PRAMS Livebirth Phase 9 Standard Web Module (Spanish)

Attachment 10j – PRAMS Livebirth Phase 9 Standard Web Module - Spanish

Form Approved

OMB No. 0920-1273

Exp. Date xx/xx/xxxx

Pregnancy Risk Assessment Monitoring System (PRAMS)

Sistema De Evaluación Del Riesgo En El Embarazo

Phase 9 Standard Mail Questionnaire – Spanish

Cuestionario Correo Estándar De La Fase 9 - En Español

Assisted Reproduction and Fertility

Breastfeeding

Occupational Status and Workplace Leave

Contraception

Infant Sleep Environment

Maternal Nutrition and Supplement Use

Health Insurance

HIV and Sexually Transmitted Infections

Postpartum Care

Preconception Care

Labor and Delivery

Preconception Health

Vaccinations

Mental Health

Maternal Morbidity

Maternal Warning Signs

Food Security and Economic Stability

Neighborhood and Built Environment

Family Planning

Prenatal Care

Injury Prevention and Safety

Infant Healthcare

Substance Use

Social Services Including Home Visitation

Social Support Including Partner Experiences

Oral Health

Intimate Partner Violence

Tobacco and Nicotine Product Use and Cessation

Experiences of Discrimination and Racism

Physical Activity

Reproductive History

Demographic Information

Alcohol Consumption

Disaster and Emergency Preparedness

Maternal Childhood Experiences

Disability

Sexual Orientation and Gender Identity

Natural Disaster Module

Environmental Exposures