For the most part, labor and delivery takes place at a healthcare provider site. When a baby is delivered at home, or on the way to the hospital, the mother and baby are typically taken to the hospital for evaluation and possible treatment. Personal and pregnancy information is collected from the mother or an informant, while information regarding labor and delivery and the condition of the newborn is collected from the responsible party at the healthcare facility.

The data requirements for provider supplied live birth information are based on the

• 2003 Revision of the U.S. Standard Certificate of Birth
• 2016 US Standard Facility Worksheet for the Live Birth Certificate
• 2016 US Standard Attachment to the Facility Worksheet for the Live Birth Certificate for Multiple Births
• 2016 US Standard Mothers Worksheet for Child’s Birth Certificate

The jurisdiction may have additional data requirements and edit specifications that will be addressed at the jurisdictional level.

See Patient Worksheet Questionnaires for information about including a QuestionnaireResponse in this Composition.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Composition

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	Provider Live Birth Report
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
liveBirthCertificateNumber	S	0..1	Identifier	Birth Number URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-live-birth-certificate-number
liveBirthLocalFileNumber	S	0..1	Identifier	Local File No. URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-live-birth-local-file-number
dateFiledByRegistrar	S	1..1	dateTime	Date filed by registrar URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-date-filed-by-registrar
replacementStatus	S	0..1	CodeableConcept	Extension URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-replacement-status Binding: ValueSet - Replacement Status (required)
status	S	1..1	code	In the case of a live birth sent in error, a status of 'entered-in-error' must be set.
type	S	1..1	CodeableConcept	U.S. standard certificate of live birth - 2003 revision Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 68998-4
subject	S	1..1	Reference(Patient - Child - Vital Records)	The subject of the composition is the newborn baby: the "US Standard Mothers Worksheet for Child’s Birth Certificate" should be the source of truth for the baby's name.
encounter	S	0..1	Reference(Encounter - Birth)	The Encounter for the Composition is the newborn's birth encounter.
Extension-encounter-maternity-reference		0..1	Reference(Encounter - Maternity)	The Encounter is the maternity encounter. URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-encounter-maternity-reference
date	S	1..1	dateTime	Date report completed
author	S	1..1	Reference(Practitioner - Vital Records)	The author is the person who verifies/approves the accuracy of the data to be sent to the vital records system.
Slices for section	S	1..*	BackboneElement	The Composition is broken into sections that, where possible, align with the sections in the Live Birth Certificate. Slice: Unordered, Open by pattern:code
section:motherPrenatal	S	0..1	BackboneElement	Mother (prenatal) section on the Live Birth Certificate
code	S	1..1	CodeableConcept	Prenatal records Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 57073-9
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother: the "US Standard Mothers Worksheet for Child’s Birth Certificate" should be the source of truth for the mother's name, address, dob, birthplace, race, and ethnicity.
Slices for entry	S	1..*	Reference(Resource)	Entries that are contained in the Mother Prenatal section Slice: Unordered, Open by profile:$this.resolve()
entry:plannedToDeliverAtHome	S	0..1	Reference(Observation - Planned to Deliver at Home)	Planned to deliver at home
entry:firstPrenatalCareVisit	S	0..1	Reference(Observation - Date of First Prenatal Care Visit)	First prenatal care visit
entry:numberPrenatalCareVisits	S	0..1	Reference(Observation - Number of Prenatal Visits - Vital Records)	Number of prenatal care visits
entry:dateLastNormalMenses	S	0..1	Reference(Observation - Last Menstrual Period - Vital Records)	Date last normal menses began
entry:numberNowLiving	S	0..1	Reference(Observation - Number of Births Now Living - Vital Records)	Number of previous live births now living
entry:numberNowDead	S	0..1	Reference(Observation - Number of Births Now Dead - Vital Records)	Number of previous live births now dead
entry:dateLastLiveBirth	S	0..1	Reference(Observation - Date of Last Live Birth)	Date of last live birth
entry:numberOtherOutcomes	S	0..1	Reference(Observation - Number of Other Pregnancy Outcomes - Vital Records)	Number of other pregnancy outcomes
entry:dateLastOtherOutcome	S	0..1	Reference(Observation - Date of Last Other Pregnancy Outcome)	Date of last other pregnancy outcome
entry:principalSourceOfPayment	S	0..1	Reference(Coverage - Principal Payer for Delivery)	Principal source of payment for this delivery
entry:mothersWeightAtDelivery	S	0..1	Reference(Observation - Mother Delivery Weight - Vital Records)	Mother's weight at delivery
entry:mothersHeight	S	0..1	Reference(Observation - Mother Height - Vital Records)	Mother's height: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
entry:mothersPrepregnancyWeight	S	0..1	Reference(Observation - Mother Prepregnancy Weight - Vital Records)	Mother's prepregnancy weight: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
entry:motherReceivedWICFood	S	0..1	Reference(Observation - Mother Recieved WIC Food)	Use of the WIC nutritional program by the mother: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
entry:cigaretteSmokingBeforeDuringPregnancy	S	0..4	Reference(Observation - Cigarette Smoking Before and During Pregnancy)	Cigarettes smoked by the mother before and during the pregnancy: the "US Standard Mothers Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
section:medicalHealthInformation	S	0..1	BackboneElement	Medical and Health Information section on the Live Birth Certificate
code	S	1..1	CodeableConcept	Clinical information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 55752-0
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother
Slices for entry	S	1..*	Reference(Resource)	Entries that are contained in the medical and health information section Slice: Unordered, Open by profile:$this.resolve()
Slices for entry				Content/Rules for all slices
entry:pregnancyRiskFactors	S	0..*	Reference(Condition - Prepregnancy Diabetes - Vital Records | Condition - Gestational Diabetes - Vital Records | Condition - Prepregnancy Hypertension - Vital Records | Condition - Gestational Hypertension - Vital Records | Condition - Eclampsia Hypertension - Vital Records | Observation - Previous Preterm Birth - Vital Records | Procedure - Infertility Treatment - Vital Records | Procedure - Artificial Insemination - Vital Records | Procedure - Assisted Fertilization - Vital Records | Observation - Previous Cesarean - Vital Records | Observation - None Of Specified Pregnancy Risk Factors - Vital Records)	Risk factors in this pregnancy: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for the infertility treatment, artificial insemination, and assisted fertilization data elements.
Slices for entry				Content/Rules for all slices
entry:numberPreviousCesareans	S	0..1	Reference(Observation - Number of Previous Cesareans - Vital Records)	If mother had a previous cesarean delivery, how many
Slices for entry				Content/Rules for all slices
entry:infectionsDuringPregnancy	S	0..*	Reference(Condition - Infection Present During Pregnancy)	Infections present and/or treated during this pregnancy
Slices for entry				Content/Rules for all slices
entry:obstetricProcedures	S	1..1	Reference(Procedure - Obstetric)	Obstetric procedures
Slices for entry				Content/Rules for all slices
entry:characteristicsLaborDelivery	S	0..*	Reference(Procedure - Induction of Labor | Procedure - Augmentation of Labor | Observation - Administration of Steroids for Fetal Lung Maturation | Observation - Antibiotics Administered During Labor | Condition - Chorioamnionitis | Procedure - Epidural or Spinal Anesthesia | Observation - None Of Specified Characteristics of Labor and Delivery)	Characteristics of labor and delivery
Slices for entry				Content/Rules for all slices
entry:fetalPresentation	S	0..1	Reference(Observation - Fetal Presentation at Birth/Delivery)	Fetal presentation at birth
Slices for entry				Content/Rules for all slices
entry:finalRouteMethodDelivery	S	0..1	Reference(Procedure - Final Route and Method of Delivery)	Final route and method of delivery
Slices for entry				Content/Rules for all slices
entry:maternalMorbidity	S	0..*	Reference(Procedure - Blood Transfusion | Condition - Perineal Laceration | Condition - Ruptured Uterus | Procedure - Unplanned Hysterectomy | Observation - ICU Admission | Observation - None Of Specified Maternal Morbidities)	Maternal morbidity (complications associated with labor and delivery)
section:newbornInformation	S	0..1	BackboneElement	Newborn section on the Live Birth Certificate
code	S	1..1	CodeableConcept	Newborn delivery information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 57075-4
Slices for entry	S	1..*	Reference(Resource)	Entries that are contained in the newborn section Slice: Unordered, Open by profile:$this.resolve()
Slices for entry				Content/Rules for all slices
entry:birthWeight	S	0..1	Reference(Observation - Birth Weight - Vital Records)	Birthweight
Slices for entry				Content/Rules for all slices
entry:gestationalAgeAtDelivery	S	0..1	Reference(Observation - Gestational Age at Delivery - Vital Records)	Obstetric estimate of gestation
Slices for entry				Content/Rules for all slices
entry:ApgarScore	S	0..2	Reference(Observation - Apgar Score - Vital Records)	Apgar Score - while the Apgar timing value set contains 3 possible values, 5 and 10 are the only scores used.
Slices for entry				Content/Rules for all slices
entry:numberLiveBirthsThisDelivery	S	0..1	Reference(Observation - Number of Live Births This Delivery - Vital Records)	Number of live births this delivery
Slices for entry				Content/Rules for all slices
entry:abnormalConditionsNewborn	S	0..*	Reference(Procedure - Assisted Ventilation Following Delivery | Procedure - Assisted Ventilation More Than Six Hours | Observation - NICU Admission | Procedure - Surfactant Replacement Therapy | Procedure - Antibiotic for Suspected Neonatal Sepsis | Condition - Seizure | Observation - None Of Specified Abnormal Conditions of Newborn)	Abnormal conditions of the newborn
Slices for entry				Content/Rules for all slices
entry:congenitalAnomaliesNewborn	S	0..*	Reference(Condition - Congenital Anomaly of Newborn)	Congenital anomolies of the newborn
Slices for entry				Content/Rules for all slices
entry:infantLiving	S	0..1	Reference(Observation - Infant Living - Vital Records)	Is infant living at time of report?
Slices for entry				Content/Rules for all slices
entry:infantBreastfedAtDischarge	S	0..1	Reference(Observation - Infant Breastfed at Discharge)	Is infant being breastfed at discharge?
section:motherInformation	S	0..1	BackboneElement	Composition is broken into sections
code	S	1..1	CodeableConcept	Mother's administrative information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 92014-0
focus	S	1..1	Reference(Patient - Mother - Vital Records)	Who/what the section is about, when it is not about the subject of composition
Slices for entry	S	1..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
Slices for entry				Content/Rules for all slices
entry:marriedDuringPregnancy	S	0..1	Reference(Observation - Mother Married During Pregnancy)	Mother married during pregnancy: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
Slices for entry				Content/Rules for all slices
entry:ssnRequestedForChild	S	0..1	Reference(Observation - Social Security Number Requested For Child)	Was social security number requested for the child: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
Slices for entry				Content/Rules for all slices
entry:mothersEducation	S	0..1	Reference(Observation - Parent Education Level - Vital Records)	Mother's education: the US Standard Mother's Worksheet for Child’s Birth Certificate should be the source of truth for this data element.
section:fatherInformation	S	0..1	BackboneElement	Father section on the Live Birth Certificate
code	S	1..1	CodeableConcept	Father's administrative information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 92013-2
focus	S	1..1	Reference(RelatedPerson - Father Natural - Vital Records)	The focus of this section is the father: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for the father's name, dob, birthplace, ssn, race, and ethncity.
Slices for entry	S	1..*	Reference(Resource)	Entries that are contained in the fatherInformation section Slice: Unordered, Open by profile:$this.resolve()
Slices for entry				Content/Rules for all slices
entry:paternityAcknowledgementSigned	S	0..1	Reference(Observation - Paternity Acknowledgement Signed)	Paternity acknowledgement signed by father: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
Slices for entry				Content/Rules for all slices
entry:fathersEducation	S	0..1	Reference(Observation - Parent Education Level - Vital Records)	Father's education: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
section:patientsQuestionnaireResponse		0..1	BackboneElement	Optional section containing a QuestionnaireResponse with recorded answers to the Questionnaire - Mother's Worksheet for Child's Birth Certificate
code		1..1	CodeableConcept	Questionnaire response Document Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 74465-6
entry		1..1	Reference(QuestionnaireResponse)	QuestionnaireResponse with recorded answers to the Questionnaire - Patient's Worksheet for Fetal Death Report
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	Provider Live Birth Report
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
liveBirthCertificateNumber	S	0..1	Identifier	Birth Number URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-live-birth-certificate-number
liveBirthLocalFileNumber	S	0..1	Identifier	Local File No. URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-live-birth-local-file-number
dateFiledByRegistrar	S	1..1	dateTime	Date filed by registrar URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-date-filed-by-registrar
replacementStatus	S	0..1	CodeableConcept	Extension URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-replacement-status Binding: ValueSet - Replacement Status (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	In the case of a live birth sent in error, a status of 'entered-in-error' must be set. Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	SΣ	1..1	CodeableConcept	U.S. standard certificate of live birth - 2003 revision Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 68998-4
subject	SΣ	1..1	Reference(Patient - Child - Vital Records)	The subject of the composition is the newborn baby: the "US Standard Mothers Worksheet for Child’s Birth Certificate" should be the source of truth for the baby's name.
encounter	SΣ	0..1	Reference(Encounter - Birth)	The Encounter for the Composition is the newborn's birth encounter.
Extension-encounter-maternity-reference		0..1	Reference(Encounter - Maternity)	The Encounter is the maternity encounter. URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-encounter-maternity-reference Slice: Unordered, Open by value:url
date	SΣ	1..1	dateTime	Date report completed
author	SΣ	1..1	Reference(Practitioner - Vital Records)	The author is the person who verifies/approves the accuracy of the data to be sent to the vital records system.
title	Σ	1..1	string	Human Readable name/title
Slices for section	SC	1..*	BackboneElement	The Composition is broken into sections that, where possible, align with the sections in the Live Birth Certificate. Slice: Unordered, Open by pattern:code cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
section:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
section:motherPrenatal	SC	0..1	BackboneElement	Mother (prenatal) section on the Live Birth Certificate cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Prenatal records Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 57073-9
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother: the "US Standard Mothers Worksheet for Child’s Birth Certificate" should be the source of truth for the mother's name, address, dob, birthplace, race, and ethnicity.
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the Mother Prenatal section Slice: Unordered, Open by profile:$this.resolve()
entry:plannedToDeliverAtHome	SC	0..1	Reference(Observation - Planned to Deliver at Home)	Planned to deliver at home
entry:firstPrenatalCareVisit	SC	0..1	Reference(Observation - Date of First Prenatal Care Visit)	First prenatal care visit
entry:numberPrenatalCareVisits	SC	0..1	Reference(Observation - Number of Prenatal Visits - Vital Records)	Number of prenatal care visits
entry:dateLastNormalMenses	SC	0..1	Reference(Observation - Last Menstrual Period - Vital Records)	Date last normal menses began
entry:numberNowLiving	SC	0..1	Reference(Observation - Number of Births Now Living - Vital Records)	Number of previous live births now living
entry:numberNowDead	SC	0..1	Reference(Observation - Number of Births Now Dead - Vital Records)	Number of previous live births now dead
entry:dateLastLiveBirth	SC	0..1	Reference(Observation - Date of Last Live Birth)	Date of last live birth
entry:numberOtherOutcomes	SC	0..1	Reference(Observation - Number of Other Pregnancy Outcomes - Vital Records)	Number of other pregnancy outcomes
entry:dateLastOtherOutcome	SC	0..1	Reference(Observation - Date of Last Other Pregnancy Outcome)	Date of last other pregnancy outcome
entry:principalSourceOfPayment	SC	0..1	Reference(Coverage - Principal Payer for Delivery)	Principal source of payment for this delivery
entry:mothersWeightAtDelivery	SC	0..1	Reference(Observation - Mother Delivery Weight - Vital Records)	Mother's weight at delivery
entry:mothersHeight	SC	0..1	Reference(Observation - Mother Height - Vital Records)	Mother's height: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
entry:mothersPrepregnancyWeight	SC	0..1	Reference(Observation - Mother Prepregnancy Weight - Vital Records)	Mother's prepregnancy weight: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
entry:motherReceivedWICFood	SC	0..1	Reference(Observation - Mother Recieved WIC Food)	Use of the WIC nutritional program by the mother: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
entry:cigaretteSmokingBeforeDuringPregnancy	SC	0..4	Reference(Observation - Cigarette Smoking Before and During Pregnancy)	Cigarettes smoked by the mother before and during the pregnancy: the "US Standard Mothers Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
section:medicalHealthInformation	SC	0..1	BackboneElement	Medical and Health Information section on the Live Birth Certificate cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Clinical information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 55752-0
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the medical and health information section Slice: Unordered, Open by profile:$this.resolve()
Slices for entry				Content/Rules for all slices
entry:pregnancyRiskFactors	SC	0..*	Reference(Condition - Prepregnancy Diabetes - Vital Records | Condition - Gestational Diabetes - Vital Records | Condition - Prepregnancy Hypertension - Vital Records | Condition - Gestational Hypertension - Vital Records | Condition - Eclampsia Hypertension - Vital Records | Observation - Previous Preterm Birth - Vital Records | Procedure - Infertility Treatment - Vital Records | Procedure - Artificial Insemination - Vital Records | Procedure - Assisted Fertilization - Vital Records | Observation - Previous Cesarean - Vital Records | Observation - None Of Specified Pregnancy Risk Factors - Vital Records)	Risk factors in this pregnancy: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for the infertility treatment, artificial insemination, and assisted fertilization data elements.
Slices for entry				Content/Rules for all slices
entry:numberPreviousCesareans	SC	0..1	Reference(Observation - Number of Previous Cesareans - Vital Records)	If mother had a previous cesarean delivery, how many
Slices for entry				Content/Rules for all slices
entry:infectionsDuringPregnancy	SC	0..*	Reference(Condition - Infection Present During Pregnancy)	Infections present and/or treated during this pregnancy
Slices for entry				Content/Rules for all slices
entry:obstetricProcedures	SC	1..1	Reference(Procedure - Obstetric)	Obstetric procedures
Slices for entry				Content/Rules for all slices
entry:characteristicsLaborDelivery	SC	0..*	Reference(Procedure - Induction of Labor | Procedure - Augmentation of Labor | Observation - Administration of Steroids for Fetal Lung Maturation | Observation - Antibiotics Administered During Labor | Condition - Chorioamnionitis | Procedure - Epidural or Spinal Anesthesia | Observation - None Of Specified Characteristics of Labor and Delivery)	Characteristics of labor and delivery
Slices for entry				Content/Rules for all slices
entry:fetalPresentation	SC	0..1	Reference(Observation - Fetal Presentation at Birth/Delivery)	Fetal presentation at birth
Slices for entry				Content/Rules for all slices
entry:finalRouteMethodDelivery	SC	0..1	Reference(Procedure - Final Route and Method of Delivery)	Final route and method of delivery
Slices for entry				Content/Rules for all slices
entry:maternalMorbidity	SC	0..*	Reference(Procedure - Blood Transfusion | Condition - Perineal Laceration | Condition - Ruptured Uterus | Procedure - Unplanned Hysterectomy | Observation - ICU Admission | Observation - None Of Specified Maternal Morbidities)	Maternal morbidity (complications associated with labor and delivery)
section:newbornInformation	SC	0..1	BackboneElement	Newborn section on the Live Birth Certificate cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Newborn delivery information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 57075-4
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the newborn section Slice: Unordered, Open by profile:$this.resolve()
Slices for entry				Content/Rules for all slices
entry:birthWeight	SC	0..1	Reference(Observation - Birth Weight - Vital Records)	Birthweight
Slices for entry				Content/Rules for all slices
entry:gestationalAgeAtDelivery	SC	0..1	Reference(Observation - Gestational Age at Delivery - Vital Records)	Obstetric estimate of gestation
Slices for entry				Content/Rules for all slices
entry:ApgarScore	SC	0..2	Reference(Observation - Apgar Score - Vital Records)	Apgar Score - while the Apgar timing value set contains 3 possible values, 5 and 10 are the only scores used.
Slices for entry				Content/Rules for all slices
entry:numberLiveBirthsThisDelivery	SC	0..1	Reference(Observation - Number of Live Births This Delivery - Vital Records)	Number of live births this delivery
Slices for entry				Content/Rules for all slices
entry:abnormalConditionsNewborn	SC	0..*	Reference(Procedure - Assisted Ventilation Following Delivery | Procedure - Assisted Ventilation More Than Six Hours | Observation - NICU Admission | Procedure - Surfactant Replacement Therapy | Procedure - Antibiotic for Suspected Neonatal Sepsis | Condition - Seizure | Observation - None Of Specified Abnormal Conditions of Newborn)	Abnormal conditions of the newborn
Slices for entry				Content/Rules for all slices
entry:congenitalAnomaliesNewborn	SC	0..*	Reference(Condition - Congenital Anomaly of Newborn)	Congenital anomolies of the newborn
Slices for entry				Content/Rules for all slices
entry:infantLiving	SC	0..1	Reference(Observation - Infant Living - Vital Records)	Is infant living at time of report?
Slices for entry				Content/Rules for all slices
entry:infantBreastfedAtDischarge	SC	0..1	Reference(Observation - Infant Breastfed at Discharge)	Is infant being breastfed at discharge?
section:motherInformation	SC	0..1	BackboneElement	Composition is broken into sections cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Mother's administrative information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 92014-0
focus	S	1..1	Reference(Patient - Mother - Vital Records)	Who/what the section is about, when it is not about the subject of composition
Slices for entry	SC	1..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
Slices for entry				Content/Rules for all slices
entry:marriedDuringPregnancy	SC	0..1	Reference(Observation - Mother Married During Pregnancy)	Mother married during pregnancy: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
Slices for entry				Content/Rules for all slices
entry:ssnRequestedForChild	SC	0..1	Reference(Observation - Social Security Number Requested For Child)	Was social security number requested for the child: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
Slices for entry				Content/Rules for all slices
entry:mothersEducation	SC	0..1	Reference(Observation - Parent Education Level - Vital Records)	Mother's education: the US Standard Mother's Worksheet for Child’s Birth Certificate should be the source of truth for this data element.
section:fatherInformation	SC	0..1	BackboneElement	Father section on the Live Birth Certificate cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Father's administrative information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 92013-2
focus	S	1..1	Reference(RelatedPerson - Father Natural - Vital Records)	The focus of this section is the father: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for the father's name, dob, birthplace, ssn, race, and ethncity.
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the fatherInformation section Slice: Unordered, Open by profile:$this.resolve()
Slices for entry				Content/Rules for all slices
entry:paternityAcknowledgementSigned	SC	0..1	Reference(Observation - Paternity Acknowledgement Signed)	Paternity acknowledgement signed by father: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
Slices for entry				Content/Rules for all slices
entry:fathersEducation	SC	0..1	Reference(Observation - Parent Education Level - Vital Records)	Father's education: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
section:patientsQuestionnaireResponse	C	0..1	BackboneElement	Optional section containing a QuestionnaireResponse with recorded answers to the Questionnaire - Mother's Worksheet for Child's Birth Certificate cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Questionnaire response Document Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 74465-6
entry	C	1..1	Reference(QuestionnaireResponse)	QuestionnaireResponse with recorded answers to the Questionnaire - Patient's Worksheet for Fetal Death Report
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	preferred	Pattern: LOINC Code 68998-4 http://hl7.org/fhir/ValueSet/doc-typecodes from the FHIR Standard
Composition.section:motherPrenatal.code	example	Pattern: LOINC Code 57073-9 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:medicalHealthInformation.code	example	Pattern: LOINC Code 55752-0 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:newbornInformation.code	example	Pattern: LOINC Code 57075-4 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:motherInformation.code	example	Pattern: LOINC Code 92014-0 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:fatherInformation.code	example	Pattern: LOINC Code 92013-2 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:patientsQuestionnaireResponse.code	example	Pattern: LOINC Code 74465-6 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:motherPrenatal, Composition.section:medicalHealthInformation, Composition.section:newbornInformation, Composition.section:motherInformation, Composition.section:fatherInformation, Composition.section:patientsQuestionnaireResponse	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:motherPrenatal, Composition.section:medicalHealthInformation, Composition.section:newbornInformation, Composition.section:motherInformation, Composition.section:fatherInformation, Composition.section:patientsQuestionnaireResponse	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	Provider Live Birth Report
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
liveBirthCertificateNumber	S	0..1	Identifier	Birth Number URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-live-birth-certificate-number
liveBirthLocalFileNumber	S	0..1	Identifier	Local File No. URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-live-birth-local-file-number
dateFiledByRegistrar	S	1..1	dateTime	Date filed by registrar URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-date-filed-by-registrar
replacementStatus	S	0..1	CodeableConcept	Extension URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-replacement-status Binding: ValueSet - Replacement Status (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..1	Identifier	Version-independent identifier for the Composition
status	?!SΣ	1..1	code	In the case of a live birth sent in error, a status of 'entered-in-error' must be set. Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	SΣ	1..1	CodeableConcept	U.S. standard certificate of live birth - 2003 revision Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 68998-4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject	SΣ	1..1	Reference(Patient - Child - Vital Records)	The subject of the composition is the newborn baby: the "US Standard Mothers Worksheet for Child’s Birth Certificate" should be the source of truth for the baby's name.
encounter	SΣ	0..1	Reference(Encounter - Birth)	The Encounter for the Composition is the newborn's birth encounter.
id		0..1	string	Unique id for inter-element referencing
Extension-encounter-maternity-reference		0..1	Reference(Encounter - Maternity)	The Encounter is the maternity encounter. URL: https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-encounter-maternity-reference Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
date	SΣ	1..1	dateTime	Date report completed
author	SΣ	1..1	Reference(Practitioner - Vital Records)	The author is the person who verifies/approves the accuracy of the data to be sent to the vital records system.
title	Σ	1..1	string	Human Readable name/title
confidentiality	Σ	0..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester		0..*	BackboneElement	Attests to accuracy of composition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time		0..1	dateTime	When the composition was attested
party		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)	Who attested the composition
custodian	Σ	0..1	Reference(Organization)	Organization which maintains the composition
relatesTo		0..*	BackboneElement	Relationships to other compositions/documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(Composition)
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	Σ	0..1	Period	The period covered by the documentation
detail	Σ	0..*	Reference(Resource)	The event(s) being documented
Slices for section	SC	1..*	BackboneElement	The Composition is broken into sections that, where possible, align with the sections in the Live Birth Certificate. Slice: Unordered, Open by pattern:code cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
section:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:motherPrenatal	SC	0..1	BackboneElement	Mother (prenatal) section on the Live Birth Certificate cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code	S	1..1	CodeableConcept	Prenatal records Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 57073-9
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother: the "US Standard Mothers Worksheet for Child’s Birth Certificate" should be the source of truth for the mother's name, address, dob, birthplace, race, and ethnicity.
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the Mother Prenatal section Slice: Unordered, Open by profile:$this.resolve()
Slices for entry				Content/Rules for all slices
entry:plannedToDeliverAtHome	SC	0..1	Reference(Observation - Planned to Deliver at Home)	Planned to deliver at home
Slices for entry				Content/Rules for all slices
entry:firstPrenatalCareVisit	SC	0..1	Reference(Observation - Date of First Prenatal Care Visit)	First prenatal care visit
Slices for entry				Content/Rules for all slices
entry:numberPrenatalCareVisits	SC	0..1	Reference(Observation - Number of Prenatal Visits - Vital Records)	Number of prenatal care visits
Slices for entry				Content/Rules for all slices
entry:dateLastNormalMenses	SC	0..1	Reference(Observation - Last Menstrual Period - Vital Records)	Date last normal menses began
Slices for entry				Content/Rules for all slices
entry:numberNowLiving	SC	0..1	Reference(Observation - Number of Births Now Living - Vital Records)	Number of previous live births now living
Slices for entry				Content/Rules for all slices
entry:numberNowDead	SC	0..1	Reference(Observation - Number of Births Now Dead - Vital Records)	Number of previous live births now dead
Slices for entry				Content/Rules for all slices
entry:dateLastLiveBirth	SC	0..1	Reference(Observation - Date of Last Live Birth)	Date of last live birth
Slices for entry				Content/Rules for all slices
entry:numberOtherOutcomes	SC	0..1	Reference(Observation - Number of Other Pregnancy Outcomes - Vital Records)	Number of other pregnancy outcomes
Slices for entry				Content/Rules for all slices
entry:dateLastOtherOutcome	SC	0..1	Reference(Observation - Date of Last Other Pregnancy Outcome)	Date of last other pregnancy outcome
Slices for entry				Content/Rules for all slices
entry:principalSourceOfPayment	SC	0..1	Reference(Coverage - Principal Payer for Delivery)	Principal source of payment for this delivery
Slices for entry				Content/Rules for all slices
entry:mothersWeightAtDelivery	SC	0..1	Reference(Observation - Mother Delivery Weight - Vital Records)	Mother's weight at delivery
Slices for entry				Content/Rules for all slices
entry:mothersHeight	SC	0..1	Reference(Observation - Mother Height - Vital Records)	Mother's height: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
Slices for entry				Content/Rules for all slices
entry:mothersPrepregnancyWeight	SC	0..1	Reference(Observation - Mother Prepregnancy Weight - Vital Records)	Mother's prepregnancy weight: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
Slices for entry				Content/Rules for all slices
entry:motherReceivedWICFood	SC	0..1	Reference(Observation - Mother Recieved WIC Food)	Use of the WIC nutritional program by the mother: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
Slices for entry				Content/Rules for all slices
entry:cigaretteSmokingBeforeDuringPregnancy	SC	0..4	Reference(Observation - Cigarette Smoking Before and During Pregnancy)	Cigarettes smoked by the mother before and during the pregnancy: the "US Standard Mothers Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:medicalHealthInformation	SC	0..1	BackboneElement	Medical and Health Information section on the Live Birth Certificate cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code	S	1..1	CodeableConcept	Clinical information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 55752-0
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the medical and health information section Slice: Unordered, Open by profile:$this.resolve()
Slices for entry				Content/Rules for all slices
entry:pregnancyRiskFactors	SC	0..*	Reference(Condition - Prepregnancy Diabetes - Vital Records | Condition - Gestational Diabetes - Vital Records | Condition - Prepregnancy Hypertension - Vital Records | Condition - Gestational Hypertension - Vital Records | Condition - Eclampsia Hypertension - Vital Records | Observation - Previous Preterm Birth - Vital Records | Procedure - Infertility Treatment - Vital Records | Procedure - Artificial Insemination - Vital Records | Procedure - Assisted Fertilization - Vital Records | Observation - Previous Cesarean - Vital Records | Observation - None Of Specified Pregnancy Risk Factors - Vital Records)	Risk factors in this pregnancy: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for the infertility treatment, artificial insemination, and assisted fertilization data elements.
Slices for entry				Content/Rules for all slices
entry:numberPreviousCesareans	SC	0..1	Reference(Observation - Number of Previous Cesareans - Vital Records)	If mother had a previous cesarean delivery, how many
Slices for entry				Content/Rules for all slices
entry:infectionsDuringPregnancy	SC	0..*	Reference(Condition - Infection Present During Pregnancy)	Infections present and/or treated during this pregnancy
Slices for entry				Content/Rules for all slices
entry:obstetricProcedures	SC	1..1	Reference(Procedure - Obstetric)	Obstetric procedures
Slices for entry				Content/Rules for all slices
entry:characteristicsLaborDelivery	SC	0..*	Reference(Procedure - Induction of Labor | Procedure - Augmentation of Labor | Observation - Administration of Steroids for Fetal Lung Maturation | Observation - Antibiotics Administered During Labor | Condition - Chorioamnionitis | Procedure - Epidural or Spinal Anesthesia | Observation - None Of Specified Characteristics of Labor and Delivery)	Characteristics of labor and delivery
Slices for entry				Content/Rules for all slices
entry:fetalPresentation	SC	0..1	Reference(Observation - Fetal Presentation at Birth/Delivery)	Fetal presentation at birth
Slices for entry				Content/Rules for all slices
entry:finalRouteMethodDelivery	SC	0..1	Reference(Procedure - Final Route and Method of Delivery)	Final route and method of delivery
Slices for entry				Content/Rules for all slices
entry:maternalMorbidity	SC	0..*	Reference(Procedure - Blood Transfusion | Condition - Perineal Laceration | Condition - Ruptured Uterus | Procedure - Unplanned Hysterectomy | Observation - ICU Admission | Observation - None Of Specified Maternal Morbidities)	Maternal morbidity (complications associated with labor and delivery)
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:newbornInformation	SC	0..1	BackboneElement	Newborn section on the Live Birth Certificate cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code	S	1..1	CodeableConcept	Newborn delivery information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 57075-4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the newborn section Slice: Unordered, Open by profile:$this.resolve()
Slices for entry				Content/Rules for all slices
entry:birthWeight	SC	0..1	Reference(Observation - Birth Weight - Vital Records)	Birthweight
Slices for entry				Content/Rules for all slices
entry:gestationalAgeAtDelivery	SC	0..1	Reference(Observation - Gestational Age at Delivery - Vital Records)	Obstetric estimate of gestation
Slices for entry				Content/Rules for all slices
entry:ApgarScore	SC	0..2	Reference(Observation - Apgar Score - Vital Records)	Apgar Score - while the Apgar timing value set contains 3 possible values, 5 and 10 are the only scores used.
Slices for entry				Content/Rules for all slices
entry:numberLiveBirthsThisDelivery	SC	0..1	Reference(Observation - Number of Live Births This Delivery - Vital Records)	Number of live births this delivery
Slices for entry				Content/Rules for all slices
entry:abnormalConditionsNewborn	SC	0..*	Reference(Procedure - Assisted Ventilation Following Delivery | Procedure - Assisted Ventilation More Than Six Hours | Observation - NICU Admission | Procedure - Surfactant Replacement Therapy | Procedure - Antibiotic for Suspected Neonatal Sepsis | Condition - Seizure | Observation - None Of Specified Abnormal Conditions of Newborn)	Abnormal conditions of the newborn
Slices for entry				Content/Rules for all slices
entry:congenitalAnomaliesNewborn	SC	0..*	Reference(Condition - Congenital Anomaly of Newborn)	Congenital anomolies of the newborn
Slices for entry				Content/Rules for all slices
entry:infantLiving	SC	0..1	Reference(Observation - Infant Living - Vital Records)	Is infant living at time of report?
Slices for entry				Content/Rules for all slices
entry:infantBreastfedAtDischarge	SC	0..1	Reference(Observation - Infant Breastfed at Discharge)	Is infant being breastfed at discharge?
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:motherInformation	SC	0..1	BackboneElement	Composition is broken into sections cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code	S	1..1	CodeableConcept	Mother's administrative information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 92014-0
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus	S	1..1	Reference(Patient - Mother - Vital Records)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	SC	1..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:resolve()
Slices for entry				Content/Rules for all slices
entry:marriedDuringPregnancy	SC	0..1	Reference(Observation - Mother Married During Pregnancy)	Mother married during pregnancy: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
Slices for entry				Content/Rules for all slices
entry:ssnRequestedForChild	SC	0..1	Reference(Observation - Social Security Number Requested For Child)	Was social security number requested for the child: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
Slices for entry				Content/Rules for all slices
entry:mothersEducation	SC	0..1	Reference(Observation - Parent Education Level - Vital Records)	Mother's education: the US Standard Mother's Worksheet for Child’s Birth Certificate should be the source of truth for this data element.
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:fatherInformation	SC	0..1	BackboneElement	Father section on the Live Birth Certificate cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code	S	1..1	CodeableConcept	Father's administrative information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 92013-2
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus	S	1..1	Reference(RelatedPerson - Father Natural - Vital Records)	The focus of this section is the father: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for the father's name, dob, birthplace, ssn, race, and ethncity.
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the fatherInformation section Slice: Unordered, Open by profile:$this.resolve()
Slices for entry				Content/Rules for all slices
entry:paternityAcknowledgementSigned	SC	0..1	Reference(Observation - Paternity Acknowledgement Signed)	Paternity acknowledgement signed by father: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
Slices for entry				Content/Rules for all slices
entry:fathersEducation	SC	0..1	Reference(Observation - Parent Education Level - Vital Records)	Father's education: the "US Standard Mother's Worksheet for Child’s Birth Certificate" should be the source of truth for this data element.
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:patientsQuestionnaireResponse	C	0..1	BackboneElement	Optional section containing a QuestionnaireResponse with recorded answers to the Questionnaire - Mother's Worksheet for Child's Birth Certificate cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		1..1	CodeableConcept	Questionnaire response Document Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 74465-6
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	1..1	Reference(QuestionnaireResponse)	QuestionnaireResponse with recorded answers to the Questionnaire - Patient's Worksheet for Fetal Death Report
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	preferred	Pattern: LOINC Code 68998-4 http://hl7.org/fhir/ValueSet/doc-typecodes from the FHIR Standard
Composition.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes from the FHIR Standard
Composition.encounter.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Composition.confidentiality	required	v3.ConfidentialityClassification http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26 from the FHIR Standard
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard
Composition.event.code	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
Composition.section.code	example	DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:motherPrenatal.code	example	Pattern: LOINC Code 57073-9 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:motherPrenatal.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:motherPrenatal.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:motherPrenatal.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:medicalHealthInformation.code	example	Pattern: LOINC Code 55752-0 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:medicalHealthInformation.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:medicalHealthInformation.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:medicalHealthInformation.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:newbornInformation.code	example	Pattern: LOINC Code 57075-4 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:newbornInformation.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:newbornInformation.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:newbornInformation.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:motherInformation.code	example	Pattern: LOINC Code 92014-0 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:motherInformation.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:motherInformation.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:motherInformation.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:fatherInformation.code	example	Pattern: LOINC Code 92013-2 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:fatherInformation.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:fatherInformation.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:fatherInformation.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard
Composition.section:patientsQuestionnaireResponse.code	example	Pattern: LOINC Code 74465-6 http://hl7.org/fhir/ValueSet/doc-section-codes from the FHIR Standard
Composition.section:patientsQuestionnaireResponse.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section:patientsQuestionnaireResponse.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section:patientsQuestionnaireResponse.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:motherPrenatal, Composition.section:medicalHealthInformation, Composition.section:newbornInformation, Composition.section:motherInformation, Composition.section:fatherInformation, Composition.section:patientsQuestionnaireResponse	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:motherPrenatal, Composition.section:medicalHealthInformation, Composition.section:newbornInformation, Composition.section:motherInformation, Composition.section:fatherInformation, Composition.section:patientsQuestionnaireResponse	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()