Information for Midwives and Community Birth Settings

Newborn screening is a critical preventative measure. It allows for the early identification and treatment of health issues to prevent serious illness, disability, or death. Early identification and treatment promote healthy child development and overall quality of life for newborns and their families.

Midwives play a key role in promoting the health and well-being of babies and families. By educating parents about evidence-based newborn screening benefits and options, midwives can engage families in informed choice discussions. This web page contains information specifically directed for midwives and those who work in community birth settings.

In California, newborn screening blood collection needs to be done from 12 to 48 hours after birth, with 24 hours being the optimal time for collection. The specimen needs to be shipped to the processing laboratory using the preferred California Newborn Screening (NBS) Program vendor so that it is received within 48 hours of collection.

Additional information, including a list of disorders tested for on the NBS Program screening panel and how to get results, can be found through the NBS Program landing page.

Please also visit the California Prenatal Screening (PNS) Program landing page for more information on the options available to all pregnant people in California to check fetuses for genetic conditions and birth defects.

Advantages of newborn screening at home or at a birthing center

There are many advantages for being able to perform newborn screening blood collection in the home setting. The family can avoid taking their newborn to a hospital-based laboratory and the screening will be done by a trusted person already known to the family. You and your client have flexibility in scheduling the best time for the screening, keeping in mind that it should be collected as close to the 24-hour mark after birth as possible.

Peer discussions on newborn screening blood collection at home or in an out-of-hospital setting in this video:

Introducing newborn screening to your clients

Many midwives begin educating their clients on required newborn screening during pregnancy. This allows for the family to ask questions and to make decisions for their family about newborn screening. The California Newborn Screening (NBS) Program provides you with education materials regarding newborn screening to share with the parents.

Education Resources

The Newborn Screening: Important Information for Parents tri-fold (English and Spanish, PDF) is a tool that lends itself to a discussion with the parents. It is available in 12 languages on the NBS Program Information for Families web page. Please make sure to give a copy of this tri-fold to the parent(s).

The Midwife Factsheet/Communicating with Confidence About Newborn Screening (PDF, 2 pages) is a resource to you as a provider in the home or community birth setting. This sheet provides answers to most frequently asked questions about newborn screening outside of a hospital. For your convenience, you can print this Info Sheet to take with you as needed by following the link above. The QR codes provided will link you to additional resources should further information on a given topic be needed.”

Process overview of home newborn screening collection

In California, a newborn screening specimen must be collected within 12 to 48 hours of birth, with 24 hours of life being the optimal time for collection. A general overview video (not California-specific) on newborn screening blood spot collection:

Test Request Form (TRF)

A complete Test Request Form (TRF) is needed for every California birth, whether performed at home or at a freestanding birth center. Newborn screening documentation using the TRF must be completed within 12 to 48 hours of birth. All birth attendants should keep the TRF’s yellow copy and provide the TRF’s pink/blue copy to the family. The family will use the pink/blue copy to help the pediatrician get the results and use the copy for registering the birth.

Please make sure to follow the instructions outlined in the Newborn Screening Program Collection Poster (PDF) and communicate the importance of this form with the child’s parents. Please note that a completed TRF must be sent to the processing laboratory regardless of whether a newborn screening specimen was collected or not.

Shipping your newborn screening specimens to the processing laboratory

Newborn screening blood specimens and the TRF must be sent to processing laboratory no later than the next business day after collection and filling out TRF using contracted shipping vendor(s), such as GLS
A log sheet must be filled out and placed in the shipping envelope, even if only one specimen and TRF is placed in the envelope

Online specimen tracking

Online Specimen Tracking (OST) is a regulatory requirement (17 CCR § 6506) that helps ensure all babies born in California have the best possible start in life. OST is accessed via the California Department of Public Health Screening Information System (SIS).

Hospitals, midwives, and those working in community birth settings are required to access SIS within 7 days of a birth to verify that newborn screening specimens are received by an NBS Program laboratory. If a specimen has not been received, it is reported as a missing specimen and an investigation is conducted to locate the specimen. This is an important measure to make sure the specimen(s) are not lost and thus prevent any delays in getting results.

Request OST training for yourself or any a new provider by emailing this address: NBSOST@cdph.ca.gov

Please visit the NBS Program Online Specimen Tracking web page to find out more about OST.

Billing and payment for newborn screening

After the newborn screening specimen has been processed, the parents will be sent an invoice for the test along with a form for their insurance information. By filling out and sending back the insurance form, the California Newborn Screening Program will bill the parents’ insurance directly for the screening.

The parents will always have the choice of paying the invoice themselves as well if they do not wish to use their insurance as a payor for the screening. To pay for your child’s newborn screening test directly, please visit the NBS Program Payment Portal or call 1-800-597-0832 for assistance.

For invoice payment and billing Information and the current Newborn Screening Program fee, please see the NBS Program Billing and Payment FAQ web page.

Newborn Screening Supplies

To order Newborn Screening Forms (TRF's, Transport Logs, IIP's):

Online: NBS Supply Order Portal (recommended)
E-mail: nbsorders@cdph.ca.gov

For inquiries/status of Newborn Screening supplies, please e-mail nbsorders@cdph.ca.gov

Shipping Supplies

To order GLS (formerly GSO) supplies:

E-mail: govtaccts@gls-us.com
Phone: (800) 322-5555

When contacting GLS, you will need to provide:

Facility name
Facility code
GLS account #50481
Designated NAPS laboratory

Please note the following:

Scheduled pick up requests can only be made from your listed address on file. Pick up locations other than your listed address will not be serviced.
You may drop off your envelopes at a GLS drop box or office location but notify GLS beforehand.
GLS shipping labels expire every six months. Ensure your shipping labels are current to avoid shipping delays.

Find your assigned newborn screening Area Service Center (ASC)

The Area Service Center (ASC) is your local California Newborn Screening Program support center. Their staff are ready to support you with all your newborn screening questions and will guide you to achieve best outcomes for your clients regarding newborn screening.

The ASC staff monitors adequacy of newborn screening specimens collected and sent for processing and contacts providers for any needed follow up when indicated. ASCs will contact newly registered providers and provide periodic program updates and provider feedback.

Please find your local ASC with their contact information in the map on the Area Service Centers webpage.

Newborn screening sample storage and destruction

California, like many other states, stores newborn screening blood spot collection cards. The blood spots may be used to improve the screening program or to develop screens and tests for new disorders.

The blood spots may also be used for studies about diseases in women and children. The stored blood spot cards do not have information, such as names or addresses, that can be used to identify you or your baby. The NBS Program follows all federal and state privacy and research laws.

If you do not want your baby’s or your own blood spots to be stored, you can request for them to be destroyed. This is your right. You can make this request after newborn screening has been completed. Remember, if you request that the blood spots be destroyed, they will never be available to you or your baby in the future for any additional screening or testing.

Visit the NBS Program “What Happens to My Baby's Blood Spots After the Newborn Screening Test?” web page for more information. To ask the NBS Program to destroy your baby’s or your own blood spots, please do the following:

Complete and submit this form: Parent Request to Have Newborn Blood Specimen Card Destroyed (CDPH 4410) (PDF)
Contact the California Biobank Program Coordinator at (510) 412-1500 or CaliforniaBiobank@cdph.ca.gov if you have any questions.

California Code of Regulations, Title 17, Newborn Screening

Midwives and other out of hospital providers are mandated to collect, educate, and inform families about newborn screening blood collection. Please refer to the text below:

Newborn screening is mandated by the California Code of Regulations, Title 17—all babies born in California are required to get screened soon after birth—regardless of birth plan or setting, including those born at home or in an out-of-hospital setting.

CCR, Title 17, §6500.55. Out-of-Hospital Newborn Screening Providers. “Out-of-Hospital Newborn Screening Providers” means: (a) all healthcare professionals including, but not limited to, licensed midwives (LM), certified nurse midwives (CNM), registered nurses (RN), physician assistants (PA), pediatric nurse practitioners (PNP), physicians/medical doctors (MD), doctors of osteopathy (DO), and naturopathic doctors (ND), who are licensed or certified by the State to provide maternal care and to deliver pregnant women in alternative settings other than perinatal licensed health facilities including, but not limited to, private homes and clinics and (b) staff of health care entities, such as clinics and free-standing independent laboratories that are authorized by the Department to collect newborn screening specimens in alternative settings other than perinatal licensed health facilities.

Out-of-Hospital Newborn Screening Providers - California Code of Regulations

Newborn screening testimonials: Parent to parent

Testimonials of how participating in newborn screening helped these families and babies. Please feel free to share them with your clients when educating them about newborn screening.

Newborn Screening: Family Stories | Flickr

Helpful links/Tips/Fast facts

Tips

This section contains tips on collecting a newborn screening specimen in the community birth setting.

There are many advantages as well as special considerations for collecting a newborn screen at home or at a birthing center. A video discussion and some important tips for newborn screening blood collection at home:

California newborn screening resources

Data

Did you know that just under 450,000 babies are born in California annually and that over 5000 babies are born at home or in a birth center. For detailed information, please visit the California Open Data Portal: Statewide Live Birth Profiles

Timeliness

Timeliness in newborn screening specimen collection is of vital importance. Please see the video below to review the key components of a successful and timely newborn screening process: California Newborn Screening Timeliness Project - YouTube

midwives

Newborn screening program

Information for Midwives and Community Birth Settings

Advantages of newborn screening at home or at a birthing center

Introducing newborn screening to your clients