This page is part of the Vital Records Birth and Fetal Death Reporting (v2.0.0: STU2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
This example provides a narrative description of the live birth report for Baby Girl Quinn, following the birth report form.
This information is transmitted in both a Provider bundle to the VRO, and in a Jurisdiction bundle to NCHS. The main difference between the two bundles is the inclusion of edit flags.
| Field(s) | Example Instance |
|---|---|
| Child | Baby Girl Quinn, Time of Birth: 2019-02-12 07:00 |
| Mother | Jada Ann Quinn |
| Father | James Brandon Quinn |
| Certifier | Avery Jones |
| Birth Encounter | Birth Encounter |
| Mother Married During Pregancy | Married |
| Paternity Acknowledgement Signed | Yes |
| SSN Requested for Child | True |
| Mother's Education | Doctoral or Post-Graduate |
| Mother's Present Job-Occupation | Carpenter |
| Mother's Present Job-Industry | Construction |
| Mother's Race and Ethnicity | White/AIAN/OtherAsian, Non-Hispanic |
| Father's Education | Doctoral or Post-Graduate |
| Father's Present Job-Occupation | Lawyer |
| Father's Present Job-Industry | Legal Services |
| Father's Race and Ethnicity | White/AIAN/OtherAsian, Non-Hispanic |
| Place of Birth | Birth at South Hospital , Discharge to East Hospital |
| Attendant | Avery Jones |
| Mother Transferred | Yes |
| First Prenatal Care Visit Date | 2018-07-20 |
| Number of Prenatal Care Visits | 8 |
| Mother's Height | 67 in |
| Mother's Prepregnancy Weight | 145 lb |
| Mother's Weight at Delivery | 175 lb |
| Mother WIC Food | Yes |
| Number of Previous Live Births | Living = 1, Dead = 0 |
| Number of Other Pregnancy Outcomes | Other Outcomes = 0 |
| Cigarette Smoking | Prepregnancy = 20, First Trimester = 3, Second Trimester = 1, Third Trimester = 0 |
| Principal Source of Payment | Private Health Insurance |
| Last Live Birth Date | 2014-11-20 |
| Last Other Outcomes Date | 2015-05 |
| Last Normal Menses Date | 2018-06-05 |
| Risk Factors During Pregnancy | Gestational Hypertension, Prepregnancy Diabetes, Infertility Treatment, Artificial Insemination, Previous Caesarean = 1'] |
| Infections During Pregnancy | Chlamydial Infection |
| Obstetric Procedures | External Cephalic Version - Unsuccessful |
| Characteristics of Labor and Delivery | Induction, Antibiotics, Chorioamnionitis, Epidural |
| Fetal Presentation | Breech |
| Final Route/Method of Delivery | Cesarean with trial labor attempted |
| Maternal Morbidity | Ruptured Uterus |
| Newborn Birthweight | 2500g |
| Obstetric Estimate of Gestation | 36 wk |
| Apgar Score | 5min = 5, 10min = 7 |
| Number of Live Births this Delivery | 2 |
| Plurality / Birth Order | Plurality = 1 , Order = 1 |
| Abnormal Conditions of the Newborn | Antibiotics Received |
| Congenital Anomolies of the Newborn | Cyanotic Congenital Heart Disease, Anomaly of Chromosome Pair 21 |
| Infant Transferred | Yes |
| Infant Living | True |
| Infant Breastfed at Discharge | True |