This snapshot provides an overview of the findings of the Report on Maternity: Maternal and Newborn Information 2003 [refer Library Catalogue], which is set for release 30 June 2006. It is a statistical snapshot; a commentary of the findings will be available in the full publication.
Report on Maternity: Maternal and Newborn Information 2003 is the fourth annual report on mothers and babies using maternity services in New Zealand. It is based on information reported to the National Minimum Dataset (NMDS) and to the Maternal and Newborn Information System (MNIS). The NMDS has achieved complete coverage of all hospital births, while the MNIS coverage has improved considerably from around 70 percent in 2002 to 83 percent in 2003.
In 2003, 55,289 live babies were born in New Zealand. Hospital births accounted for 55,119 live babies who were delivered to 54,581 women. This accounts for 98.2 percent of the 56,134 live babies born in 2003 that were registered by Births, Deaths, and Marriages (as reported by Statistics NZ).
- The majority of mothers who gave birth in 2003 were European (57.3 percent). The proportion of Maori and Pacific mothers who gave birth (19.8 and 10.5 percent respectively) was higher than the relative proportion of each in the total population of women of reproductive age (15.3 and 6.0 percent respectively).
- The average age of all mothers was 30.2 years. Seven percent of mothers (3845) were less than 20 years of age.
- Although pregnant mothers had on average 2.1 ultrasound examinations, 14 percent of mothers had none reported.
- There were 7.1 maternal deaths per 100,000 live births.
- Of the women who gave birth, 67.4 percent had a spontaneous vaginal birth (normal delivery) and 0.6 percent had a vaginal breech birth. Caesarean sections were performed on 23.1 percent of mothers, while 5.5 percent of deliveries were vacuum extractions and 3.4 percent were deliveries in which forceps were used.
- The use of caesarean sections has increased steadily to 23.1 percent in 2003 from 20.8 percent in 2000 and 11.7 percent in 1988.
- Of the 23.1 percent of mothers who had a caesarean section, 38.0 percent had the procedure electively. Older women were more likely to have a caesarean section (see the graph below).
Percentage of mothers, by type of birth and maternal age group, 2003
- Maori and Pacific mothers were more likely to have a normal delivery, while caesarean sections were more common among Asian and European mothers.
- The proportion of caesarean sections performed within each DHB ranged from 29.9 percent (Southland DHB) to 14.2 percent (Northland DHB).
- The national rate of epidural administration was 24.2 per 100 births. Mothers aged between 30 and 34 years and Asian mothers had the highest rates of epidural administration (26.3 and 32.0 per 100 births respectively), while Maori mothers had the lowest (13.2 per 100 births).
- Rates of epidural use ranged from 40.0 per 100 births in Capital and Coast DHB to 3.7 per 100 births in Lakes DHB.
- The national rate of inductions was 19.7 per 100 births. Mothers aged 40 years and over had the highest rate of inductions (25.8 per 100 births), and Maori mothers had the lowest (15.9 per 100 births).
- Rates of inductions ranged from a high of 26.2 per 100 births in West Coast DHB to 12.4 per 100 births in both Hawke’s Bay DHB.
- Of the 55,289 live babies born in New Zealand, 7.2 percent were born preterm (less than 37 weeks gestation). Babies of Maori mothers were more likely to be preterm (7.6 percent) or very preterm (less than 28 weeks gestation, 0.7 percent).
- In 2003, 51.4 percent of live babies born were male.
- The average birthweight of babies born in New Zealand was 3.41 kg. Male babies were on average heavier (3.46 kg) than female babies (3.35 kg). Asian babies had the lowest average birthweight (3.22 kg), while Pacific babies had the highest (3.55 kg).
- More Pacific babies had a birthweight over 4500 g (5.2 percent), compared with babies born to other ethnic groups (ranges from 1.0 percent to 2.7 percent).
- Low birthweight (less than 2500 grams) occurred in 3292 liveborn babies (6.0 percent). Of the full-term babies born (37 or more completed weeks of gestation), 2.0 percent had a low birthweight. The highest proportions of low-birthweight babies were born to Asian (7.9 percent) and Maori mothers (6.7 percent).
- The proportion of full-term babies with a low birthweight ranged from 4.0 percent in Whanganui DHB to 1.4 percent in Capital and Coast DHB.
- Of the babies born in hospital in 2003, Pacific babies had the highest perinatal death rate (13.8 deaths per 1000 total births), while Maori babies had the highest late neonatal death rate (0.9 deaths per 1000 live births). (See the definitions of perinatal deaths and neonatal deaths below.)
- The national rate of hospital born babies who died within the first 27 days of life (neonatal deaths) was 3.3 per 1000 live hospital births. Neonatal deaths ranged from 9.8 per 1000 live hospital births (West Coast DHB) to 0.5 per 1000 live hospital births (MidCentral DHB).
Maternity Service Providers
- Lead Maternity Carers submit claims to HealthPAC under the Section 88 Maternity Notice, which are subsequently reported to the Maternal and Newborn Information System (MNIS).
- Of the mothers who gave birth in hospital, Pacific and Asian mothers were more likely to give birth in a tertiary facility (67.9 and 65.0 percent respectively), while 48.8 percent of Maori mothers used secondary facilities. European mothers were fairly evenly split between secondary and tertiary facilities (42.6 and 42.4 percent respectively). (See the definition of secondary and tertiary facilities below.)
- In 2003, 7.0 percent of mothers did not have a Lead Maternity Carer registered to provide them with maternity care.
- At first registration, the majority of mothers registered with a midwife (78.1 percent), although 7.9 percent registered with a general practitioner and 7.8 percent with an obstetrician.
- Of the mothers registered with a Lead Maternity Carer, Maori mothers were more likely to register with a midwife (85.5 percent) and less likely to register with a general practitioner (5.7 percent). In contrast, while the majority of Asian mothers were registered with a midwife (72.0 percent), they had the highest proportion registered with a general practitioner (10.5 percent).
- Overall Tairawhiti DHB had the highest proportion of its mothers registered with a midwife (98.3 percent), whereas mothers in South Canterbury DHB were more likely to be registered with an obstetrician (79.9 percent).
- Midwives performed the highest proportion of normal deliveries (72.6 percent), and obstetricians performed the highest proportion of caesarean sections (18.9 percent acute; 12.0 percent electively).
Perinatal deaths are defined as the number of stillbirth (fetal deaths of 20 weeks gestation or 400 grams birthweight) plus early neonatal death.
Neonatal deaths are defined as deaths occurring up to 27 days after birth, and are classified as early or late neonatal deaths. Early neonatal death is defined as the death of a liveborn infant dying before 168 completed hours (seven days) after birth, and late neonatal death is defined as the death of a liveborn infant dying after seven days and before 28 completed days after birth.
For the purposes of this summary, secondary facilities are defined as facilities which have the capability to perform caesarean sections, and tertiary facilities are defined as providing neonatal intensive care units.