Overhaul of Utah birth certificate gets more detailed, more personal

Published December 26, 2008 4:27 pm
Updated questionnaire » On the old one, a mother has to mark 'etc.' if she's multiracial or Latino.
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The state is about to know a lot more about Utah women and their births, starting Jan. 1.

Did you choose to have your Caesarean section, or was it necessary? Did you need artificial insemination or fertility drugs to get pregnant? Do you have chlamydia?

These are all new questions that will be answered as Utah launches a new birth certificate next week.

But don't worry: Any birth secrets you have will remain safe, since the piece of paper parents take home will remain the same -as today. That form includes basic information such as parents' names, place of birth and the baby's weight.

It's the data collected for each birth, through interviews with the mother and a review of medical records, that has been overhauled.

"Individual citizens probably won't notice a difference at all in the certificate they get," said Jeffrey Duncan, director of the state health department's Office of Vital Records and Statistics. But "public health will benefit because of better data."

Utah's current questionnaire is two decades old, adopted in 1989. Some portions are clearly outdated: There isn't an option to note if the mother is multiracial. And the options for race are only American Indian, black, white, Japanese, or "etc."

The state is late in adopting the new survey, which was created in 2003. It's the national standard developed by the National Center for Health Statistics. The state had to develop a new software system to implement it, which is why it took so long, Duncan said.

Utah wasn't required to adopt it, but the state receives federal funding for data it provides to the center, and some of that money could be at risk without changing, said Duncan. He believes two-thirds of the states have already switched.

The new form leaves out some information Utah collects today, such as whether a baby has fetal alcohol syndrome and the mother's alcohol use during pregnancy. Laurie Baksh, a reproductive health epidemiologist with the state health department, said babies are rarely diagnosed with the birth defect upon delivery. And designers of the questionnaire don't believe women accurately report their alcohol use during pregnancy.

However, women will continue to be asked about their cigarette use.

Utah health officials ask similar questions of a sample of new mothers through an annual survey. According to 2004-05 data, the most recent available, 23 percent drank during the three months before they got pregnant, considered a good measure of consumption during the early weeks of pregnancy. And nearly 6 percent smoked during their last trimester.

Utah added some of its own questions to the new birth certificate, including whether the mother has depression and whether the baby has a variety of birth defects. The national version has several congenital anomalies but not everything that Utah researchers want to track, such as malformed genitalia and club foot.

The national certificate includes a question on whether the pregnancy resulted from infertility treatments and what kind was used. Utah researchers added a question about how long the couple had been trying to get pregnant.

Utah's version also specifically asks whether labor was induced, and if so, if it was medically necessary or elective. Ditto for a C-section.

Early elective inductions and C-sections have been linked to the rise in the premature birth rate. And babies born even a couple of weeks early are at risk for respiratory and feeding problems, jaundice, long-term mental disabilities and sudden death.

Lois Bloebaum, the health department's reproductive health program manager, is looking forward to having firm numbers on induction and surgery trends. "Unless we can tease out why that rate is going up," she said, "it's hard to develop programs and strategies to address the problem."

hmay@sltrib.com" Target="_BLANK">hmay@sltrib.com

Snapshot of Utah pregnancies

While the new birth certificate will provide more data, other sources offer a picture of Utah births.

In 2004-05:

» 5.4 percent of Utah women needed treatment to get pregnant. Of those women, 60 percent used drugs like Clomid, almost 14 percent used artificial insemination and 12 percent used technology like in vitro. Others used options that include surgery.

» 27 percent used Medicaid coverage for prenatal care.

» 34 percent had a sexually transmitted disease or a urinary tract or vaginal infection during pregnancy.

In 2005:

» 21.6 percent of births were by Caesarean section.

» 35.3 percent of births were induced.

Source: Utah Pregnancy Risk Assessment Monitoring System, 2004-05; Centers for Disease Control and Prevention; University of Utah.

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