28 Jul 2011

Govt working to address gaps in maternity services

9:37 pm on 28 July 2011

The Government says changes are being made to address gaps in New Zealand's maternity services.

A report by the Perinatal and Maternal Mortality Review Committee released on Thursday says there were 98 potentially avoidable deaths of unborn and newborn babies in 2009.

Perinatal mortality covers foetal and early neonatal deaths, from 20 weeks' gestation until less than seven days after birth, or until a baby weighs at least 400 grams.

The committee says the perinatal death rate in 2009 was about 11 for every 1000 births, which is comparable to the rate in Australia and the United Kingdom.

But the committee also says teenage mothers are among those at higher risk of stillbirth and neonatal death, and that suicide is one of the most frequent causes of maternal death in New Zealand.

Better and earlier access to services are recommended, and backed by midwives and obstetricians.

The Government on Thursday launched new maternity standards and praised cooperation between all groups involved over the past two years to address the service gaps.

Health Minister Tony Ryall says each case involving a potentially avoidable death is a tragedy and the committee's report confirms that maternity services are performing well, but improvements are needed.

Mr Ryall says an information system designed to better record and monitor antenatal and postnatal care for mothers and babies, known as Data Mart, is going live this weekend.

The minister says the new programme will improve communication, teamwork and the quality of maternity care generally.

Money was also made available in the Budget in May to make other improvements, he says.

Medical Association deputy chairman Mark Peterson says the standards have been developed over the past two years by clinical leaders of midwifery, specialist obstetricians and general practitioners.

Dr Peterson says a new shared maternity record between the groups should ensure smoother and quicker referrals in future.

Call for rethink on service for teen mums

Professor Cindy Farquhar, the chairperson of the Perinatal and Maternal Mortality Review Committee, says it is time for a radical rethink of the way maternity care is delivered to teenage mothers.

The committee's report says the mothers involved tended to have high blood pressure, bleeding during pregnancy and conditions like diabetes, but more could have been done to prevent the deaths, including by better access to care.

Professor Farquhar says teenage mothers are particularly at risk and more must be done to meet their specific needs.

The report found Maori and Pacific mothers are more likely to have stillbirths and neonatal deaths, with deprivation playing the key role.

The committee wants maternity care provided to all pregnant women before 10 weeks and better maternal mental health care.

The College of Midwives says smaller antenatal classes targeting at-risk young mothers could help address the alarming mortality rate.

Chief executive Karen Guilliland told Checkpoint antenatal classes for up to four women could help prevent further deaths. At present, the classes are held for up to 30 people and many young unmarried women simply won't go, she says.

High suicide rate a concern

Midwives say they have been worried for years about the number of suicides that contribute to the maternal death rate.

Suicide is among the three most frequent causes of maternal death in New Zealand, according the Perinatal and Maternal Mortality Review Committee.

There were 49 maternal deaths in the four years from 2006 to 2009, according to its report.

College of Midwives chief executive Karen Guilliland says midwives tell her some women have trouble accessing maternity services, and that alcohol, other drugs and depression may also be factors.