ADEQUACY OF PRENATAL CARE UTILIZATION INDEX (APNCU) - This index, also known as the Kotelchuck Index of Prenatal Care, was designed as an improvement on the Kessner Index. It has 5 values: 1 = adequate plus, 2 = adequate, 3 = intermediate, 4 = inadequate and 5 = unknown. Its major advantage is that it divides the adequate into two categories. Those with adequate plus had other risk factors, which increased the number of visits. The index can serve as an indicator that some medical condition required additional prenatal care. [Kotelchuck M., "An Evaluation of the Kessner Adequacy of Prenatal Care Index and a Proposed Adequacy of Prenatal Care Utilization Index", American Journal of Public Health, 1994, 84(9):1414-20.]
ANNULMENT - "To nullify, to abolish, to make void by competent authority. An annulment differs from a divorce in that a divorce terminates a legal status, whereas an annulment establishes that a marital status never existed." Black's Law Dictionary, Sixth Edition. In this website, annulments are included with divorces for rate calculation purposes and are available only by place of occurrence.
BIRTH INTERVAL - The period from the date of the current birth to the date of the last termination of pregnancy, birth or otherwise.
BIRTH ORDER - The numeric relationship of a child to other children born alive to that mother.
DEATH - Death is defined in Black's Law Dictionary, Sixth Edition as "The cessation of life; permanent cessations of all vital functions and signs." For definitions of the determination of death under other than general circumstances, the Code of Alabama should be consulted.
DIVORCE - A court decree dissolving a marital relationship. A divorce from bed and board is a separation from cohabitation which does not otherwise affect the marriage and is not included in this website. See Code of Alabama for additional information. For rate calculation purposes in this website, divorces include annulments and are reported by the county where the divorce occurred.
ESTIMATED PREGNANCIES - The sum of births, induced terminations of pregnancy, and estimated total fetal losses.
ESTIMATED TOTAL FETAL LOSSES - This term, which is a component used in determining the number of estimated pregnancies, is an estimate of the total number of fetal losses regardless of the gestational age of the fetus. Estimated total fetal losses is equal to the sum of 20 percent of births and 10 percent of induced terminations of pregnancy. Estimated total fetal losses should be distinguished from the term fetal deaths as used in this website. While Alabama law defines fetal death to include all gestations (see definition of FETAL DEATH), only fetal deaths of at least 20 weeks in gestation are required to be reported by Alabama law and are the only ones counted as fetal deaths in this website.
FETAL DEATH - "Death prior to the complete expulsion or extraction from the mother of a product of human conception, irrespective of the duration of pregnancy and which is not an induced termination of pregnancy. The death is indicated by the fact that after the expulsion or extraction the fetus does not breathe or show any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles. Heartbeats are to be distinguished from transient cardiac contractions; respirations are to be distinguished from fleeting respiratory efforts or gasps." Code of Alabama, 1975, Section 22-9A-1. While the definition of fetal death includes all gestations, only fetal deaths that have advanced to or are beyond the twentieth week of uterogestation are required to be reported under Alabama law and they are the only ones counted as fetal deaths in this website. (Also see ESTIMATED TOTAL FETAL LOSSES.)
GESTATION - The period of development from the time of fertilization of the ovum to birth. In this website, the terms gestation and uterogestation are used synonymously.
INDUCED TERMINATION OF PREGNANCY - "The purposeful interruption of an intrauterine pregnancy with the intention other than to produce a liveborn infant and which does not result in a live birth. This definition excludes management of prolonged retention of products of conception following fetal death." Code of Alabama, 1975, Section 22-9A-1 In this website, the terms induced termination of pregnancy and abortion are used synonymously.
INFANT DEATH - Death of a liveborn infant under one year of age. The term excludes fetal death.
LIVE BIRTH - "The complete expulsion or extraction from the mother of a product of human conception, irrespective of the duration of the pregnancy, which, after such expulsion or extraction, breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached. Heartbeats are to be distinguished from transient cardiac contractions; respirations are to be distinguished from fleeting respiratory efforts or gasps." Code of Alabama, 1975, Section 22- 9A-1. The terms live birth and birth are used synonymously.
LOW BIRTH WEIGHT - A weight at birth of under 2,500 grams or under 5 pounds and 8 ounces.
MARRIAGE - The legal union of a man and a woman which establishes their relationship as husband and wife. See Code of Alabama for additional information. Marriage data are reported by the county where the marriage occurred.
MATERNAL DEATH - A death due to complications of pregnancy, labor, delivery, or puerperium The period or state of confinement after labor. (ICD 10 codes: O00-O99; ICD 9 codes: 630-676).
NEONATAL DEATH - Death of a liveborn infant occurring within the first 27 days of life.
OCCURRENCE DATA - Data compiled as to the geographical place where the event occurred.
PERINATAL DEATH - Death of a fetus of 28 or more weeks gestation or death of a live born infant under seven days of age. Note that several other definitions of this term exist.
POSTNEONATAL DEATH - Death of a liveborn infant after the first 27 days of age, but before one year of age.
TEENAGE - In this website, persons aged 10 years through 19 years.
TOTAL BIRTH ORDER - An expression of the numeric relationship of the birth of a child to all deliveries to that mother regardless of the outcome of a pregnancy.
VERY LOW BIRTH WEIGHT - A weight at birth of under 1500 grams or under 3 pounds and 5 ounces.