Component A: Virginia Pregnancy Risk Assessment Monitoring System (PRAMS) seeks to implement the CDC PRAMS protocol in Virginia for 2021-2025. PRAMS utilizes a complex sampling methodology to collect data from Virginia women who have recently delivered a live birth infant. Information on health behaviors and experiences before, during and shortly after pregnancy is collected. Virginia uses PRAMS data to identify emerging health issues, establish health objectives, track progress on state and national objectives, and develop and evaluate public health policies and programs related to maternal and child health. Virginia PRAMS provides statewide and some health district level data. PRAMS is the sole data source for the majority of these indicators and provides critical data for many of Virginia’s ongoing initiatives and grants, including the Title V Maternal and Child Health Services Block Grant and the Virginia Neonatal Perinatal Collaborative (VNPC). PRAMS also provides population-level data to a host of Virginia programs, including those related to breastfeeding, home visiting, dental health, tobacco, and injury and violence prevention. PRAMS provides data on Healthy People 2030 goals related to access to health services, injury and violence prevention, immunization, maternal and child health, family planning, early and middle childhood, mental health and mental disorders, tobacco use, and oral health. There are multiple avenues through which PRAMS has the ability to impact population health. At its most basic level, PRAMS is used in Virginia to document trends in adverse birth outcomes, the first step to understanding population health. Through Virginia’s increased sampling of a high-risk population, PRAMS can further identify sub-populations at high risk and correlates of risk and develop strategies and programs in response. Success in this present application will mark Virginia’s fifteenth year of PRAMS funding and operations. As such, major project components (e.g., staffing, sampling and data analysis, data collection procedures and protocols, IRB approval, steering committee, etc.) are fully developed and presently implemented. Major project components are revised by the state PRAMS team in coordination with the Steering Committee and CDC PRAMS as operational needs dictate.