PRAMS Livebirth Phase 9 Standard Web Module (English)

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