Scrutiny of motherhood shows up NZ's patterns

LIBBY MIDDLEBROOK looks at the first analysis of the country's maternity services.

The country's maternity services have been analysed for the first time.

The Report on Maternity, an 89-page document released yesterday by the Ministry of Health, contains information about pregnancy care, labour and birth, postnatal care and outcomes for births during 1999, as well as analysis of some of the leading maternity providers.

MOTHERS AND PREGNANCY

In 1999, 52,428 mothers gave birth in New Zealand hospitals, with 53,273 babies born.

Of those births, 7 per cent were to teenagers and almost half of them were to Maori.

The Counties Manukau District Health Board, covering South Auckland and its large population of Maori and Pacific Islanders, had the most births - 6973 - out of the 21 district health boards.

The Wairarapa board had the least births that year: 532.

The report also looked at pregnancy rates among women.

New Zealand women had an average of three pregnancies, although one woman surveyed in the study had been pregnant 19 times.

Twenty-five women said they had been pregnant 12 times.

The average age of mothers giving birth was 29.

LABOUR AND BIRTH

The number of babies born normally dropped below 70 per cent - to 69 per cent - in 1999 for the first time.

Caesarean section births increased to 20 per cent. A variety of other medical procedures accounted for the rest.

The report found that Maori women were mostly likely to have a normal birth. Asians were the least likely.

Asian women had the highest rate of caesarean section, at 24 per cent.

More women in the Canterbury board's region elected to give birth by caesarean than any other area of New Zealand. Almost 12 per cent of women who gave birth in Canterbury in 1999 did so by elective caesarean section.

Large specialist maternity units with the highest rates of caesarean section births were Waikato and Wellington Hospitals.

The report said North Shore, Palmerston North and Southland Hospitals "could" also investigate increases in caesarean sections in their maternity units.

BABIES

In 1999, 26,065 female babies were born and 27,204 males.

The average birth weight for female babies was 3.35kg. Males averaged 3.46kg.

Seven per cent of babies were born within 37 weeks of pregnancy, with Pacific women having the fewest pre-term births compared with other ethnic groups.

There were 440 stillbirths and 129 babies died within seven days of being born (perinatal).

Pacific women had double the stillbirth rate of Asian women.

POSTNATAL PERIOD

The report found that 74 per cent of babies were exclusively breast-fed at six weeks, although the figure did not include information about 31 per cent of babies.

It found that older women giving birth were more likely to breast feed than young mothers.

Almost 20 per cent of Maori women did not breast feed.

More women claimed for specialist paediatrician consultations in the Canterbury board area than any other region in New Zealand.

MATERNITY FACILITY

New Zealand has six large hospitals with specialist maternity units. New mothers stayed an average of 1.8 days in the country's large units.

The Wellington unit had the highest rate of stillbirths, with 16.5 in every 1000 births. Dunedin had the lowest rate, with 8.8 in every 1000 births.

The report also highlighted striking differences between the ethnic groups of mothers giving birth.

At Middlemore, almost 50 per cent of mothers in 1999 were Pacific Islanders.

Fewer than 5 per cent of mothers in South Island hospitals were originally from the Pacific.

LEAD MATERNITY CARER

In 1999, 66 per cent of women selected midwives as their lead maternity carers.

About 20 per cent chose general practitioners and 15 per cent, obstetricians.

Midwives tended to care more for younger women and Maori.

More women with obstetricians as their lead maternity carers elected to give birth by caesarean section.

nzherald.co.nz/health