Welcome to the training on Prenatal Health: Screening and Intervention provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).
This course does not currently offer continuing education credit.
Goal
The goal of this module is to equip Texas Health Steps providers and other health-care professionals to identify and address prenatal factors that affect maternal health and safety.
Target Audience
Primary care providers and other health professionals who treat female patients who are pregnant.
Note: The information in this module focuses on adolescent and adult women ages 18 through 44 years, who deliver the majority of live babies in Texas. A companion module, Preconception Health: Screening and Intervention, addresses issues related to preconception health screening, intervention, and counseling.
Specific Learning Objectives
After completing the activities of this module, you will be able to:
- Summarize the leading causes of maternal morbidity and mortality in Texas.
- Specify the health risks and conditions that are associated with maternal morbidity and mortality.
- Integrate prenatal screening, treatment, and counseling protocols that promote maternal health and safety.
Please note this module expires on 9/11/2021.
This module was released on 9/11/2018.
Disclosures
One of the requirements of continuing education is disclosure of the following information to the learner:
- Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
- Create a Texas Health Steps account.
- Complete on-line registration process.
- Thoroughly read the content of the module.
- Complete the on-line examination.
- Complete the evaluation.
- Commercial Support.
The THSTEPS Web-based Continuing Education Series has received no commercial support. - Disclosure of Relevant Financial Relationships.
The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose. - Non-Endorsement Statement.
Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center. - Off-Label Use.
Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).
The following are policies and definitions of terms related to continuing education disclosure:
The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.
All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.
Glossary of Terms
Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.
Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.
Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).
Browser Requirements
Texas Health Steps courses are best viewed using a current browser. If you are using an out-of-date browser or a version of Internet Explorer less than 11, lesson progress and interactive features may not function properly.
Culturally Effective Health Care:
- American Academy of Pediatrics. (n.d.). Culturally Effective Care Toolkit.
Depression and Anxiety:
- American College of Obstetricians and Gynecologists. (2015). Committee Opinion 630: Screening for Perinatal Depression.
- Spitzer, R. L., Williams, J. B. W., & Kroenke, K. (2011). Generalized Anxiety Disorder Scale (Two Items) Questionnaire. Common Mental Health Disorders: Identification and Pathways to Care. British Psychological Society.
- Texas Medicaid Provider Procedures Manual.
HIV:
- An HIV and Preconception Care Toolkit from the Rutgers Francois-Xavier Bagnoud Center School of Nursing and the CDC.
- HIV Clinical Resource website offered by the New York State Department of Health AIDS Institute in collaboration with Johns Hopkins University Division of Infectious Diseases.
- Texas Department of State Health Services. Notifiable Conditions.
Hypertension and Pregnancy:
- American College of Obstetricians and Gynecologists. (2016). Practice Advisory on Low-Dose Aspirin and Prevention of Preeclampsia: Updated Recommendations.
- California Maternal Quality Care Collaborative (CMQCC). (2014). Improving Health Care Response to Preeclampsia: A California Toolkit to Transform Maternity Care.
- Preeclampsia Foundation. Order free Educational Illustrated Signs and Symptoms pads in English and Spanish to help patients understand the signs of preeclampsia
- Texas Department of State Health Services. (2018). Severe Hypertension in Pregnancy Bundle.
Oral Health and Pregnancy:
- American College of Obstetricians and Gynecologists. (2013, reaffirmed 2017). Committee Opinion 569: Oral Health Care During Pregnancy and Through the Lifespan.
- American Dental Association. Oral health information for primary care providers treating pregnant women.
- Health Reach. Tips for Good Oral Health During Pregnancy, a two-page tip sheet to give patients. Available in English, Spanish, Vietnamese, and other languages.
- Texas Health Steps. Dental Program.
Smoking Cessation:
- American College of Obstetricians and Gynecologists. Tobacco.
- American College of Obstetricians and Gynecologists. (2017). Committee Opinion 721: Smoking Cessation During Pregnancy.
- Centers for Disease Control and Prevention. Tobacco Use and Pregnancy.
- Centers for Disease Control and Prevention. Smoking Cessation.
- Texas Department of State Health Services. Yes Quit, including the toll-free 877-937-7848 (877-Yes-Quit) Quit line, available 24/7.
- U.S. Department of Health and Human Services. Smokefree.gov.
- U.S. Department of Health and Human Services. Helping Smokers Quit: A Guide for Clinicians.
- U.S. Department of Health and Human Services, National Cancer Institute. SmokefreeTXT is a 24/7 program that offers tips, advice, and encouragement
- to help individuals quit smoking. Your patients can sign up for the service on the National Cancer Institute’s Smoke Free Women website, also offers a Pregnancy & Motherhood web page with resources.
Substance Use and Pregnancy:
- American College of Obstetricians and Gynecologists. (2017). Committee Opinion 711: Opioid Use and Opioid Use Disorder in Pregnancy.
- American Academy of Pediatrics. (2011). Policy Statement: Substance Use Screening, Brief Intervention, and Referral to Treatment for Pediatricians.
- American College of Obstetricians and Gynecologists. ACOG Drinking and Reproductive Health: Tool Kit for Clinicians.
- American College of Obstetricians and Gynecologists. Fetal Alcohol Spectrum Disorders (FASD) Prevention Program.
- American College of Obstetricians and Gynecologists. 4Ps Screening Tool for Prenatal Substance Use.
- American Congress of Obstetricians and Gynecologists (ACOG). An Alcohol-Free Pregnancy is the Best Choice for Your Baby guide includes a development chart showing the periods of embryo development when major defects in bodily structure can occur.
- Center for Adolescent Substance Abuse Research, Children’s Hospital Boston. (2009). The CRAFFT screening interview.
- Council on Patient Safety in Women's Health Care. Patient Safety Bundles, including Obstetric Care for Women with Opioid Use Disorder.
- Institute for Health and Recovery publications include “Alcohol Screening in Pregnancy” and “Engagement Tips for Working with Families with Substance Use Disorders.” Fee required.
- National Organization on Fetal Alcohol Syndrome (NOFAS). Light Drinking During Pregnancy web page includes information and a video about the fact there is known safe amount of alcohol to drink while pregnant. NOFAS also offers a web page with Tools for Parents and Caregivers.
- National Organization on Fetal Alcohol Syndrome (NOFAS). The Circle of Hope: A Mentoring Network for Birth Mothers.
- Provider’s Clinical Support System for Medication Assisted Treatment, a national training and mentoring project developed in response to the prescription opioid misuse epidemic and the availability of newer pharmacotherapies to address opioid use disorder.
- Texas Council of Community Centers. Offers substance use treatment guidance to primary care providers and patients can be referred to one of the 39 local community mental health centers in Texas, also known as local mental health authorities. The council offers a map showing service areas and links to individual centers.
- Texas Department of State Health Services. View videos from the DSHS Neonatal Abstinence Syndrome web page that show how mothers dependent on opioids remain in recovery with the help of comprehensive services, including medication-assisted therapy, and how they can overcome NAS with their babies.
- Texas Health and Human Services Commission. (n.d.). Postpartum Depression Toolkit.
- Texas Health and Human Services Commission. Outreach, Screening, Assessment, and Referral Centers.
- Texas Medicaid & Healthcare Partnership (TMHP). (2018). Texas Medicaid Provider Procedures Manual, SBIRT training.
- U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). Offers clinical guidance for treating pregnant women with opioid use disorder and their infants as well as Treatment Improvement Protocol (TIP) guides for addressing fetal alcohol spectrum disorders (FASD) and women and substance abuse.
Thyroid
- American Thyroid Association. Offers (for a small fee) its Thyroid Disease During Pregnancy GUIDELINES Pocket Guide in digital or print format.
- American Thyroid Association. Pregnancy and Thyroid Disease FAQs.
- U.S. Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Thyroid Disease & Pregnancy.
Vaccinations
- Centers for Disease Control and Prevention. (2015). Resources for Educating Pregnant Women.
- Centers for Disease Control and Prevention. Maternal Vaccines: Part of a Healthy Pregnancy web page provides recommendations for vaccines to receive during pregnancy, such as for pertussis. Parent resource information is also provided.
Wellness and Pregnancy:
- American College of Obstetricians and Gynecologists. (2018). Nutrition During Pregnancy.
- American College of Obstetricians and Gynecologists. (2017). Good Health Before Pregnancy: Preconception Care.
- Before, Between, and Beyond Pregnancy. (2018). Resource Guide for Clinicians. National Preconception Health and Health Care Initiative.
- Centers for Disease Control and Prevention. Preconception Health and Health Care web page with a wealth of information about reproductive health.
- Texas Department of State Health Services. TexasAIM safety bundles.
- Text4Baby.org. Pregnant women can sign up to receive free text messages to help keep themselves healthy during pregnancy and to help keep their infants healthy after birth. Tips are timed with the baby’s gestation and texts continue through the baby’s first year.
Zika
- Centers for Disease Control and Prevention. Zika and Pregnancy: Caring for Pregnant Women.
- Centers for Disease Control and Prevention. Pregnancy & Zika Testing guidance web tool for health-care providers.
- Centers for Disease Control and Prevention. Areas with Risk of Zika.
- Texas Vendor Drug Program. Mosquito Repellent Benefit.
Other Resources
- Texas Department of State Health Services. (2018). Obstetric-Hemorrhage Bundle.
- Texas Department of State Health Services, Texas Health Steps. Adolescent Health: A Guide for Providers.
- Texas Department of State Health Services, Texas Health Steps. Periodicity Schedule.
- Texas Health and Human Services Commission. Medical Transportation Program services may be available for emergency transportation of patients enrolled in Medicaid and the Children with Special Health Care Needs Services Program.
- Texas Health and Human Services Commission. Family Violence Program provides emergency shelter and support services to victims and their children, educates the public, and provides training, and prevention support to various agencies.
- Texas Health and Human Services Commission. Offers the free Texas Home Visiting program in more than 40 counties. The program matches parents with a trained home visitor who comes to their residence to answer questions about pregnancy and parenting and to help them find services and resources.
- Texas Medicaid & Healthcare Partnership (TMHP). (n.d.). Online Provider Search.
- Texas Medicaid Provider Procedures Manual.
- Alliance for Innovation on Maternal Health. (AIM) Patient Safety Bundles for prenatal hypertension, maternal mental health, opioid use, and other pregnancy-related health conditions.
- American Academy of Pediatrics, Committee on Adolescence. (2014). Policy Statement: Addendum—Adolescent Pregnancy: Current Trends and Issues.
- American Academy of Pediatrics. (2012). Policy Statement: Breastfeeding and the Use of Human Milk.
- American Academy of Pediatrics. (n.d.). Culturally Effective Care Toolkit.
- American Academy of Pediatrics. (2011). Policy Statement: Substance Use Screening, Brief Intervention, and Referral to Treatment for Pediatricians.
- American Academy of Family Physicians. (2017). Policy Statement: Breastfeeding.
- American College of Obstetricians and Gynecologists. (2018). Nutrition During Pregnancy.
- American College of Obstetricians and Gynecologists. (2017). Good Health Before Pregnancy: Preconception Care.
- American College of Obstetricians and Gynecologists. (2017). Committee Opinion 711: Opioid Use and Opioid Use Disorder in Pregnancy.
- American College of Obstetricians and Gynecologists. (2013, reaffirmed 2017). Committee Opinion 569: Oral Health Care During Pregnancy and Through the Lifespan.
- American College of Obstetricians and Gynecologists. (2017). Committee Opinion 721: Smoking Cessation During Pregnancy.
- American College of Obstetricians and Gynecologists. (2016). Practice Advisory on Low-Dose Aspirin and Prevention of Preeclampsia: Updated Recommendations.
- American College of Obstetricians and Gynecologists. (2015). Committee Opinion 630: Screening for Perinatal Depression.
- American College of Obstetricians and Gynecologists. (2014). Car Safety for You and Your Baby.
- American College of Obstetricians and Gynecologists. (2013). Committee Opinion 554: Reproductive and Sexual Coercion.
- American Dental Association. (2017). Oral Health Topics: Pregnancy, Medication Use.
- American Diabetes Association. (2018). Standards of Medical Care in Diabetes.
- American Diabetes Association, Diabetes Risk Calculator. (2018).
- American Diabetes Association. (2013). Before Pregnancy.
- American Psychiatric Association. (2017). Depression: What is Depression?
- American Thyroid Association. (2018). Pregnancy and Thyroid Disease?
- Baeva, S., Saxton, D. L., Ruggiero, K., Kormondy, M. L., Hollier, L. M., Hellerstedt, J., Hall, M., & Archer, N. P. (2018). Identifying Maternal Deaths in Texas Using an Enhanced Method, 2012. Obstetrics & Gynecology, 131(5):762-769.
- Before, Between, and Beyond Pregnancy. (2018). Resource Guide for Clinicians. National Preconception Health and Health Care Initiative.
- Blumenfeld, Y. (2014). Updates in the Diagnosis & Management of Preeclampsia and Hypertensive Disorders of Pregnancy: ACOG and CMQCC Guidelines. Presentation, Department of Obstetrics & Gynecology Stanford University School of Medicine.
- Bryant, A. S., Worjoloh, A., Caughey, A. B., & Washington, A. E. (2010). Racial/Ethnic Disparities in Obstetrical Outcomes and Care: Prevalence and Determinants. American Journal of Obstetrics and Gynecology. 202(4): 335–343.
- California Maternal Quality Care Collaborative (CMQCC). (2014). Improving Health Care Response to Preeclampsia: A California Toolkit to Transform Maternity Care.
- Centers for Disease Control and Prevention. (2018). Prevalence and Trends in Prepregnancy Normal Weight — 48 States, New York City, and District of Columbia, 2011–2015.
- Centers for Disease Control and Prevention. (2018). Teen Birth Rate by State.
- Centers for Disease Control and Prevention. (2018). National Vital Statistics Report: Births, Final Data for 2016.
- Centers for Disease Control and Prevention. (2018). Weight Gain During Pregnancy.
- Centers for Disease Control and Prevention. (2018). Alcohol and Public Health FAQs.
- Centers for Disease Control and Prevention. (2018). Current Cigarette Smoking Among Adults in the United States.
- Centers for Disease Control and Prevention. (2018). Smoking During Pregnancy.
- Centers for Disease Control and Prevention. (2018). CMV Facts for Pregnant Women and Parents.
- Centers for Disease Control and Prevention. (2017). Unintended Pregnancy.
- Centers for Disease Control and Prevention. (2017). Reproductive Health: How Does Smoking During Pregnancy Harm My Health and My Baby?
- Centers for Disease Control and Prevention. (2017). Zika and Pregnancy: Caring for Pregnant Women.
- Centers for Disease Control and Prevention. (2017). Distracted Driving.
- Centers for Disease Control and Prevention. (2017). Gestational Diabetes.
- Centers for Disease Control and Prevention. (2017). Preventing Mother-to-Child Transmission of HIV.
- Centers for Disease Control and Prevention. (2017). Cytomegalovirus (CMV) and Congenital CMV Infection.
- Centers for Disease Control and Prevention. (2017). CMV Clinical Overview.
- Centers for Disease Control and Prevention. (2017). Letter about influenza and pregnant women.
- Centers for Disease Control and Prevention. (2017). Births: Final Data for 2015. National Vital Statistics Reports, 66(1).
- Centers for Disease Control and Prevention. (2017). Advisory on Alcohol Use in Pregnancy: A Message to Women from the U.S. Surgeon General (Richard Carmona).
- Centers for Disease Control and Prevention. (2017). Prescription Painkiller Overdoses: A Growing Epidemic, Especially Among Women.
- Centers for Disease Control and Prevention. (2017). STD in Adolescents and Young Adults.
- Centers for Disease Control and Prevention. (2017). Preventing Intimate Partner Violence Across the Lifespan: A Technical Package of Programs, Policies, and Practices. Division of Violence Prevention, National Center for Injury Prevention and Control.
- Centers for Disease Control and Prevention. (2016). Fact Sheet: STDs during Pregnancy.
- Centers for Disease Control and Prevention. (2016). Fact Sheet: Excessive Alcohol Use and Risks to Women’s Health.
- Centers for Disease Control and Prevention. (2016). Updated Estimates of Neural Tube Defects Prevented by Mandatory Folic Acid Fortification — United States, 1995–2011. Morbidity and Mortality Weekly Report (MMWR), 64(1).
- Centers for Disease Control and Prevention. (2016). Mean Age of Mothers is on the Rise: United States, 2000–2014. NCHS Data Brief, 232.
- Centers for Disease Control and Prevention. (2016). Maternal Vaccines: Part of a Healthy Pregnancy.
- Centers for Disease Control and Prevention. (2016). Rates of Any and Exclusive Breastfeeding by State among Children Born in 2014.
- Centers for Disease Control and Prevention. (2015). The Health Effects of Overweight and Obesity.
- Centers for Disease Control and Prevention. (2015). Physical Activity and Health: The Benefits of Physical Activity.
- Centers for Disease Control and Prevention. (2015). Prevalence of Obesity Among Adults and Youth: United States, 2011–2014. NCHS Data Brief No. 219.
- Centers for Disease Control and Prevention. (2015). Resources for Educating Pregnant Women.
- Centers for Disease Control and Prevention. (2014). Breastfeeding Report Card, National Center for Chronic Disease Prevention and Health Promotion.
- Centers for Disease Control and Prevention. (2014). Prevalence Estimates of Gestational Diabetes Mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007–2010.
- Centers for Disease Control and Prevention. (2013). Tobacco Use by High School Students in Texas.
- Centers for Disease Control and Prevention. (2013). Preventing Repeat Teen Births. Vital Signs.
- Centers for Disease Control and Prevention. (2013). Vital Signs: Repeat Births Among Teens — United States, 2007–2010. Morbidity and Mortality Weekly Report (MMWR), 62(13);249-255.
- Center for Adolescent Substance Abuse Research, Children’s Hospital Boston. (2009). The CRAFFT screening interview.
- Center for Public Policy Priorities. (2018). HHSC Reports Substance Use Disorder Treatment in Texas Medicaid is Working.
- Cohen, D., & Coco, A. (2014). Do Physicians Address Other Medical Problems During Preventive Gynecologic Visits? Journal of American Board of Family Medicine.
- Downs, J. S., Arslanian, S., de Bruin, W. B., Copeland, V. C., Doswell, W., Herman, W., … Charron-Prochownik. (2010). Implications of type 2 diabetes on adolescent reproductive health risk: an expert model. Diabetes Educator, 36(6): pp 911–919.
- Floyd, R. L., Jack, B. W., Cefalo, R., Atrash, H., Mahoney, Herron, A., . . .Sokol, R. J. (2008). The clinical content of preconception care: alcohol, tobacco, and illicit drug exposures. American Journal of Obstetrics & Gynecology, 199(6), S333 - S339.
- Futures without Violence. (2012). Addressing Intimate Partner Violence, Reproductive and Sexual Coercion: A Guide for Obstetric, Gynecologic and Reproductive Health Care Settings.
- Han, Z., Mulla, S., Beyene, J., Liao, G., & McDonald, S. D. (2010). Maternal underweight and the risk of preterm birth and low birth weight: a systematic review and meta-analyses. International Journal of Epidemiology, 40(1): 65–101.
- Hilton, I. (2010). Application of the Perinatal Oral Health Guidelines in Clinical Practice. Journal of the California Dental Association, 38(9): 673-679. [Abstract].
- Hollier, L. l., & Delgado, E. (2017). PowerPoint: Preventing Maternal Mortality in Texas: A Public Health Commitment. Texas Health and Human Services Commission & Texas Department of State Health Services.
- Kessler, R. C., Avenevoli, S., Costello, E. J., Green, J. G., Gruber, M. J., Heeringa, S., . . . Zaslavsky, A. M. (2009). National comorbidity survey replication adolescent supplement (NCS-A): II. Overview and design. Journal of the American Academy of Child & Adolescent Psychiatry, 48(4):380-5.
- March of Dimes. (2015). Being Overweight During Pregnancy.
- Massachusetts General Hospital’s Center for Women’s Mental Health. (2015). Psychiatric Disorders During Pregnancy.
- May, P. A., Baete, A., Russo, J., Elliott, A. J., Blankenship, J., Kalberg, W. O., …. Hoyme, H. E. (2014). Prevalence and Characteristics of Fetal Alcohol Spectrum Disorders. Pediatrics, Oct. 2014:2013-3319.
- Mayo Clinic. (2018). Sexually Transmitted Diseases (STDS).
- Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., … Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10):980-9.
- New York State Department of Health. (2006). Oral Health Care during Pregnancy and Early Childhood Practice Guidelines.
- Power to Decide. (2018). National Data: Teen Birth in US, Girls 15-19.
- Razzaghi, H., Marcinkevage, J., & Peterson, C. (2015). Prevalence of undiagnosed diabetes among non-pregnant women of reproductive age in the United States, 1999–2010. Primary Care Diabetes, 9(1): 71–73.
- Realini, J. (2017). Addressing Texas’ maternal mortality crisis, blog post. Texas Academy of Family Physicians.
- Roman, M. (2011). Preconception Care for Women With Preexisting Type 2 Diabetes. Clinical Diabetes, 29(1): 10-16.
- Samano, R., Martínez-Rojano, H., Godínez Martínez, E., Sánchez Jiménez, B., Villeda Rodríguez, G. P., Pérez Zamora, J., & Casanueva, E. (2013). Effects of breastfeeding on weight loss and recovery of pregestational weight in adolescent and adult mothers. Food and Nutrition Bulletin, 34(2):123-30.
- Ship, A.N. (2010). The Most Primary of Care — Talking about Driving and Distraction. The New England Journal of Medicine, 362:2145-2147.
- Spitzer, R. L., Williams, J. B. W., & Kroenke, K. (2011). Generalized Anxiety Disorder Scale (Two Items) Questionnaire. Common Mental Health Disorders: Identification and Pathways to Care. British Psychological Society.
- Steiner, R. J., Dariotis, J. K., Anderson, J. R., & Finocchario-Kessler, S. (2013). Preconception care for people living with HIV: recommendations for advancing implementation. AIDS, Supplement 1:S113-9.
- Tan, C. H., Denny, C. H., Cheal, N. E., Sniezek, J. E., & Kanny, D. (2015). Alcohol use and binge drinking among women of childbearing age - United States, 2011-2013. Morbidity and Mortality Weekly Report (MMWR), 64(37):1042-6.
- Texas Department of Family and Protective Services. (2016). Texas Abuse Hotline website.
- Texas Department of Family and Protective Services. (n.d.). Report Abuse, Neglect, or Exploitation.
- Texas Department of State Health Services. (2018). Obstetric-Hemorrhage Bundle.
- Texas Department of State Health Services. (2018). Notifiable Conditions.
- Texas Department of State Health Services. (2018). Severe Hypertension in Pregnancy Bundle.
- Texas Department of State Health Services, Division for Community Health Improvement. (2017). Healthy Texas Babies Data Book.
- Texas Department of State Health Services. (2017). Legislative Brief: Investigating Maternal Mortality in Texas, Nov. 2017 revised.
- Texas Department of State Health Services. (2016). Maternal Mortality in Texas: Using Precision Public Health to Improve Maternal Outcomes.
- Texas Department of State Health Services, Texas Health Steps. (2016). Adolescent Health: A Guide for Providers.
- Texas Department of State Health Services. (2016). How to Get Help — Substance Abuse.
- Texas Department of Transportation. (2015). Seat Belts.
- Texas Department of State Health Services. (2015). Healthy Texas Babies.
- Texas Department of State Health Services. (2013). Texas and Obesity.
- Texas Department of State Health Services. (n.d.). Pregnancy Risk Assessment Monitoring System (PRAMS) Survey website.
- Texas Department of State Health Services, Texas Health Steps. (n.d.). Comprehensive Care Program.
- Texas Health and Human Services Commission. (2018). Texas 211.
- Texas Health and Human Services Commission. (2018). Children’s Health Insurance Program (CHIP) and Medicaid.
- Texas Health and Human Services Commission. (n.d.). Postpartum Depression Toolkit.
- Texas Health and Human Services Commission. (n.d.). Healthy Texas Women.
- Texas Health and Human Services Commission. (n.d.). Medical and Dental Plans.
- Texas Health and Human Services Commission. (n.d.). Outreach, Screening, Assessment, and Referral Centers.
- Texas Health and Safety Code. Title 2, Health, Subtitle D., Prevention, Control, and Reports of Disease, Chapter 81, Communicable Diseases, Section 81.090: Diagnostic Testing During and After Pregnancy.
- Texas Medicaid & Healthcare Partnership (TMHP). (2018). Texas Medicaid Provider Procedures Manual.
- Texas Medicaid & Healthcare Partnership (TMHP). (2018). Texas Medicaid Provider Procedures Manual, SBIRT training.
- Texas Medicaid & Healthcare Partnership (TMHP). (n.d.). Online Provider Search.
- University of Illinois-Chicago, School of Public Health, & CityMatCH (funded by the W. K. Kellogg Foundation). (2017). Barriers to Being a Well-Woman and Accessing Well-Woman Care as told to The Well-Woman Project through Stories and Listening Sessions in 2016. The Well-Woman Project.
- U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse. (2018). Common Comorbidities with Substance Use Disorders.
- U.S. Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Thyroid Disease & Pregnancy.
- U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse. (2017). Substance Use in Women: Sex and Gender Differences in Substance Use.
- U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. (2017). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health.
- U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health. (2017.) Major Depression.
- U.S. Department of Health and Human Services, Office of Adolescent Health. (2015). Texas Adolescent Reproductive Health Facts.
- U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse. (2015). Nationwide Trends.
- U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health. (2014). Child Health USA.
- U.S. Department of Health and Human Services, U.S. Surgeon General. (2014). The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014.
- U.S. Department of Health and Human Services. (n.d.). Smokefree.gov.
- U.S. Department of Health and Human Services, National Institutes of Health, Office of Dietary Supplements. (n.d.). Dietary Supplement Fact Sheets.
- U.S. Department of Health and Human Services, National Institute of Child and Human Development. (n.d.). Moms’ Mental Health Matters: Depression and Anxiety Around Pregnancy.
- U.S. Preventive Services Task Force. (2016). Screening for Depression in Adults, US Preventive Services Task Force Recommendation Statement. JAMA, 315(4):380–387.
- U.S. Preventive Services Task Force. (2014). Final Recommendation Statement, Sexually Transmitted Infections: Behavioral Counseling.
- U.S. Preventive Services Task Force. (2014). Final Recommendation Statement, Gestational Diabetes Mellitus Screening.
- Vladutiu, C. J., & Weiss, H. B. (2012). Motor Vehicle Safety During Pregnancy. American Journal of Lifestyle Medicine, 6(3).
- van Zuylen, W. J., Hamilton, S. T., Naing, Z., Hall, B., Shand, A., & Rawlinson, W. D. (2014). Congenital cytomegalovirus infection: Clinical presentation, epidemiology, diagnosis and prevention. Obstetric Medicine. 7(4): 140–146.
- Wisner, K. L., Sit, D. K., McShea, M. C., Rizzo, D. M., Zoretich, R. A., Hughes, . . Hanusa, B. H. (2013). Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry, 70(5):490-8.
- Witt, W. P., Wisk, L. E., Cheng, E. R., Hampton, J. M., & Hagen, E. W. (2012). Preconception Mental Health Predicts Pregnancy Complications and Adverse Birth Outcomes: A National Population-Based Study. Maternal and Child Health Journal, 16(7): 1525–1541.
- World Bank. (2016). Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities.
- World Health Organization. (2014). Guidelines for identification and management of substance use and substance use disorders in pregnancy.
- World Health Organization. (2011). Statement: Exclusive breastfeeding for six months best for babies everywhere.
- World Health Organization. (n.d.). Physical Activity and Women.
- Yawn, B. P., Buchanan, G. R., Afenyi-Annan, A. N., Ballas, S. K., Hassell, K. L., James, A. H., …. John-Sowah, J. (2014). Management of Sickle Cell Disease, Summary of the 2014 Evidence-Based Report by Expert Panel Members. JAMA, 312(10):1033-1048.
- Young, J. L. (2016). Mental Health and Pregnancy: The importance of screenings for pregnant women and new mothers. Psychology Today blog, May 20, 2016.
The medical definitions provided in this module were obtained or adapted from American Academy of Pediatrics, American Diabetes Association, Centers for Disease Control and Prevention, Healthline, March of Dimes, Mayo Clinic, Merck Manual, Merriam-Webster, National Institute of Neurological Disorders and Stroke, Preeclampsia.org, Psychology Today, Substance Abuse and Mental Health Services Administration, Texas Family Code, “The New First Three Years of Life: Completely Revised and Updated” by Burton L. White, and U.S. National Library of Medicine.
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