Last Updated: January 2023

Author: Division of Maternal and Child Health, Vermont Department of Health

The Pregnancy Risk Assessment Monitoring System (PRAMS) is a survey of women who recently gave birth that asks about their experiences, behaviors, and healthcare utilization before, during and shortly after their pregnancy. Women receive the survey two to six months after giving birth. This report presents highlights for 2020 Vermont births.

Highlights on Preconception Health & Family Planning from 2017 PRAMS include:

• A third (32%) of births resulted from unintended pregnancies.  Women in younger age groups, particularly those under the age of 25, were significantly more likely to give birth following an unintended pregnancy.      
• Three-quarters (77%) of women had a visit to a health care provider during the 12 months before pregnancy.

Of these:

• • 80% were asked about what kind of work they did.
  • 75% were asked if someone was hurting them emotionally or physically.
  • 75% were asked if they were feeling down or depressed.
  • 51% were asked whether they wanted to have children.
  • 45% had a talk about using birth control.
  • 40% were told to take a vitamin with folic acid.
  • 37% discussed maintaining a healthy weight.
  • 30% had a talk about improving health before a pregnancy.
  • 27% had a talk about STIs.
  • 21% were tested for HIV.

About one third (30%) of women talked to a doctor, nurse, or other health care workers about preparing for a pregnancy.

In 2020, over 50% of births to people age 24, approximately 30% of births to people aged 25 to 34 and 22% of births  to people over age 35 resulted from an unintended pregnancy.

This indicator is part of Healthy Vermonters 2020 (the State Health Assessment).  This assessment documents the health status of Vermonters at the start of the decade and the population health indicators and goals that guided the work of public health through 2020.  The Health department is excited to showcase the new set of Healthy Vermonters 2030 objectives coming soon.   Click here for more information.

• Offices of Local Health, Maternal and Child Health Coordinators

• Primary care provider practices
• Planned Parenthood of Northern New England
• Department of Vermont Health Access
• Oregon Foundation for Reproductive Health

The importance of preconception care has become a focal point across the country and is part of a broader approach to preventive reproductive health.

Preconception health refers to the health of people during their reproductive years. It focuses on taking steps now to protect the health of a baby they might have sometime in the future.  Preconception health is about people getting and staying healthy overall, throughout their lives.

More people who are choosing pregnancy are older, may struggle with chronic medical conditions, and take medications regularly. A preconception health visit can improve the chances of a healthy pregnancy by screening for conditions that pose a risk to the pregnancy or the infant.

The One Key Question Initiative:

One Key Question™ is a national initiative that was developed by the Oregon Foundation for Reproductive Health to reduce the number of unintended pregnancies and to improve the rate of preconception health counseling. Unintended pregnancies are known to have worse health outcomes both for perinatal person and infant.

One Key Question promotes screening for pregnancy intentions on a routine basis as part of high-quality primary care to increase the proportion of pregnancies that are planned, wanted and as healthy as possible.

• Promote national resources on preconception health and counseling, such as Before, Between and Beyond Pregnancy: http://beforeandbeyond.org/
• Support Offices of Local Health to promote One Key Question to people of reproductive age and primary care practices in their communities.
• Disseminate tools to primary care providers to support implementation.

Similar to statewide efforts, local partners are using data to drive local strategy. For regional data on Maternal and Infant Health indicators, check out our Public Health Data Explorer.

Data is updated as it becomes available and timing may vary by data source.

The PRAMS sample of women who have had a recent live birth is drawn from the state's birth certificate file. Each participating state samples between 1,300 and 3,400 women per year. Women from some groups are sampled at a higher rate to ensure adequate data are available in smaller but higher risk populations. Selected women are first contacted by mail. If there is no response to repeated mailings, women are contacted and interviewed by telephone. Data collection procedures and instruments are standardized to allow comparisons between states.