Report into birthing outcomes shows wide variation.
(Forecasts and trends)
Health boards (Powers and duties)
Maternal health services (Services)
|Publication:||Name: Kai Tiaki: Nursing New Zealand Publisher: New Zealand Nurses' Organisation Audience: Trade Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2012 New Zealand Nurses' Organisation ISSN: 1173-2032|
|Issue:||Date: March, 2012 Source Volume: 18 Source Issue: 2|
|Topic:||Event Code: 010 Forecasts, trends, outlooks; 360 Services information Computer Subject: Market trend/market analysis|
|Geographic:||Geographic Scope: New Zealand Geographic Code: 8NEWZ New Zealand|
The Ministry of Health's (MoH) first report on a set of 12
maternity clinical indicators identifies significant variations between
district health boards (DHBs), and individual secondary and tertiary
facilities. Variations occur in the types of birth, depending on
location, types of intervention, use of general anaesthetic (GA) and
According to the MoH's senior adviser, maternity services, Bronwen Pelvin, the report, which covers births in 2009, will provide DHBs with standardised data so they can see how their maternity services compare to others in New Zealand, where services should be reviewed and quality improvements made.
In 2009, 69.1 per cent of births by women aged 20 to 34 giving birth for the first time--standard primiparae--at their local DHB were spontaneous vaginal births. The lowest rate of spontaneous vaginal births occurred at Christchurch DHB (58.7 per cent), while the highest was at Lakes DHB (79.8 per cent). Waikato had a 79.2 per cent rate. Canterbury also had the highest rate of standard primiparae undergoing an instrumental vaginal birth (22.2 per cent), while South Canterbury recorded the lowest rate at 6.4 per cent. For standard primiparae giving birth by Caesarean (C) section, Wairarapa recorded the highest rate at 27.1 percent, with Hutt Valley the next highest at 23.4. The lowest rate was at Waikato (8.3 per cent).
Labour was induced among standard primiparae at a rate of 9.7 per cent in Southland, while Tairawhiti and Whanganui DHBs had rates of only 2.1 per cent. Tairawhiti also recorded the highest rate of women giving birth vaginally with an intact lower genital tract at 64.6 per cent, while Capital and Coast had the lowest rate of 21.6. A 6.1 episiotomy percentage rate with no other major tears was recorded in Tairawhiti, while at Wairarapa, there was a 29 per cent rate of episiotomy without other tears.
At Tairawhiti, 13.7 percent of women had a C section under GA, while at Wairarapa the C section rate under GA was only 3.9 per cent. Tairawhiti and MidCentral recorded the highest rates of premature births (8.1 and 8.5 respectively), double the rate recorded in Nelson Marlborough.
NZNO professional services manager Susanne Trimm said the variations among indicators were concerning, although there would likely be a number of contextual issues affecting the results. "We would hope women would have similar birthing outcomes, no matter where they lived in New Zealand, but the report suggests this is not the case. It is hoped investigations over the coming year will see improvements in these indicators," she said.
The full report is available at www.health.govt.nz/publication/new-zealand-maternityclinical-indicators-2009. It will be published annually.
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