This first report on the New Zealand Maternity Clinical Indicators is the result of a collaborative process involving the Ministry of Health and maternity stakeholders, representing consumer, midwifery, obstetric, general practice, paediatric and anaesthetic perspectives. Building on previous work undertaken across Australasia, an expert working group has established a set of 12 maternity clinical indicators that are relevant to the New Zealand setting and can be measured using available data collections.
This is the first time maternity clinical data has been benchmarked in such a comprehensive way using a standardised definition and presented at the national level in New Zealand. The use of the standard primipara definition allows the separate assessment of a group of women for whom interventions and outcomes should be similar. In addition to eight indicators for standard primiparae, there are also three indicators for all women giving birth in hospital and one indicator covering all babies born in hospital. Other indicators will be added over time as improved data becomes available.
The release of this report provides an opportunity for district health boards (DHBs) and local maternity stakeholders to participate in and add value to the process by undertaking further investigation at a local level as part of maternity quality and safety programmes.
This first report identifies significant variation between DHBs and between individual secondary and tertiary facilities. This variation among a group of women who would be expected to have similar outcomes needs to be investigated. There is particularly significant variation in rates of spontaneous vaginal birth, instrumental vaginal birth, induction of labour and intact lower genital tract. These findings should encourage further detailed investigation of data quality and integrity, as well as the practice management reasons for these variations.