PRAMS Livebirth Phase 9 Standard Web Module (English)

Pregnancy Risk Assessment Monitoring System (PRAMS)

Att 10i - PRAMS Livebirth Phase 9 Standard Web Module - ENGLISH

OMB: 0920-1273

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Attachment 10i – PRAMS Livebirth Phase 9 Standard Web Module - English




Form Approved

OMB No. 0920-1273

Exp. Date xx/xx/xxxx






Pregnancy Risk Assessment Monitoring System (PRAMS)

Phase 9 Standard Web Module – English



Assisted Reproduction and Fertility























Breastfeeding







































Occupational Status and Workplace Leave



















































Contraception





























Infant Sleep Environment

























Maternal Nutrition and Supplement Use





























Health Insurance

Infant Health Insurance Coverage



















Maternal Health Insurance Coverage























HIV and Sexually Transmitted Infections











Postpartum Care



























Preconception Care



















Labor and Delivery





































Preconception Health



























Vaccinations

Maternal





















Child Vaccinations









































Mental Health









































































Maternal Morbidity











































Maternal Warning Signs





Food Security and Economic Security



























Neighborhood and Built Environment





















Family Planning

































Prenatal Care









































































Injury Prevention and Safety



































Infant Healthcare

Sick Child Care



















Well Child Care

















Substance Use





























Social Services including Home Visiting































































Social Support Including Partner Support











































Oral Health









































Intimate Partner Violence

























Tobacco and Nicotine Product Use and Cessation



















































Experiences of Discrimination and Racism









Physical Activity



















Reproductive History

































Demographic Information Including Maternal Weight





















Alcohol Consumption



























Disaster and Emergency Preparedness



















Maternal Childhood Experiences

















Disability













Sexual Orientation and Gender



















Natural Disaster Module





































Environmental Exposures Module























Environmental Exposure


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