Improving the health of Louisiana's mothers and babies

Understanding women’s experiences surrounding pregnancy and childbirth is a cornerstone of the Louisiana Department of Health’s (LDH) efforts to improve the health of Louisiana mothers and babies.

LDH’s Bureau of Family Health uses the Louisiana Pregnancy Risk Assessment Monitoring System (PRAMS), an ongoing surveillance system administered in partnership with the Centers for Disease Control and Prevention (CDC), as a primary source of quantitative and qualitative data around those experiences and maternal behaviors before, during, and immediately following pregnancy.

Each month, approximately 200 PRAMS questionnaires are mailed to a random sample of women in Louisiana who have recently given birth. While participation is voluntary, the CDC recommends a response rate of 55 percent to ensure data best represents the experiences of the majority of Louisiana women. Response rates have increased and remained high in recent years at 66 percent in 2015, 63 percent in 2016, and 67 percent in 2017. Completed surveys are returned to the Bureau of Family Health, where answers are grouped to provide representative data for the entire state.

The Bureau of Family Health compiles Louisiana PRAMS data into two types of annual reports: Data Reports, which include complete quantitative PRAMS data, and Surveillance Reports, which highlight key findings, analyze their implications, and include direct quotes from Louisiana mothers. These reports are designed to help health professionals, policymakers, and researchers develop, modify and evaluate programs and policies to improve the health of mothers and infants. Both reports provide information on:

• Factors that influence pregnancy outcomes, including health insurance status, chronic conditions, pregnancy intention, contraceptive use, prenatal care, alcohol use, tobacco use, physical abuse, and life stress.
• Mothers’ experience of pregnancy complications, including hypertension, diabetes and hospitalizations.
• Maternal experiences and behaviors after the baby is born, including depression, maternity leave experiences, breastfeeding, contraceptive use, tobacco and alcohol use, and safe infant sleep practices.

The most recent reports are the 2014 Surveillance Report and 2015 Data Report. Highlights from the 2014 Surveillance Report include:

• Family Planning: Over half (56 percent) of mothers did not intend to become pregnant or were unsure if they wanted to become pregnant. Of those, 60 percent reported not doing anything to prevent a pregnancy.
• Previous Birth Outcomes: 25 percent of mothers who had previously given birth experienced an adverse birth outcome, namely low birth weight and/or preterm births. Of those, 59 percent experienced another adverse birth outcome for their latest pregnancy.
• Breastfeeding: 66 percent of mothers breastfed or fed pumped milk to their new babies at least once. 41 percent of mothers who initiated breastfeeding were still breastfeeding at the time of the survey.
• Black mothers had different hospital breastfeeding experiences than white mothers. 79 percent of black moms were given a gift pack containing formula at the hospital, as compared to 47 percent of white moms.
• One PRAMS mom highlighted the challenges of balancing breastfeeding and work, writing, “I stopped breastfeeding after five weeks because the stress of returning to work so soon affected my milk supply…if more time off was given to new moms, there may be more others who would breastfeed their babies for a longer period of time.
•  Safe Infant Sleep: 1 in 5 babies were exposed to 3 or more risk factors for Sudden Unexpected Infant Death (SUID), including bedsharing, stomach or side sleeping position, cigarette smoke exposure, non-firm sleep surfaces, and/or sleeping with soft objects. 

All Louisiana PRAMS reports and fact sheets can be found and downloaded on the Partners for Family Health Data Center. To request additional Louisiana PRAMS data, submit a data request. For more information about Louisiana PRAMS, contact Rosaria Trichilo, Program Coordinator, at Rosaria.Trichilo@la.gov or 504-568-3504.