In 2006, West Virginia surpassed the national average birth rate for teens ages 15 to 19 years old. Through the use of the state wide Birth Score data, this article presents a retrospective examination of 8,094 teens who gave birth in West Virginia during the years of 2003-2008. Descriptive data on health issues such as prenatal care, infant birth weight and mortality, as well as demographic characteristics, such a racial background and Medicaid status are presented. Implications of these health issues are discussed along with special considerations for health providers who work within the Appalachian region.

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