Better Public Services Result 2: Healthy mums and babies

What is the target?

By 2021, 90% of pregnant women are registered with a Lead Maternity Carer in the first trimester, with an interim target of 80% by 2019, with equitable rates for all population groups.

Why is this important for New Zealand?

Early and continued regular engagement with a Lead Maternity Carer (usually a midwife) is associated with normal healthy births and better pregnancy outcomes.

Having a Lead Maternity Carer helps set up children for a good start in life. Lead Maternity Carers also connect mother and child with other core health services, such as general practice, immunisation, Well Child Tamariki Ora, and oral health services. They connect families to other social services that may be needed.

How will we know we are achieving this result?

Currently about 65% of all women who give birth register with a Lead Maternity Carer in the first trimester of their pregnancy. Rates of first trimester registration vary widely according to age, deprivation, ethnic group and geographical location.

For example, in 2015:

  • 39% of Pacific women, and 55% of Māori women, registered with a Lead Maternity Carer in the first trimester
  • 54% of women living in areas of high deprivation registered with a Lead Maternity Carer in the first trimester, compared with 76% of women living in the least deprived areas
  • 50% of pregnant women under 20 years of age registered in the first trimester, compared with 72% of women in the 30-39 age group.
  • We will know we are achieving Result 2 when the overall rates of first trimester registrations are going up, and the disparities that exist between the population groups are reducing.

What are we doing to achieve this result?

We have a number of priority actions underway or planned that will contribute to healthy mums and babies. These include the following.

  • Work with maternity providers, district health boards and others to ensure all pregnant women have access to maternity services provided by Lead Maternity Carers.
  • Work with district health boards and stakeholders to explore primary/community service models that improve the availability of preventive initiatives, and access to services, for children and pregnant women.
  • Work with district health boards and their stakeholders to improve outcomes for pregnant women and children by continuing to implement the System Level Measures. The System Level Measures are an improvement framework that concentrates on improving core health outcomes, with a particular focus on equity. Measures that impact on pregnant women and babies include:
    • increasing the number of women registering with a Lead Maternity Carer in the first trimester
    • improving youth access to, and utilisation of, youth appropriate health services (for ages 10–24). These include sexual and reproductive health, mental health and wellbeing, and alcohol and other drug treatment services
    • increasing the rates of babies living in smoke-free households
    • implementing the Fetal Alcohol Spectrum Disorder (FASD) Action Plan, a comprehensive set of cross-government actions to prevent FASD. The Plan includes expanding the pregnancy and parenting services for women with addictions. It includes actions to identify and support children affected by FASD
    • working with experts and stakeholders to develop a National Sudden Unexpected Death in Infancy Prevention Programme. This ensures every infant and their family is provided with comprehensive and customised safe sleep information, with follow-up support.
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