Many new mothers in Hawaii rely on federal nutritional assistance, according to a new report released by the state Department of Health that provides a snapshot of a local mother’s experience before, during and after pregnancy.

In an average year in the state, one in eight expectant mothers develop gestational diabetes, one in 10 have high blood pressure during pregnancy, and one in 11 have preterm deliveries, based on aggregated data from surveys distributed from 2012-2015, reported in the 2019 Hawaii Pregnancy Risk Assessment Monitoring System report.

During 2012-2015, the average annual percentage of new mothers and children who relied on WIC assistance was about 42%, and many of them live on the Big Island. WIC, which stands for Women, Infants and Children, is a federally-funded supplemental nutrition program that assists pregnant women, breastfeeding women, non-breastfeeding postpartum women, and children up to age 5.

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But Hawaii’s WIC program covers only about half of the total number of new mothers and children estimated to be eligible across the state, according to national data from the U.S. Department of Agriculture’s Food and Nutrition Service. In 2014, there were 64,600 eligible, but 33,300 participated, the USDA’s participant and program characteristics report found.

Nearly a third of Hawaii mothers who responded to the PRAMS survey reported a household income that was at or below the federal poverty level.

Matthew Shim, the chief of the Family Health Services Division at the Hawaii Department of Health, says participation in WIC in the islands has declined over the past few years, as it has across the nation. In 2018, there were about 26,000 Hawaii WIC participants — about 7,000 fewer compared to 2014, he said.

“We think there’s more women we can serve with the WIC Program that aren’t partaking,” he said.

The PRAMS report also highlights which health issues are most prevalent in certain populations. For example, Samoan and Native Hawaiian mothers surveyed were found to have the highest prevalence of obesity before conception, and Filipino mothers were the most likely to report having developed gestational diabetes.

The PRAMS report is a follow-up to one published nearly a decade ago. The 2019 report assesses trends from data collected from 2009 to 2015 via monthly surveys. Data is weighted and vetted by the national Centers for Disease Control and Prevention.

Shim called the report a “conversation starter” that could prompt further investigation by scientists and epidemiologists.

Since 2010, the state saw improvement in some areas, such as fewer mothers reporting stressful life events and more mothers reporting successful breastfeeding.

The prevalence of other health indicators of concern — such as cigarette smoking and alcohol use during pregnancy, postpartum depression and Cesarean delivery — had relatively similar rates compared to the the last report, which analyzed data from 2000 to 2008.

In an average year, approximately 18,400 babies are born in Hawaii.