment Monitoring System (PRAMS) - Before Pregnancy


Pregnancy Risk Assessment Monitoring System (PRAMS) - During Pregnancy


Pregnancy Risk Assessment Monitoring System (PRAMS) - After Pregnancy


Pregnancy Risk Assessment Monitoring System (PRAMS) - Infant


The information provided above is from the Hawaii Health Data Warehouse and the Hawaii State Department of Health's Hawaii-IBIS web site (http://ibis.hhdw.org/ibisph-view.). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Fri, 22 October 2021 15:41:26 from Hawaii State Department of Health, Hawaii Health Data Warehouse, Indicator-Based Information System for Public Health Web site: http://ibis.hhdw.org/ibisph-view ".

Content updated: Mon, 9 Nov 2020 14:05:34 HST