17 Feb 2014 | Perinatal & Maternal Mortality Review Committee
The Perinatal and Maternal Mortality Review Committee (PMMRC) has commended Counties Manukau Health for carrying out a report into women’s experiences of its maternity services.
Giving women a voice is the first step in discovering why some women are reluctant to use the maternity services available to them, says Dr Sue Belgrave, who chairs the PMMRC.
The independent report – Maternity Care Experiences of Teen, Young, Maori, Pacific and Vulnerable Mothers at Counties Manukau Health – focused on women who were less likely to use maternity services and were less likely to complain or fill out surveys.
Released today, the report found that some of the small sample of women interviewed had poor access to midwives and felt they were given poor service at Middlemore Hospital.
PMMRC’s annual reports have found that Counties Manukau Health has had higher than average perinatal mortality rates. After discussion with the PMMRC, Counties Manukau Health commissioned an independent review into the provision of maternity care, followed by the current review into women’s experiences of maternity care.
Dr Belgrave says Counties Manukau has a significant number of women who are choosing not to use its maternity services till late pregnancy or labour, and it needed to find out why this was.
Late or infrequent access to antenatal care has been identified as the most important factor in potentially avoidable perinatal deaths.
"Giving women a voice is an important first step in understanding the best way to engage with them so they can be supported during their pregnancy," says Dr Belgrave.
"Engaging in maternity care early in pregnancy is essential if health workers are to give early advice about issues such as weight gain in pregnancy, or smoking. If women stop smoking by 15 weeks, there is no risk to their baby compared to women who don't smoke. It’s also an important time to screen for health conditions such as diabetes and high blood pressure.
"We know there are some women who are reluctant to use maternity services, so we need to go out to the community to find out what kind of maternity services would work best for them."
While the Counties Manukau Health report interviewed only women living in the district, Dr Belgrave says the challenge of encouraging vulnerable women to seek support during their pregnancies is a wider problem in New Zealand. Maori and Pacific women living in low socio-economic areas are particularly unlikely to use maternity services at all, or to delay seeking help until later in their pregnancies.
"It can be challenging to ask people for their experiences of health services, but Counties Manukau Health’s decision to ask women for their experiences of maternity services will be of benefit to other district health boards working to improve their services to mothers and babies," says Dr Belgrave.