Pregnancy Risk Assessment Monitoring System (PRAMS)

WA PRAMS is a survey of new mothers conducted by Washington State Department of Health and the Centers for Disease Control and Prevention (CDC). PRAMS gathers information from mothers about their experiences before, during, and after their most recent pregnancy. The goal of WA PRAMS is to improve the health of mothers and babies in Washington by reducing the risk of adverse birth outcomes such as low birth weight and promoting best practices such as breastfeeding. PRAMS is the best routine source of this information in Washington.

Who Should Participate

Every month women who recently had a baby, are randomly selected from birth records to respond to the PRAMS survey. If selected, you will receive a survey request in the mail, with the option to complete by mail, online or by phone. The PRAMS survey gives us information about access to health care, quality of health care, and other circumstances that may affect the health of the mother and her new baby. Responses from every selected mother are needed to provide a full picture of the health of moms and babies in Washington. All information is kept confidential. Your experiences are important to us.

What Washington Mothers Say

“Thank you for allowing me to share my experience to help others.”

“I had a great experience during my time of pregnancy and received the best healthcare I've had in my lifetime. Although I lost my job early in my pregnancy, I am so thankful that I was able to receive insurance through the state of WA.”

“This project is a wonderful idea and hope my input can help other mothers and their children. If you need any further help, please feel free to contact me. I would love to help in any way.”

“There was a lot of talk about Post-Partum Depression, which was great. I would have liked to see the hospital (or other service) offer a Post-Partum Depression support group for new mother's that is open /acceptable to bring newborns to.”

“I really appreciate this kind of research for all mothers and babies.”

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How PRAMS Data Are Used

PRAMS provides data not available from other sources. The PRAMS survey gives us information about access to health care, quality of health care, and other circumstances that may affect the health of the mother and her new baby. The information collected is used to develop health programs and policies; help doctors and nurses improve care; and make better use of health resources.

All answers are kept private. No one will know the name of the mother who answered the questions. Because of the small number of mothers picked, it is important to have everyone’s answers. Each pregnancy is different. To get a better overall picture of the health of mothers and infants, we need each mother selected to answer the questions.

Examples of PRAMS data use can be found below:

PRAMS Data Collection

In Washington, about 2,000 surveys are sent to participants each year. Each month approximately 200 mothers are randomly drawn from birth records, similar to a lottery drawing. Women from some groups are sampled at a higher rate to ensure adequate data are available for smaller subpopulations. In Washington, we oversample by mother’s race and ethnicity reported on the birth certificate. Once selected, a survey is mailed to the mother along with information about completing the survey by mail, online, or with a phone interviewer.

Telephone follow-up is done for those who do not respond to the mailing. The mail and telephone surveys are available in English and Spanish.

Examples of PRAMS Survey Topics

The PRAMS questionnaire changes periodically. While many topics stay the same, new topics are added with each revision or Phase.

Phase 8 was collected from 2016-2022. PRAMS is currently collecting Phase 9. Which began in 2023.

Phase 8 Topics

Preconception care
Pregnancy intention
Contraception
Prenatal care
Smoking, alcohol, and drug use
Medical complications of pregnancy, labor, or delivery affecting the mother
Postpartum care
Medicaid and WIC participation
Breastfeeding
Babies’ health and care
Physical abuse
Oral health
Infant sleep environment
Mental health and wellbeing
Social support

New Phase 9 Topics

Feelings on healthcare services received (respected/comfortable)
Disabilities
Home visiting services
Mental health
Maternity leave
Firearms
Discrimination (expanded)

WA PRAMS Advisory Committee

The WA PRAMS Advisory Committee gives guidance to help the PRAMS program implement the surveillance system to ensure resources are used effectively to meet the needs of public health in Washington. They provide input on strategic directions and planning for the survey and use of findings. The Advisory Committee commenced meeting in February 2024 and will meet at minimum semi-annually. Meeting materials will be posted here; please check back for updates.

February 2, 2024 Meeting - Agenda (PDF) | Notes (PDF) | Slide Deck (PFD)
June 17, 2024 Meeting - Agenda (PDF) | Notes (PDF) | Slide Deck (PFD)
October 17, 2024 Meeting - Agenda (PDF) | Notes (PDF) | Slide Deck (PFD)

Requesting PRAMS Data

Our standard PRAMS analytic file contains PRAMS questionnaire and birth certificate variables. We do not release PHI such as birth certificate numbers, dates of birth, or counties to protect the confidentiality of our participants. Requests may require a Data Sharing Agreement for our standard datafile or IRB approval if select PHI is requested.

Working with these data files requires use of spreadsheet, database management, or statistical software that are not provided.

2022 PRAMS Data is now available for request

Request PRAMS Data