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9 out of 10 women happy with maternity care

Hon Steve Chadwick
Associate Minister of Health

9 May 2008
Media Statement
9 out of 10 women happy with maternity care

Nine out of 10 women are happy with the maternity care they received, according to the report on the Maternity Services Consumer Satisfaction Survey 2007 launched today by Associate Health Minister Steve Chadwick.

"This is wonderful news for New Zealand women and their families. The survey demonstrates that our services are working well for the vast majority of women," Steve Chadwick said.

“Ninety per cent women gave birth and received post-natal care where they wanted to, and a similar proportion expressed overall satisfaction with their hospital stay.”

The survey also showed that women are better informed about maternity services and the majority felt well looked after by their lead maternity carer (LMC).

“Women, midwives and other maternity providers highly value our model of care and the seamless maternity services provided in New Zealand. I congratulate all the people and organisations that provide and support maternity services for their care and effort.”
The survey canvassed the views of 2936 women who gave birth to live babies
in New Zealand during March and April 2007. The objective of the survey was to obtain women’s perceptions of maternity services, and to assess whether there has been any change since women were last surveyed in 2002.

All key areas of maternity services (antenatal care, lead maternity care, hospital stay, and postnatal care) scored satisfaction levels of 90 per cent or higher.

“Compared to 2002, the latest survey found a greater percentage of women had difficulty finding a suitable LMC – this was not a surprise to us but is something the government and sector groups are working together to address.”

To address the shortage of midwives, the Ministry of Health has implemented a range of initiatives, including a pilot scheme to mentor first-year midwifery graduates as they join the workforce, providing funding support for rural midwives who face high travel costs, and increasing pay rates under the Section 88 Notice.

"New Zealand has a world class maternity system. These results show there have been improvements in key aspects of care and reflect a very high level of satisfaction with maternity services," Steve Chadwick said.

The report is available at: www.moh.govt.nz/maternity
Speech available at: www.beehive.govt.nz/chadwick

--

Maternity Services Consumer Satisfaction Survey 2007


Summary of key findings

Overall findings
Overall the survey showed a very high level of satisfaction with maternity services and indicated that the vast majority of women are happy with the maternity care they received. The key areas of maternity services – antenatal care, lead maternity care, hospital stay, and postnatal care – all scored satisfaction levels of 90 per cent or higher.

Antenatal Care
* 96 percent were satisfied with the care they received (78 percent said they felt “well looked after” and 18 percent felt that the care was satisfactory)
* women report high levels of satisfaction with care from Specialist Obstetricians
* 89 percent received information about immunisation and 95 percent of these women decided to immunise their baby
* 43 percent attended antenatal class – 78 percent of first time mothers attended
* 19 percent reported difficulty finding an LMC.
* there was a very low rate of attendance at antenatal classes among Maori and Pacific women (around 25 percent).

Labour and Birth Care
* 86 percent were able to give birth in the facility of their choice
* 94 percent said communication between LMC and specialist was either satisfactory or excellent
* 82 percent felt well looked-after by LMC
* 85 percent felt ready to leave hospital
* 18 percent reported pain relief was not satisfactory in some way
* there was an increase in proportion of women discharged within 12 hours to 14 percent (from 8 percent)
* some women were dissatisfied with their hospital care, and 2 percent were very dissatisfied.

Post Natal Care
* 92 percent were in their facility of choice
* 90 percent were satisfied with number of home visits
* 91 percent rated the advice they received about feeding as either good or excellent.

Questions and Answers

Who was surveyed?
2,936 women who gave birth to live babies in New Zealand during March and April 2007.

What did the survey show?
Overall the survey showed a very high level of satisfaction with maternity services and indicated that the vast majority of women are happy with the maternity care they received. The key areas of maternity services – antenatal care, lead maternity care, hospital stay, and postnatal care – all scored satisfaction levels of 90 per cent or higher. The survey also indicated that new and expectant mothers are well informed about maternity services.

The survey also raised some issues for us to look at, including an increase in women having difficulty finding a Lead Maternity Carer (LMC), and women who reported not feeling ready to leave hospital. A small percentage of women were not satisfied with some aspects of services.

How will the survey results inform policy or improve maternity services?
The survey report will be forwarded to the Maternity Services Strategic Advisory Group. The Group will assist the Ministry and DHBs to develop a strategic vision for maternity services and advise on implementation issues and priorities. It will also be circulated to DHBs to guide them in planning and improving services.

How does NZ's maternity system compare to other systems internationally?
New Zealand’s maternity services compare well to other first world nations. Our workforce issues are common to the health sectors of other first world health systems. Our childhood outcomes rank similarly to comparable countries.

What has improved since 2002?
The survey shows there have been many improvements, including:
* a higher percentage (90 %) of women gave birth and received post-natal care where they wanted or intended to
* a higher proportion of women expressed overall satisfaction with their hospital stay (90% were either very satisfied or satisfied)
* expectant mothers are better informed about maternity services
* an increased proportion of women know they have to register with a LMC and know who their Well Child provider is
* women are more aware of the need for antenatal tests and immunisation
* post-natal home visits made by LMCs have increased over the last five years
* ninety-six percent of babies were referred for the six-week GP check.

What is being done to further improve maternity services?
* the establishment of the Maternity Services Strategic Advisory Group, which will report back to the Minister in about six months with a strategic plan for maternity services
* funding for midwives increased by around $11.4 million annually from July 2007
* the Ministry of Health has introduced a one-year mentoring pilot support programme for new graduate midwives (worth $4.7 million over two years) – early indications are that this is helping to retain new graduates
* the Ministry funds the New Zealand College of Midwives to run a rural locum register – putting available midwives in touch with regions that need them
* the Ministry is in discussions with District Health Boards New Zealand about a coordinated overseas recruitment drive designed to increase the number of both LMC and core midwives
* the Tertiary Education Commission is undertaking a review of midwifery training needs
* the Minister has asked the Ministry to report to her on funding for ongoing professional development, similar to what doctors already receive.

What is being done to make it easier for pregnant women to find an LMC?
There is a free-phone service that provides a list of LMCs available in the woman's area. Where LMCs are not available, the DHB provides care. The Ministry of Health, district health boards, the Midwifery Council, midwifery training schools and the Immigration Service are all taking steps to assist with the recruitment (and retention) of midwives from New Zealand and from overseas.

What is being done to make antenatal classes more accessible, particularly for Maori and Pacific women?
Antenatal classes appear to attract low numbers of Maori and Pacific women. District health boards will need to consider the issues raised by the survey and consider whether the existing antenatal education programmes need to be changed, or whether new programmes and providers are needed to address the needs of Maori and Pacific women.

Why do some women leave hospital within 12 hours after birth?
Some women plan and/or choose to leave within 12 hours of birth. With midwifery and family/whanau support, women often feel better in their own environment, particularly if it is their second or subsequent child. LMCs are required to visit within 24 hours of discharge and must provide a minimum of seven postnatal visits over 4-6 weeks and as many other visits as are required.

Are there national guidelines on how long a woman should stay in the hospital after giving birth?
There is no international standard as to how long women should stay in hospital after giving birth. There are also no national guidelines and practice varies across DHBs. It is a joint decision made by the women and her LMC. Nationally the average length of stay following a birth in a maternity facility is 2.9 days.

What is a Lead Maternity Carer?
A Lead Maternity Carer is a midwife, an obstetrician or a GP with a diploma in obstetrics or equivalent, selected by a woman to provide her care.


ENDS

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