Birth And Fetal Death (BFDR) - STU2-ballot
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Birth And Fetal Death (BFDR) - STU2-ballot, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.0.0-Preview1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of and changes regularly. See the Directory of published versions

Live Birth Report Example - Baby G Quinn

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 Usual Work-Occupation Carpenter
Mother’s Usual Work-Industry Construction
Mother’s Race and Ethnicity White/AIAN/OtherAsian, Non-Hispanic
Father’s Education Doctoral or Post-Graduate
Father’s Usual Work-Occupation Lawyer
Father’s Usual Work-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 1min = 5, 5min = 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