The following 3 test cases may be loaded into testing environments (sandboxes) for EHR, EMR, or HIE systems.

If the testing environment already has data for similar live birth events, loading these data is not required for the January 2023 Connectathon.

Test Cases, Facility Worksheet For The Live Birth Certificate

Test Case Summaries (text version of above items)

TC1: Amanda Alvarez (mother) gave birth to male baby Angelo at a hospital, attended by Sylvia Salem, M.D.

  • Prenatal Information:
    • Date of first prenatal care visit: 09/18/2021
    • Total number of prenatal care visits for this pregnancy: 11 
    • Date last normal menses began : 07/15/2021
    • Number of previous live births now living: 2
    • Number of previous live births now dead: 0
    • Date of last live birth: 02/11/2019
    • Number of other pregnancy outcomes: None
    • Overall: Mother was not transferred to the facility for delivery; labor was augmented and mother received antibiotics; no serious complications experienced by the mother associated with labor and delivery (maternal morbidity)
    • Labor and Delivery details:
      • Date of birth: 04/20/2022
      • Time of birth: 11:15am
      • Certifier’s name and title: Sylvia Salem, M.D.
      • Date certified: 04/20/2022
      • Principal source of payment for this delivery: Private Insurance
      • Attendant’s name, title, and N.P.I.: Sylvia Salem, M.D., 4443332221
      • Mother’s weight at delivery (pounds): 170
      • Method of delivery: C. Fetal presentation at birth: Cephalic; D. Final route and method of delivery: Vaginal/Spontaneous
    • Newborn Information:
      • Birthweight: 2600 grams
      • Obstetric estimate of gestation at delivery (completed weeks): 39 weeks
      • Sex: Male
      • Apgar score: Score at 5 minutes: 5; Score at 10 minutes: 6
      • Plurality: 1
      • Abnormal birth conditions:
        • NICU admission
        • Antibiotics received by the newborn for suspected neonatal sepsis -
      • Overall: Infant with abnormal conditions was admitted to NICU; no congenital anomalies of the newborn; no transfer within 24 hours of delivery; infant living at time of report; infant being breastfed at discharge.
      • Details:
    • Overall: Risk factors in this pregnancy included gestational diabetes; infections present and/or treated during this pregnancy included Chlamydia (a positive test for Chlamydia trachomatis); no obstetric procedures during pregnancy.
    • Prenatal details:
    • Labor and Delivery Information:

TC2: Brenda Baker (mother) gave birth to female baby Barbara at a hospital, attended by Ramona Randolf, D.O.

  • Prenatal Information:
    • Date of first prenatal care visit: 09/15/2021
    • Total number of prenatal care visits for this pregnancy: 11
    • Date last normal menses began : 07/12/2021
    • Number of previous live births now living: 1
    • Number of previous live births now dead: None
    • Date of last live birth: 07/11/2018
    • Number of other pregnancy outcomes: None
    • Overall: Mother was not transferred to the facility for delivery; labor was induced; after trail labor, cesarian was performed with serious complications (maternal morbidity) resulting in admission to ICU.
    • Labor and Delivery details:
      • Maternal transfusion
      • Ruptured uterus
      • Admission to intensive care unit
      • Overall: Infant with abnormal conditions was admitted to NICU; no congenital anomalies of the newborn; no transfer within 24 hours of delivery; infant living at time of report; infant not being breastfed at discharge.
      • Details:
        • Assisted ventilation required immediately following delivery
        • Assisted ventilation required for more than six hours
        • NICU admission
        • Newborn given surfactant replacement therapy
        • Birthweight: 2700 grams
        • Obstetric estimate of gestation at delivery (completed weeks): 40 weeks
        • Sex: Female
        • Apgar score: Score at 5 minutes: 6
        • Plurality: 1
        • Abnormal birth conditions:
      • Date of birth: 04/18/2022
      • Time of birth: 8:50am
      • Certifier’s name and title: Ramona Randolf, D.O
      • Date certified: 04/18/2022
      • Principal source of payment for this delivery: Medicaid (or a comparable State program)
      • Attendant’s name, title, and N.P.I.: Ramona Randolf, D.O., 6665554443
      • Mother’s weight at delivery (pounds): 165
      • Method of delivery: C. Fetal presentation at birth: Breech; D. Final route and method of delivery: Cesarean (with trial labor attempted)
      • Maternal morbidity (serious complications) associated with labor and delivery:
      • Newborn Information:
    • Overall: Risk factors in this pregnancy included gestational hypertension (PIH, preeclampsia); no infections present and/or treated during this pregnancy; no obstetric procedures during pregnancy.
    • Prenatal details:
    • Labor and Delivery Information:

TC3: Clarissa Collins (mother) gave birth to female baby Catherine at a freestanding birthing center, attended by midwife, Talia Turner.

  • Prenatal Information:
    • Date of first prenatal care 09/25/2021
    • Total number of prenatal care visits for this pregnancy: 10
    • Date last normal menses began : 07/22/2021
    • Number of previous live births now living: 1
    • Number of previous live births now dead: None
    • Date of last live birth: 02/15/2017
    • Number of other pregnancy outcomes: None
    • Overall: Mother was not transferred to the facility for delivery; no induction, augmentation, medications or diagnoses during labor; no serious complications experienced by the mother associated with labor and delivery (maternal morbidity)
    • Labor and Delivery details:
      • Date of birth: 04/24/2022
      • Time of birth: 5:20pm
      • Certifier’s name and title: Talia Turner, Other midwife (midwife other than CNM/CM)
      • Date certified: 04/24/2022
      • Principal source of payment for this delivery: Medicaid (or a comparable State program)
      • Attendant’s name, title, and N.P.I.: Talia Turner, Other Midwife, 5554443332
      • Mother’s weight at delivery (pounds): 150
      • Method of delivery: C. Fetal presentation at birth: Cephalic; D. Final route and method of delivery: Vaginal/Spontaneous
    • Newborn Information:
      • Birthweight: 2650 grams
      • Obstetric estimate of gestation at delivery (completed weeks): 38 weeks
      • Sex: Female
      • Apgar score: Score at 5 minutes: 7
      • Plurality: 1
      • Overall: no abnormal birth conditions or congenital anomalies of the newborn; no transfer within 24 hours of delivery; infant living at time of report and being breastfed at discharge
      • Details:
    • Overall: No risk factors in this pregnancy; no infections present and/or treated during this pregnancy; no obstetric procedures during pregnancy.
    • Prenatal details:
    • Labor and Delivery Information:
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