Maternity report released

July 6

The number of women having caesarean section births in New Zealand continues to increase slowly.

The Report on Maternity: Maternal and Newborn Information 2002 is the third report analysing comprehensive maternity services information. It contains information on the outcomes, availability and utilisation of maternal and newborn services for women who gave birth in New Zealand in 2002.

The report shows that in 2002, 22.7 percent of hospital births were by caesarean section, compared to 22.1 percent in 2001.

It also highlights wide regional differences in caesarian section rates in New Zealand.

A number of factors seem to have driven this regional variability, including differences in regional populations, different expectations among women and differences in clinical practice.

Ministry of Health Chief Advisor for child and youth health Dr Pat Tuohy says the Ministry is actively working to reduce these differences in clinical practice.

New "Guidelines on breech birth and vaginal birth following a previous caesarian section" are being developed by the Ministry-funded NZ Guidelines Group.

Guidelines for the best care in labour will be developed next.

These guidelines will be progressively implemented in consultation with DHBs, and monitoring and evaluation strategies will be put in place.

The Ministry also has a number of other initiatives underway to address the caesarian section rate. This includes:

Distributing pamphlets which are based on the 'Breech birth and vaginal birth following a previous caesarian section' guidelines. The pamphlets will help expectant mothers become fully aware of their birth options. Clarifying, for DHBs through their accountability process, that caesarean sections must not be performed using public funding unless they are medically indicated. Canvassing women?s views on caesarean section to assist in developing strategies to reverse the trend. This will be done in the next Maternity Services Consumer Survey (2005). Establishing of a national Maternity Policy Advisory Group to assist the Ministry in policy development and implementation to optimise clinical care delivery and outcomes in maternity.

The report also shows how the proportion of women giving birth in the 30-34 year age group and the 35+ age group continues to grow as a proportion of all women giving birth.

Dr Tuohy says this has implications for maternity and reproductive and sexual health services with, for example, implications for fertility, interventions during labour and birth, and low birth weight.

The proportion of under-19 year old women giving birth has declined, however, this is as a result of an increasing abortion rate, rather than a declining fertility rate. New Zealand?s teen pregnancy rate remains high by international standards.

Reducing rates of teen pregnancy and teen abortion are the concerns of DHBs. Guidance to assist DHBs reduce their rates of teen pregnancy and teen abortion has been shared with DHBs and will soon be published by the Ministry of Health in the Child Health Toolkit.

Other points of interest in the report include:

In 2002, 53,037 women gave birth in a hospital to a total of 53,589 babies. Deliveries involving operative vaginal procedures such as forceps were 9.6 percent in 2002, compared to 10.3 percent the year before. Just under 68 percent of hospital births were normal vaginal deliveries in 2002, compared to 70 percent in 2001. In 2002, 72.6 percent of all pregnant women had a midwife as lead carer and 8.6 percent had a GP.

Full report available at NZHIS website: http://www.nzhis.govt.nz/publications/maternityreport.html

ENDS

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