statistical data on maternity 2005 v5

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Statistical Information on Hospital-based Maternity

Events

2005

New Zealand Health Information Service – 2008

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• the New Zealand Health Information Service is acknowledged as the source.

Disclaimer

The purpose of this paper is to inform discussion and assist policy development. The opinions expressed in

the paper do not necessarily reflect the official views of the Ministry of Health.

All care has been taken in the production of this paper; the data were deemed to be accurate at the time of

release, but may be subject to slight changes over time as more information is received. It is advisable to

check the current status of figures given here with the New Zealand Health Information Service before

quoting or using them in further analysis.

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responsibility for the accuracy, correctness, completeness or use of the information or data in this paper.

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Acknowledgements

Many people have assisted in the production of this paper. In particular, the New Zealand Health Information

Service thanks the peer reviewers for their valuable contribution.

© 2008 Ministry of Health, PO Box 5013, Wellington, New Zealand

ISBN: 978-0-478-31754-1 (Online)

This document is available on the Ministry of Health website: http://www.moh.govt.nz

and the New Zealand Health Information Service website: http://www.nzhis.govt.nz

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CONTENTS Executive Summary .............................................................................................................. 8

1 Introduction ........................................................................................................ 9

1.1 Background 9

1.2 Purpose of this paper 9

1.3 Data sources 9

1.4 Coverage and data quality issues 10

1.5 Explanatory notes 12

1.6 Data presentation 12

2 Mother and Pregnancy ..................................................................................... 14

2.1 Demographic profile 14

2.2 Deprivation 20

2.3 Miscarriages 22

2.4 Pregnancy complications 23

2.5 Maternal deaths 25

3 Labour and Birth............................................................................................... 27

3.1 Type of birth 27

3.2 Caesarean sections 30

3.3 Other birth interventions and events 32

4 Babies .............................................................................................................. 35

4.1 Babies at birth 35

4.2 Birth outcomes 42

5 Postnatal Period ............................................................................................... 48

5.1 Postnatal hospital admissions of the mother and baby 48

6 Maternity Facility............................................................................................... 48

Appendix 1 The New Zealand Index of Deprivation ............................................................. 56

Appendix 2 Diagnosis Related Group (DRG)....................................................................... 57

Appendix 3 Ethnicity ........................................................................................................... 59

Appendix 4 Population Data................................................................................................ 60

Appendix 5 District Health Board Regions ........................................................................... 61

Appendix 6 Catchment Areas.............................................................................................. 62

Appendix 7 Standardisation ................................................................................................ 64

Appendix 8 Statistical Tables of Babies ............................................................................... 67

Appendix 9 Fetal and Infant Mortality .................................................................................. 71

Appendix 10 Statistical Tables of Maternity Facilities ........................................................... 72

Glossary ......................................................................................................................... 96

References ....................................................................................................................... 104

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LIST OF TABLES

Table 1.1: Number of mothers and live babies in 2005, by data source ......................................10 Table 2.1: Number of mothers, by mother’s age group and year of delivery, 1999–2005 ...........15 Table 2.2: Age distribution of mothers, by ethnicity of the mother, 2005 .....................................16 Table 2.3: Number of mothers, by DHB region of mother’s place of residence and ethnicity, 2005

.........................................................................................................................................17 Table 2.4: Number of mothers, by DHB region of mother’s place of residence and DHB of facility

of birth, 2005.....................................................................................................................19 Table 2.5: Number of mothers, by the New Zealand Index of Deprivation decile of mother’s place

of residence and rural/urban status, 2005..........................................................................20 Table 2.6: Antenatal hospital admissions (excluding transfers) and average length of stay for

mothers, by selected Diagnosis Related Groups and ethnicity, 2005 ................................23 Table 2.7: Antenatal hospital admissions (excluding transfers) and average length of stay for

mothers, by principal diagnosis (Diagnosis Related Groups O65A and O65B), 2005 .........24 Table 2.8: Maternal deaths, 1995–2005.....................................................................................25 Table 3.1: Number of mothers, by type of birth, 2005.................................................................27 Table 3.2: Number of mothers, by birth type, maternal ethnicity and age groups, 2005 ..............28 Table 3.3: Number of mothers, by birth type and DHB region of mother’s place of residence, 2005

.........................................................................................................................................30 Table 3.4: Number of mothers, by birth-related procedures and events, by DHB region of

mother’s place of residence, 2005.....................................................................................32 Table 3.5: Rate of birth-related procedures and events, by DHB region of mother’s place of

residence, 2005 ................................................................................................................33 Table 3.6: Use of inductions, by age group and ethnicity of the mother, 2005.............................34 Table 3.7: Use of epidurals, by age group and ethnicity of the mother, 2005 ..............................34 Table 4.1: Number of babies delivered in hospital, by birth status and plurality, 2005 .................35 Table 4.2: Number of liveborn babies, by sex and ethnicity, 2005 ..............................................36 Table 4.3: Average birthweight of babies born in hospital, by sex and ethnicity, 2005.................37 Table 4.4: Percentage of live babies born, by gestational age and ethnicity, 2005......................38 Table 4.5: Percentage of live babies born, by birthweight and ethnicity, 2005.............................38 Table 4.6: Numbers of live babies born, by gestational age and birthweight at birth, 2005..........39 Table 4.7: Percentage of full-term babies (37 or more weeks’ gestation) with a low birthweight

(under 2500g), by year and mother’s ethnicity, 2000–2005................................................40 Table 4.8: Proportion of full-term babies (37 or more weeks’ gestation) with a low birthweight

(under 2500g), by mother’s age group, ethnicity and NZDep quintile of place of residence, 2005 .................................................................................................................................41

Table 4.9: Number of full-term babies (37 or more weeks’ gestation) with a low birthweight (under 2500g), by DHB region of mother’s place of residence, 2005.............................................42

Table 4.10: Number and rate of in-hospital live births, stillbirths and neonatal deaths, by ethnicity, 2005 .................................................................................................................................43

Table 4.11: Number and rate of in-hospital live births, stillbirths and neonatal deaths, by DHB region of mother’s place of residence, 2005 ......................................................................44

Table 4.12: Stillbirth rate, by mother’s age group and NZDep decile of mother’s place of residence, 2005 ................................................................................................................45

Table 4.13: Number and rate of in-hospital neonatal deaths, by birthweight and gestational age, 2005 .................................................................................................................................46

Table 4.14: Number of in-hospital neonatal deaths, by gestational age and birthweight, 2005 ....47 Table 5.1: Postnatal readmissions for mothers with problems relating to pregnancy, by principal

diagnosis (DRGs O04Z and O61Z), 2005..........................................................................49 Table 5.2: Number and rate of hospital readmissions for mothers and babies, by the District

Health Board region of mother’s and baby’s place of residence, 2005 ...............................51 Table 6.1: Total live and stillbirths delivered in hospital, by facility type, 2005.............................53 Table 6.2: Antenatal hospital admissions and average length of stay, by facility type, 2005........54

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Table 6.3: Type of hospital birth (rate per 100 deliveries), by facility type, 2005..........................54 Table 6.4: Number and rate of inductions, epidurals and episiotomies, by facility type, 2005 ......54 Table 6.5: Number and percentage of mothers and average length of stay, by PCCL and facility

type, 2005.........................................................................................................................55 Table 6.6: Numbers of live babies born, by gestational age and facility type, 2005 .....................55

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LIST OF FIGURES

Figure 1.1: Coverage of NMDS as a percentage of BDM registrations, 1999–2005 ....................11 Figure 2.1: Percentage of live birth registrations by age of mother, 1978–2005 ..........................14 Figure 2.2: Percentage of mothers by ethnicity, 2005.................................................................15 Figure 2.3: Birth rates per 1000 women of reproductive age, by mother’s ethnicity and age group,

2005 .................................................................................................................................16 Figure 2.4: Hospital birth rates (standardised by age and ethnicity) with 95 percent confidence

intervals, per 1000 women of reproductive age, by DHB of mother’s place of residence, 2005 .................................................................................................................................18

Figure 2.5: Hospital birth rates per 1000 women of reproductive age, by the New Zealand Index of Deprivation quintile of mother’s place of residence and rural/urban status, 2005 ...........21

Figure 2.6: Birth rates per 1000 women of reproductive age, by the New Zealand Index of Deprivation quintile of mother’s place of residence and ethnicity, 2005 .............................21

Figure 2.7: Rate of hospital miscarriages per 100 mothers, by ethnicity and age group of the mother, 2005.....................................................................................................................22

Figure 2.8: Rates of maternal deaths, three-year moving average, 1993–2005 ..........................26 Figure 3.1: Percentage of mothers, by birth type and age group, 2005.......................................28 Figure 3.2: Rate of birth type per 100 births, by ethnicity, 2005 ..................................................29 Figure 3.3: Percentage of mothers, by year and birth type, 2005................................................31 Figure 3.4: Hospital caesarean section rates (standardised by age and ethnicity) and 95 percent

confidence intervals, by DHB region of mother’s place of residence, 2005.........................31 Figure 4.1: Percentage of total live births, by ethnicity, 1999–2005 ............................................36 Figure 4.2: Percentage of liveborn babies, by birthweight and sex, 2005....................................37 Figure 4.3: Percentage of liveborn babies, by gestational age, 2005 ..........................................38 Figure 4.4: Percentage of babies, by early and late gestational age (excluding babies born

between 37 and 41 weeks’ gestation), 1999–2005 ............................................................39 Figure 4.5: Percentage of live babies, by low birthweight, high birthweight, preterm and full-term

low birthweight, 1999–2005...............................................................................................40 Figure 4.6: Rate of in-hospital stillbirths and neonatal deaths, by ethnicity and 95 percent

confidence intervals, 2005.................................................................................................43 Figure 4.7: Rate of in-hospital neonatal deaths, by gestational age (under 37 weeks and 37 or

more weeks), 2000–2005..................................................................................................46 Figure 5.1: Rate of hospital readmission of mothers (standardised by age and ethnicity) with 95

percent confidence intervals, by DHB of mother’s place of residence, 2005.......................48 Figure 5.2: Rate of hospital admission of babies (standardised by age and ethnicity) with 95

percent confidence intervals, by DHB of baby’s place of residence, 2005 ..........................52 Figure 6.1: Use of primary, secondary and tertiary facilities, by ethnicity, 2005...........................53

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LIST OF APPENDIX TABLES AND FIGURES

Tables

Table A1.1: Nine socioeconomic variables in the New Zealand Index of Deprivation (NZDep) Table A3.1: Standard prioritisation of ethnicity Table A4.1: Prioritised usually resident female population by ethnicity and age for New

Zealand, as at 6 March 2001 Table A7.1: World Health Organization (WHO) world population age weights Table A8.1: Percentage of liveborn babies, by birthweight and DHB region of mother’s place

of residence, 2005 Table A8.2: Percentage of liveborn babies, by gestational age and DHB region of mother’s

place of residence, 2005 Table A10.1: Number of total live and stillbirths, by facility, 2005 Table A10.2: Number and percentage of mothers, by mother’s ethnicity and facility, 2005 Table A10.3: Live births, by facility and DHB region of mother’s place of residence, 2005 Table A10.4: Number of antenatal hospital admissions and average length of stay, by facility,

2005 Table A10.5: Number and percentage of mothers, by type of hospital birth and facility, 2005 Table A10.6: Number and rate of inductions, epidurals and episiotomies, by facility, 2005 Table A10.7: Number and percentage of mothers, by patient clinical complexity level (PCCL)

and facility, 2005 Table A10.8: Average length of stay (days) for mothers, by patient clinical complexity level

(PCCL) and facility, 2005 Table A10.9: Number of live babies born, by gestational age at birth and facility type, 2005 Table A10.10: Percentage of total caesarean sections performed, by facility, 2005

Figures Figure A8.1: Average birthweight of female babies by ethnicity, 1999–2005 Figure A8.2: Average birthweight of male babies by ethnicity, 1999–2005 Figure A8.3: Rate of in-hospital neonatal deaths, by gestational age (under 37 weeks and 37

or more weeks) and ethnicity, 2000–2005 Figure A9.1: Classification of fetal and infant mortality

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Executive Summary

The Statistical information on hospital-based maternity events 2005 paper presents information

from the National Minimum Dataset on the demographics of mothers, their newborns and the

maternity services provided to them in New Zealand hospitals in 2005. The National Minimum

Dataset has complete coverage of all publicly funded hospital births.

In 2005, Births, Deaths and Marriages registered 58,727 liveborn babies (as reported by Statistics

New Zealand). The New Zealand hospital sector reported 55,192 live babies who were either

born in hospital or subsequently admitted following their birth outside a hospital setting. There

were 54,849 women who gave birth in hospital to 55,712 babies, of which 55,192 were liveborn.

These in-hospital liveborn babies account for around 94 percent of the liveborn babies registered

with Births, Deaths and Marriages. Births outside hospitals may account for the difference

between the in-hospital birth numbers and the Statistics New Zealand numbers.

In 2005, the median age of mothers was 30.4 years. This continued the gradual increase in the

median age of mothers observed in previous years. The first year in which the median age of

mothers was over 30 years was 2003. In 2005, nearly one-third (30.7 percent) of all mothers who

gave birth in hospital were in the 30–34 age group, which is the largest of the reproductive age

groups. Māori and Pacific mothers were more likely to give birth at younger ages (20–24 years

and 25–29 years respectively) compared with European and Asian mothers.

Among the 54,849 mothers, two-thirds (66.8 percent) had normal vaginal births and 23.8 percent

had caesarean sections. The remaining 9.4 percent of deliveries involved assisted births or

spontaneous breech births. The percentage of caesarean sections in 2005 continued the slow but

steady increase in this type of birth, in keeping with recent trends observed in other developed

countries (Anderson 2004). New Zealand’s caesarean section rate is above the 10–15 percent

level that the World Health Organization suggested in 1985 as unlikely to be associated with

additional health benefits (WHO 1985).

In 2005, 0.7 percent (393) of total hospital births were stillbirths. Neonatal deaths remained

relatively small, accounting for 179 cases (0.3 percent) of all hospital births. Europeans have

markedly lower early neonatal death rates than all other ethnicities. The perinatal death rate for

Pacific babies was the highest (14.2 perinatal deaths per 1000 total births) compared with the

other ethnic groups.

Of the mothers who gave birth in hospital, Pacific and Asian mothers were more likely to give

birth in tertiary maternity care facilities (62.8 percent and 59.6 percent respectively). This may be

because the District Health Board region in which the majority of those mothers resided had

fewer primary maternity units than other regions. In comparison, 49.9 percent of Māori mothers

used secondary maternity facilities, while European mothers were split between secondary and

tertiary facilities (44.6 percent and 40.3 percent respectively).

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1 Introduction

1.1 BACKGROUND

Maternal and newborn health care services are a critical component of public health services.

The World Health Organization stated that ‘care for pregnant women is often the entry point for

health services for the family and community’ (WHO 2005).

Monitoring maternal and newborn health constitutes an integral part of monitoring the health of

the overall population, and such activity should encourage a positive focus on the maintenance

and enhancement of well health.

This paper presents information on the availability and use of maternity services, and health

outcomes for women who gave birth in 2005 and their babies. This paper will be useful to those

who plan health services as well as being of interest to other health professionals, researchers

and the community in general.

The robustness of any analysis is dependent on the quality of data submitted to the New Zealand

Health Information Service. Potential issues affecting data integrity have been highlighted

throughout this paper.

1.2 PURPOSE OF THIS PAPER

The Statistical information on hospital-based maternity events 2005 provides some health

statistics on the pregnancy and childbirth characteristics of mothers who gave birth to babies

(liveborn or stillborn), and the babies’ characteristics and outcomes. It also presents regional and

national comparisons. The information is presented by calendar year and is drawn from the

National Minimum Dataset. It does not include information on primary and community health

maternity events and therefore presents an incomplete picture of the maternity services in New

Zealand.

Primary and community health care data for 2005 were not available as at May 2008. When

these data become available, they will be incorporate with the hospital information presented in

this paper to produce the annual Report on Maternity. Publication of the annual Report on

Maternity is expected in the first quarter of 2009.

1.3 DATA SOURCES

Unless otherwise stated, the information presented in the tables and graphs in this paper is

sourced from the National Minimum Dataset. Some information was sourced from the Births,

Deaths and Marriages register and reported by Statistics New Zealand.

National Minimum Dataset

Information is collected routinely for all publicly funded events in which a patient is discharged

from a facility in New Zealand. This information contains a substantial amount of clinical data,

including health conditions and procedures that are coded using the appropriate clinical codes.

The event information is forwarded to the New Zealand Health Information Service, where it is

checked, validated and loaded into the National Minimum Dataset.

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Birth, Deaths and Marriages

Births, Deaths and Marriages registers and maintains New Zealand birth and death information

and provides access to that information. Every birth (including stillbirths) in New Zealand must, by

law, be registered.

1.4 COVERAGE AND DATA QUALITY ISSUES

The number of women giving birth (hereafter referred to as mothers) and live births as recorded

in the National Minimum Dataset are presented in Table 1.1, with a comparison to the

corresponding figures registered under Births, Deaths and Marriages and reported by Statistics

New Zealand.

Statistics New Zealand reports the number of births registered in New Zealand to mothers

resident in New Zealand where the date of registration was within the calendar year ended 31

December. It is important to note that Statistics New Zealand reports on the date of registration

rather than the date of birth. Therefore, some births that took place in one year may not be

registered until the following year. This under-count is likely to be counterbalanced by

registrations of births that took place in the previous year. Therefore, the overall effect from the

registration time lag is expected to be minimal.

Table 1.1: Number of mothers and live babies in 2005, by data source

Number

Total mothers* 57,196

Mothers recorded in NMDS (discharged from hospital)

54,849

Live babies* 58,727

Live babies recorded in NMDS (hospital births)

55,192

Data source: National Minimum Dataset and Statistics New Zealand

* Registered in 2005 with Births, Deaths and Marriages, reported by Statistics New Zealand in 2006.

The National Minimum Dataset has complete coverage of all hospital births and it is likely that the

difference between the National Minimum Dataset and Statistics New Zealand numbers

presented in Table 1.1 represents birth events outside of a facility setting.

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Figure 1.1: Coverage of NMDS as a percentage of BDM registrations, 1999–2005

50

55

60

65

70

75

80

85

90

95

100

1999 2000 2001 2002 2003 2004 2005

Year

Percentage

NMDS coverage (live babies)

NMDS coverage (mothers)

Data source: BDM and NMDS Note BDM = Births, Deaths and Marriages NMDS = National Minimum Dataset.

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1.5 EXPLANATORY NOTES

In this paper, a birth is defined as a live or stillborn baby (or babies, in the case of a multiple birth)

of at least 20 weeks’ gestation and/or over 400g birthweight; reproductive age is defined as

women aged from 15 to 44 years.

A facility is the place mothers attend, or are resident in, for the primary purpose of receiving

maternity care. A facility is either a hospital or a birthing centre. In this publication both types of

facilities are referred to as hospitals. Hospital antenatal events are defined as hospital admissions

during a women’s pregnancy prior to delivery in a particular year, irrespective of the diagnosis.

Hospital readmissions are defined as the readmission of the mother to hospital in the six weeks

after an in-hospital birth or the admission of a baby up to three months after the date of birth,

irrespective of the diagnosis. (See Glossary for full definitions.)

Throughout this paper, the type of birth is classified by the delivery method into normal births,

caesarean sections, spontaneous breech births and assisted vaginal births (assisted births).

Caesarean sections are further classified as acute caesarean sections (performed urgently for

clinical reasons, such as the health of the mother or baby, once labour has started) or elective

caesarean sections (performed as a planned procedure before or after the onset of labour, when

the decision was made before the commencement of labour). Assisted births are further classified

as assisted breech births and births using forceps and/or vacuum extractions.

This paper uses two classification systems: the International Statistical Classification of Diseases

and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM), First Edition

(NCCH 1998) and the Australian Refined Diagnosis Related Groups (AR-DRG) Version 4.2.

ICD-10-AM is designed for classification of morbidity and mortality information for statistical

purposes and for indexing hospital records by disease and operations, for data storage and

retrieval. The clinical codes are used to classify the clinical description of a condition, the cause of

intentional and unintentional injury, the underlying cause of death, the operation or procedures

performed and the pathological nature of a tumour.

The AR-DRG provides a clinically meaningful way of relating the types of conditions patients were

treated for in a hospital to the resources required by the hospital. This classification scheme was

developed in Australia for use in monitoring and managing health care services. For further

information, see Appendix 2.

1.6 DATA PRESENTATION

The information in this paper presents data by the calendar year of the maternity event.

1.6.1 Confidence intervals

Confidence intervals have been calculated for rates standardised by age and ethnicity for all

District Health Boards and for the rate of in-hospital stillbirths and neonatal deaths. The

confidence intervals have been calculated at the 95 percent level.

A confidence interval is a range of values used to describe the uncertainty around a single value,

such as an age-standardised rate. A confidence interval is used to estimate the true value in a

population, such as the underlying or true rate. Confidence intervals describe how different the

estimate could have been if chance had led to a different set of data. Confidence intervals are

calculated with a stated probability and indicate that there is a 95 percent chance that the true

value lies within the confidence intervals.

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Confidence intervals may assist in comparing the rates, for example, between DHBs and the

national rate. If two confidence intervals do not overlap, it is reasonable to conclude that the

difference between the rates is not due to chance. However, if two confidence intervals do

overlap, it is not possible to make a conclusion about the significance of any difference between

the rates.

1.6.2 Numbers and rates

Some tables in this paper present information by multiple categories, for example low birthweight

full-term babies by maternal age, ethnicity and the New Zealand Index of Deprivation quintile of

place of residence. For clarity, one total is shown in each table. This total applies to all categories

within the table. Rounding issues may affect the percentages stated. For example, percentages

may not sum to 100, or the addition of percentages for individual categories may not equal the

stated percentage for a grouped category.

Small numbers can affect the reliability, and therefore the interpretability, of the results through

the appearance of large variations in trends over time. Therefore, it is important to treat all rates

derived from small numbers with caution.

Three-year moving average rates are the average rates for a rolling three-year period. The three-

year moving average is plotted against the final year of the three-year period; for example, the

2003–2005 three-year moving average is plotted against 2005. Maternal death rates tend to show

large variations between years because of the affect of small numbers, which can be smoothed

out using a three-year moving average. Underlying trends can then be more clearly demonstrated

by using a three-year moving average in a graphical representation. The term ‘three-year moving

average’ is further defined in the Glossary.

1.6.3 Symbols

The interpretation of the symbols used throughout this paper is as follows:

.. = figures not available

... = calculation of rates not applicable.

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2 Mother and Pregnancy This section provides a brief demographic profile of mothers who gave birth in hospitals in 2005.

Information on pregnancy complications, including miscarriage and events leading to a hospital

admission in the antenatal period, is also discussed.

2.1 DEMOGRAPHIC PROFILE

In 2005, Births, Deaths and Marriages registered 58,727 liveborn babies to 57,196 mothers

(reported by Statistics New Zealand). In the same year, New Zealand hospitals reported that

54,849 women gave birth in hospital to 55,712 babies, of which 55,192 were liveborn (reported in

the National Minimum Dataset). The in-hospital liveborn babies account for around 94 percent of

the liveborn babies registered with the Births, Deaths and Marriages. Births outside hospitals may

account for the difference between the in-hospital birth numbers and the Births, Deaths and

Marriages (Statistics New Zealand) numbers.

Figure 2.1 shows the trends from 1978 to 2005 in the percentages of live births by mother’s age

(presented in five-year age groups). The proportion of women giving birth over 30 years of age

increased steadily until 2002, since then it appears to have stabilised at around 51.5 percent of

live births. In comparison, births amongst women aged under 25 years decreased until 2003, but

rose in 2004 and 2005.

Figure 2.1: Percentage of live birth registrations by age of mother, 1978–2005

0

5

10

15

20

25

30

35

40

1978

1979

1980

1981

1982

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

Year

Percentage of

live births

10-19 20-24 25-29 30-34 35+

Data source: New Zealand Health Information Service

In 2005, the median age for mothers was 30.4 years, with Māori and Pacific mothers having the

lowest median ages (26.0 years and 27.8 years respectively; Statistics New Zealand 2006). The

percentage of mothers aged 30 years and over continued to increase gradually, accounting for

51.4 percent of births in 2005 (Table 2.1). Correspondingly, the percentage of mothers aged 20–

29 years continued to decrease (41.0 percent).

15

Table 2.1: Number of mothers, by mother’s age group and year of delivery, 1999–2005

Year

1999 2000 2001 2002 2003 2004 2005

Under 16 132 145 149 129 153 158 150

16–19 3738 3632 3632 3568 3692 3808 3951

20–24 9467 9908 9689 9348 9537 9615 9460

25–29 14,760 15,254 14,397 13,517 13,584 13,226 13,054

30–34 15,549 16,415 16,251 16,322 16,806 17,151 16,834

35–39 7485 8065 8074 8379 8899 8895 9411

40 and over 1297 1527 1613 1774 1910 2018 1986

Age g

roup

Not stated 0 0 0 0 0 4 3

Total 52,428 54,946 53,805 53,037 54,581 54,875 54,849

Figure 2.2: Percentage of mothers by ethnicity, 2005

20.2%

10.2%

8.5%

57.2%

2.9%1.1%

Māori Pacific peoples Asian European Other Not stated

Pacific mothers had the highest crude birth rate1 at 112.1 births per 1000 women of reproductive

age2. Māori mothers had a crude birth rate of 86.9 births per 1000 women of reproductive age.

European mothers had a crude birth rate of 57.4, which was below the New Zealand average of

66.1 births per 1000 women of reproductive age. Asian mothers were just above the New

Zealand average, with a crude birth rate of 68.5 births per 1000 women of reproductive age.

Note

In this paper the ‘Not stated’ ethnic group refers to those who did not provide details of their ethnicity, while

the ‘Other’ ethnic group refers to those who indicated an ethnic group other than Māori, Pacific peoples,

Asian or European.

1 Crude birth rate is the ratio between the total number of mothers giving birth and the total number of women of

reproductive age. See the Glossary. 2

Women aged from 15 to 44 years. See the Glossary.

16

Table 2.2: Age distribution of mothers, by ethnicity of the mother, 2005

Ethnicity Total

Age group Māori

Pacific peoples

Asian European Other Not stated No %

Under 16 87 13 1 46 1 2 150 0.3

16–19 1865 430 46 1500 61 49 3951 7.2

20–24 3245 1375 581 3896 250 113 9460 17.2

25–29 2664 1505 1361 7003 390 131 13,054 23.8

30–34 1976 1250 1576 11,319 516 197 16,834 30.7

35–39 951 808 905 6360 298 89 9411 17.2

40 and over 267 194 196 1230 68 31 1986 3.6

Not stated 1 1 0 1 0 0 3 0.0

Total number 11,056 5576 4666 31,355 1584 612 54,849

Total percentage

20.2 10.2 8.5 57.2 2.9 1.1 100.0

Māori women tended to have children at a younger age than other ethnic groups. The Māori

fertility rate peaked in the 20–24 age group (Figure 2.3). In comparison, the peak for Pacific

women was in the 25–29 age group, and for Asian and European women in the 30–34 age group.

This pattern was similar to that in 2004.

Figure 2.3: Birth rates per 1000 women of reproductive age, by mother’s ethnicity and age group, 2005

0

20

40

60

80

100

120

140

160

180

200

Under 16 16–19 20–24 25–29 30–34 35–39 40 and over

Age group

Rate*Māori

Pacific peoples

Asian

European

* Crude birth rate per 1000 women of reproductive age.

The majority of women who gave birth in 2005 resided in the major cities, which is consistent with

the distribution of the general population. Mothers residing in the greater Auckland region

(Waitemata, Auckland and Counties Manukau District Health Boards) accounted for over one-

third of all mothers (37.1 percent).

District Health Boards are responsible for funding and providing publicly funded facility-based

maternity services for the population in their specific geographical area, whereas the Ministry of

Health directly funds primary Lead Maternity Carer (LMC) maternity services.

17

Among the 21 District Health Board regions (see Appendices 5 and 6), Counties Manukau had

the highest number of women giving birth (7829 births; 14.3 percent of total), while West Coast

had the lowest (313 births; 0.6 percent of total). The largest proportion of Māori (16.3 percent)

and Pacific (43.5 percent) mothers resided in Counties Manukau. The largest proportion of Asian

mothers (26.3 percent) resided in Auckland, whereas the largest proportion of European mothers

(14.9 percent) resided in Canterbury (Table 2.3).

Table 2.3: Number of mothers, by DHB region of mother’s place of residence and ethnicity, 2005

DHB region Māori Pacific peoples

Asian European Other Not

stated Total %

Crude birth rate*

Northland 874 25 40 836 25 52 1852 3.4 68.2

Waitemata 796 740 964 3832 197 38 6567 12.0 67.0

Auckland 499 1084 1230 2558 422 155 5948 10.8 63.0

Counties Manukau 1806 2428 1020 2166 311 98 7829 14.3 91.3

Waikato 1283 110 211 2718 108 46 4476 8.2 65.5

Lakes 751 43 41 656 21 7 1519 2.8 72.9

Bay of Plenty 911 47 95 1445 15 42 2555 4.7 72.4

Tairawhiti 417 28 14 262 15 5 741 1.4 81.0

Hawke's Bay 817 108 51 1096 23 19 2114 3.9 72.7

Taranaki 272 17 21 911 92 20 1333 2.4 64.2

MidCentral 387 80 74 1517 22 26 2106 3.8 62.7

Whanganui 294 18 8 468 4 2 794 1.4 63.1

Capital & Coast 485 371 300 2252 94 7 3509 6.4 57.0

Hutt Valley 394 192 137 1124 26 5 1878 3.4 63.9

Wairarapa 100 9 5 312 6 0 432 0.8 60.2 Nelson Marlborough

135 25 48 1143 4 14 1369 2.5 55.7

West Coast 38 2 4 263 4 2 313 0.6 53.2

Canterbury 456 182 307 4662 116 40 5763 10.5 60.7

South Canterbury 40 6 19 495 5 0 565 1.0 57.6

Otago 138 34 41 1525 43 25 1806 3.3 47.3

Southland 161 22 34 1096 30 8 1351 2.5 60.8

Not stated 2 5 2 18 1 1 29 0.1 …

Total 11,056 5576 4666 31,355 1584 612 54,849 100 66.2

… = calculation of rates not applicable.

* Crude birth rate per 1000 women of reproductive age.

Figure 2.4 presents hospital birth rates for each District Health Board, standardised by age and

ethnicity and presented with 95 percent confidence intervals (See Appendix 7). The rate is

calculated by multiplying the ratio between observed and expected in-hospital births, by the

national crude birth rate (see Appendix 7).

The general fertility rate for New Zealand (that is, the national rate) was 63.9 per 1000 women of

reproductive age. Figure 2.4 shows that the majority of District Health Boards in the upper and

central North Island had higher birth rates than the national rate, with the exception of Auckland

District Health Board.

Counties Manukau District Health Board had the highest standardised birth rate of 79.0 per 1000

women of reproductive age. In contrast, most District Health Boards in the lower North Island and

South Island had rates lower than the national average. For example, the lowest standardised

birth rates were in Otago and Capital and Coast District Health Boards (50.9 and 52.8 per 1000

women of reproductive age respectively).

18

Figure 2.4: Hospital birth rates (standardised by age and ethnicity) with 95 percent confidence intervals, per

1000 women of reproductive age, by DHB of mother’s place of residence, 2005

30

40

50

60

70

80

90

Nort

hla

nd

Waite

mata

Auckla

nd

Countie

s M

anukau

Waik

ato

Lakes

Bay o

f P

lenty

Tairaw

hiti

Haw

ke's

Bay

Tara

naki

Mid

Centr

al

Whanganui

Capita

l & C

oast

Hutt V

alle

y

Wairara

pa

Nels

on M

arlboro

ugh

West C

oast

Cante

rbury

South

Cante

rbury

Ota

go

South

land

DHB region

Rate*

NZ

* Standardised hospital birth rate per 1000 women of reproductive age.

The majority of women used the maternity services in their region, although some women

accessed maternity services outside their residential District Health Board region (Table 2.4). It

appears that women residing in District Health Board regions without major tertiary maternity

facilities accessed these services in neighbouring District Health Board regions. For example, the

Auckland region has a major tertiary maternity facility and 69.7 percent of mothers who accessed

services provided by the Auckland District Health Board resided in the Auckland region, with the

remainder residing predominantly in the Counties Manukau or Waitemata regions (15.0 percent

and 13.5 percent respectively).

19

Table 2.4: Number of mothers, by DHB region of mother’s place of residence and DHB of facility of birth, 2005

DHB of facility

DHB region of residence N

ort

hla

nd

Waitem

ata

Auckla

nd

Counties M

anukau

Waik

ato

Lakes

Bay o

f P

lenty

Tair

aw

hiti

Haw

ke's

Bay

Tara

naki

Mid

Centr

al

Whanganui

Capital &

Coast

Hutt

Wairara

pa

Nels

on M

arl

boro

ugh

West C

oast

Cante

rbury

South

Can

terb

ury

Ota

go

South

land

Total

Northland 1786 24 21 8 2 9 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1852

Waitemata 10 5553 973 17 3 0 2 1 0 0 4 0 1 0 0 0 0 0 1 2 0 6567

Auckland 5 303 5017 607 5 2 2 0 2 0 3 0 1 0 0 0 0 0 0 1 0 5948

Counties Manukau 11 32 1077 6683 10 3 5 1 1 0 3 0 0 0 0 1 0 0 0 1 1 7829

Waikato 3 8 20 28 4316 20 70 0 0 3 4 1 1 0 0 0 0 1 0 0 1 4476

Lakes 0 2 4 6 45 1442 15 1 0 0 2 1 0 0 0 0 0 1 0 0 0 1519

Bay of Plenty 0 2 7 0 55 59 2429 1 0 0 1 0 1 0 0 0 0 0 0 0 0 2555

Tairawhiti 0 0 1 0 9 0 1 705 23 0 1 0 1 0 0 0 0 0 0 0 0 741

Hawke's Bay 1 3 2 1 0 2 0 25 2044 1 7 1 22 0 1 1 0 3 0 0 0 2114

Taranaki 1 1 3 4 8 0 0 0 0 1276 5 32 1 0 0 0 0 2 0 0 0 1333

MidCentral 1 0 40 7 1 1 1 0 10 0 1978 5 45 1 15 0 0 0 0 1 0 2106

Whanganui 0 1 2 7 2 2 1 1 1 1 117 649 9 0 0 0 0 1 0 0 0 794

Capital & Coast 1 2 4 1 2 1 0 0 0 1 9 1 3346 138 1 1 0 1 0 0 0 3509

Hutt Valley 0 0 4 1 0 1 0 0 0 0 0 0 120 1751 1 0 0 0 0 0 0 1878

Wairarapa 0 0 0 0 0 0 0 0 0 0 10 0 16 15 390 0 0 0 0 0 1 432 Nelson Marlborough

0 0 2 1 1 0 0 0 0 0 1 0 8 1 0 1346 2 7 0 0 0 1369

West Coast 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280 27 1 2 2 313

Canterbury 1 4 1 0 3 0 1 0 0 0 2 0 1 0 0 7 1 5719 9 10 4 5763

South Canterbury 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 8 550 5 0 565

Otago 0 1 1 0 2 0 0 0 0 0 2 0 0 0 0 0 0 10 12 1758 20 1806

Southland 1 2 5 0 1 1 0 0 0 0 0 0 0 0 0 0 0 23 1 57 1260 1351

Not stated 0 2 4 4 0 0 0 0 0 1 0 0 1 0 0 1 4 0 0 10 2 29

Total 1822 5940 7188 7375 4467 1543 2528 735 2081 1283 2149 690 3574 1906 408 1357 287 5804 574 1847 1291 54,849

20

2.2 DEPRIVATION

The New Zealand Index of Deprivation is an index of neighbourhood socioeconomic deprivation

calculated using data from the 2001 Census of Population and Dwellings. The scale runs from

decile 1 (domicile areas that are deemed the least deprived) to decile 10 (domicile areas that are

deemed the most deprived). Table 2.5 presents data by the New Zealand Index of Deprivation

and the rural/urban status of the mother’s place of residence. (See Appendix 1 for a description of

the New Zealand Index of Deprivation.)

A noticeably higher proportion of mothers lived in more deprived areas. This is consistent with the

observation that Māori and Pacific women were over-represented in the most deprived deciles

and that these ethnic groups have younger age structures and higher birth rates than the national

average. Around 69.0 percent of women who gave birth in 2005 lived in urban areas, of which

32.7 percent resided in the most deprived neighbourhoods (deciles 9 and 10).

The deciles have been grouped into quintiles to minimise the wide fluctuations in annual rates

that arise when small numbers of births are analysed. Quintile 1 (deciles 1 and 2) represents

areas that are least deprived and quintile 5 (deciles 9 and 10) represents the most deprived

areas. Figures 2.5 and 2.6 present the birth rates by the New Zealand Index of Deprivation

quintiles.

Table 2.5: Number of mothers, by the New Zealand Index of Deprivation decile of mother’s place of

residence and rural/urban status, 2005

Number Socio-economic distribution (%) NZDep decile

Rural Urban Not stated Total Rural Urban Not stated Total

1 (least deprived) 1167 2737 0 3904 6.9 7.2 0 7.1

2 1470 2567 0 4037 8.7 6.8 0 7.4

3 1575 2585 0 4160 9.3 6.8 0 7.6

4 1873 2659 0 4532 11.1 7.0 0 8.3

5 1737 2887 0 4624 10.3 7.6 0 8.4

6 1695 3727 0 5422 10.0 9.8 0 9.9

7 1727 3438 0 5165 10.2 9.1 0 9.4

8 1844 4885 0 6729 10.9 12.9 0 12.3

9 1963 6110 0 8073 11.6 16.1 0 14.7

10 (most deprived) 1851 6275 0 8126 10.9 16.6 0 14.8

Not stated 10 1 66 77 0.1 0.0 100 0.1

Total 16,912 37,871 66 54,849 100 100 100 100

21

Figure 2.5: Hospital birth rates per 1000 women of reproductive age, by the New Zealand Index of Deprivation quintile of mother’s place of residence and rural/urban status, 2005

0

20

40

60

80

100

1 2 3 4 5NZDep quintile

Rate* Rural

Urban

* Crude hospital birth rate per 1000 women of reproductive age.

Figure 2.6: Birth rates per 1000 women of reproductive age, by the New Zealand Index of Deprivation quintile of mother’s place of residence and ethnicity, 2005

0

20

40

60

80

100

120

140

1 2 3 4 5

NZDep quintile

Rate* Māori

Pacific peoples

Asian

European

* Crude hospital birth rate per 1000 women of reproductive age.

22

2.3 MISCARRIAGES

Spontaneous miscarriage is a common complication of pregnancy. Miscarriages are defined as

pregnancies that end spontaneously before 20 weeks’ gestation. Induced terminations of

pregnancy are excluded.

Data integrity

Data on women who miscarry should be interpreted with caution. Hospital miscarriages include all women

who are referred to a hospital during a miscarriage. However, miscarriages may occur at home or

elsewhere, and may not be referred to a hospital, in which case they are not included in the hospital data

presented here.

Figure 2.7 illustrates the rate of hospital miscarriages by the mother’s age and ethnic group.

Women at both ends of the reproductive age range tended to have higher rates of miscarriage.

Māori and Pacific women had similar miscarriages rates, at 6.6 and 6.3 hospital miscarriages per

100 mothers respectively. Asian women had the highest rate of miscarriage (6.8 hospital

miscarriages per 100 mothers), while European women had the lowest rate of 5.8 per 100

mothers. As shown in Figure 2.7, Asian and European women aged 16–19 years had the highest

miscarriage rates, at 10.9 and 9.9 hospital miscarriages per 100 mothers respectively.

Figure 2.7: Rate of hospital miscarriages per 100 mothers, by ethnicity and age group of the mother, 2005

0

5

10

15

20

25

30

Under 16 16–19 20–24 25–29 30–34 35–39 40 and overAge group

Rate* Māori

Pacific peoples

Asian

European

* Rate per 100 mothers.

23

2.4 PREGNANCY COMPLICATIONS

Pregnancy complications (other than miscarriage) are summarised in Tables 2.6 and 2.7 using

the Australian Refined Diagnosis Related Group (AR-DRG) classification scheme. Diagnosis

Related Groups are commonly used in clinically meaningful analyses involving the number and

type of patients treated in a hospital. Diagnosis Related Groups are characterised by both clinical

homogeneity and the resources used during the hospital treatment. (See Appendix 2 for a

detailed description of Diagnosis Related Groups.)

Total antenatal admissions may include more than one admission for the same woman, but

exclude transfers between facilities. Admission due to false labour in Table 2.6 refers to women

who were admitted to hospital for three or more hours but discharged because they were not in

established labour.

The number of antenatal admissions may appear low in Table 2.7 because only the principal

diagnosis is presented for each admission. The principal diagnosis is the primary reason the

woman is admitted to hospital.

Table 2.6: Antenatal hospital admissions (excluding transfers) and average length of stay for mothers, by

selected Diagnosis Related Groups and ethnicity, 2005

Admissions DRG Description Ethnic group

Number Percentage

Average length of stay (days)

Māori 166 1.7 0.5

Pacific peoples 73 0.8 0.7

Asian 68 0.7 0.4

European 317 3.3 0.5

Other 26 0.3 0.4

Not stated 7 0.1 0.1

O62Z Threatened abortion

O62Z Total 657 6.8 0.5

Māori 368 3.8 1.0


Asian 148 1.5 0.5

European 715 7.3 1.1

Other 37 0.4 1.8


O64Z False labour

O64Z Total 1450 14.9 1.0

Māori 410 4.2 2.0


Asian 153 1.6 2.0

European 1051 10.8 2.2

Other 48 0.5 1.6


O65A

Other antenatal admission with severe complicating diagnosis

O65A Total 1912 19.7 2.2

Māori 1198 12.3 1.3


Asian 468 4.8 1.3

European 2871 29.5 1.3

Other 219 2.3 1.3


O65B

Other antenatal admission with moderate or no complicating diagnosis

O65B Total 5710 58.7 1.3

Total 9729 100 1.4

24

Table 2.7: Antenatal hospital admissions (excluding transfers) and average length of stay for mothers, by

principal diagnosis (Diagnosis Related Groups O65A and O65B), 2005

Admissions

Principal diagnosis Number Percentage

Average length of

stay (days)

Abnormal findings on antenatal screening of mother 6 0.1 1.7

Abnormalities of forces of labour 39 0.5 0.5

Antenatal screening 211 2.8 0.4

Antepartum haemorrhage, not elsewhere classified 619 8.1 1.4

Complications specific to multiple gestation 4 0.1 0.8

Diabetes mellitus in pregnancy 111 1.5 2.9

Eclampsia 11 0.1 1.4

Excessive vomiting in pregnancy 1646 21.6 2.0

Failed induction of labour 29 0.4 2.0

Gestational (pregnancy-induced) hypertension with significant proteinuria 212 2.8 2.1

Gestational (pregnancy-induced) hypertension without significant proteinuria 467 6.1 1.6

Gestational (pregnancy-induced) oedema and proteinuria without hypertension 27 0.4 0.5

Infections of genitourinary tract in pregnancy 589 7.7 1.5

Labour and delivery complicated by fetal stress (distress) 1 0.0 0.0

Maternal care for known or suspected abnormality of pelvic organs 194 2.5 1.4

Maternal care for known or suspected disproportion 1 0.0 0.0

Maternal care for known or suspected fetal abnormality and damage 15 0.2 0.3

Maternal care for known or suspected malpresentation of fetus 85 1.1 1.5

Maternal care for other conditions predominantly related to pregnancy 169 2.2 1.0

Maternal care for other known or suspected fetal problems 156 2.0 1.7

Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

87 1.1 1.3

Multiple gestation 22 0.3 1.7

Other disorders of amniotic fluid and membranes 25 0.3 1.8

Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

2121 27.8 1.2

Placenta praevia 153 2.0 4.0

Placental disorders 12 0.2 1.3

Polyhydramnios 22 0.3 1.6

Pre-existing hypertension complicating pregnancy, childbirth and the puerperium

69 0.9 2.8

Pre-existing hypertensive disorder with superimposed proteinuria 27 0.4 3.2

Premature rupture of membranes 225 3.0 1.6

Premature separation of placenta (abruptio placentae) 22 0.3 1.4

Prolonged pregnancy 70 0.9 0.4

Supervision of high-risk pregnancy 41 0.5 1.2

Supervision of normal pregnancy 21 0.3 0.2

Unspecified maternal hypertension 76 1.0 1.4

Venous complications in pregnancy 37 0.5 1.4

Total 7622 100.0 1.5

25

2.5 MATERNAL DEATHS

Table 2.8 presents the number and rate of maternal deaths from 1995 to 2005 according to the

World Health Organization definition of maternal death:

A maternal death is defined as the death of a woman while pregnant or within 42 days of

termination of pregnancy, irrespective of the duration and the site of the pregnancy, from

any cause related to or aggravated by the pregnancy or its management but not from

accidental or incidental causes.

Figure 2.8 presents the three-year moving average for maternal deaths. For statistical purposes,

the World Health Organization further defined maternal deaths into two groups:

1. Direct obstetric deaths: those resulting from obstetric complications of the pregnant state

(pregnancy, labour and the puerperium), from interventions, omissions, incorrect

treatment, or from a chain of events resulting from any of the above.

2. Indirect obstetric deaths: those resulting from previously existing disease or disease that

developed during pregnancy and which was not due to direct obstetric causes, but which

was aggravated by the physiologic effects of pregnancy.

Data integrity

Because of the relatively small number of maternal deaths each year in New Zealand, the maternal death

rate fluctuates markedly from year to year. Therefore, caution should be used when making international

comparisons of maternal death rates, especially as some countries may use definitions other than the World

Health Organization definition.

Table 2.8: Maternal deaths, 1995–2005

Direct Indirect Total Year

Number Rate* Number Rate* Number Rate*

Live Births

1995 2 3.5 0 0 2 3.5 57,791

1996 4 7 0 0 4 7 57,434

1997 2 3.5 1 1.7 3 5.2 57,734

1998 1 1.7 3 5.2 4 6.9 57,734†

1999 3 5.2 1 1.7 4 7 57,421

2000 2‡ 1.8§ 3 5.3 5 8.8 56,994

2001 0 0 3 5.3 3 5.3 56,224

2002 4 7.3 4 7.3 8 14.7 54,515

2003 3 5.3 1 1.8 4 7.1 56,576

2004 1 1.7 3 5.1 4 6.8 58,723

2005 3 5.1 2 3.4 5 8.5 58,727 Data source: NZHIS Mortality Collection Note: Maternal deaths are reported according to the WHO definition. * Rate per 100,000 live births. † The 1997 live birth figure has been reused for 1998 because of issues with the 1998 figure. The number of live birth registrations for 1998 was lower than expected because of inconsistencies with the prompt registration of births. ‡ One direct maternal death occurred in 1932 but was not registered until 2000. § This rate excludes the one maternal death that occurred in 1932. If this death is included, the rate increases to 3.5.

26

Figure 2.8: Rates of maternal deaths, three-year moving average, 1993–2005

0

2

4

6

8

10

12

1993–1995

1994–1996

1995–1997

1996–1998

1997–1999

1998–2000

1999–2001

2000–2002

2001–2003

2002–2004

2003–2005

Year

Rate*

Data source: NZHIS Mortality Collection

Note: Maternal deaths are reported according to the WHO definition. * Rate per 100,000 live births.

27

3 Labour and Birth This section presents analyses of events relating to labour and birth, with an emphasis on the

type of birth (delivery).

3.1 TYPE OF BIRTH

In 2005, 54,849 women gave birth in hospital to 55,192 liveborn babies. Two-thirds (66.8 percent)

of these mothers had a spontaneous vaginal birth (that is, a normal birth). Caesarean sections

accounted for 23.8 percent, representing a gradual but steady increase from previous years (see

Section 3.2). The remaining 9.4 percent of deliveries were assisted births (9.2 percent) or

spontaneous vaginal breech births (0.2 percent).

Assisted births include birth by forceps and/or vacuum extraction, or breech births that require the

use of forceps and/or vacuum extraction. Table 3.1 shows the number of women who gave birth

in hospital in 2005, by type of birth.

Table 3.1: Number of mothers, by type of birth, 2005

Mothers Type of birth

Number Percentage

Normal birth 36,661 66.8 Caesarean section 13,029 23.7 Acute caesarean section 7733 14.1

Elective caesarean section 5296 9.7

Spontaneous breech birth (unassisted) 125 0.2 Assisted birth 5034 9.2 Assisted breech birth 124 0.2

Forceps only 1615 2.9

Forceps and vacuum extraction 53 0.1

Vacuum extraction only 3242 5.9

Total 54,849 100.0

Many factors affect the type of birth, including the mother’s age and parity (the number of

previous pregnancies resulting in live births or stillbirths). Tables 3.2 and 3.3 and Figures 3.1 and

3.2 present the birth type by the mother’s age group, ethnicity and place of residence. The

percentage of normal births decreased with the increasing age of the mother, while the

percentage of caesarean sections (acute or elective) increased markedly.

Of the women aged 40 years and over,40.1 percent had a caesarean section, compared with

13.2 percent of women aged 16–19 years (Table 3.2). Māori and Pacific women were more likely

to have a normal birth compared with women in other ethnic groups. In contrast, caesarean

sections were more common among Asian and European mothers. Of the women who had a

caesarean section, the majority had the caesarean section performed acutely (59.4 percent).

European mothers had the highest proportion of elective caesarean section (43.6 percent), while

Other and Pacific mothers had the highest rate of acute caesarean section (67.1 percent and

65.4 percent respectively).

28

Figure 3.1: Percentage of mothers, by birth type and age group, 2005

0

10

20

30

40

50

60

70

80

90

Under 16 16–19 20–24 25–29 30–34 35–39 40 and over

Age group

Percentage Normal birth

Caesarean section

Unassisted breech birth or

assisted birth

Table 3.2: Number of mothers, by birth type, maternal ethnicity and age groups, 2005

Caesarean section Assisted birth

Normal

birth Total Acute Elective

Breech birth Total

Assisted breech

birth Forceps

Forceps and

vacuum extraction

Vacuum extraction

Total

Under 16 115 18 18 0 1 16 0 4 0 12 150

16–19 3082 520 432 88 8 341 5 99 2 235 3951

20–24 7196 1490 1070 420 24 750 28 222 6 494 9460

25–29 9118 2731 1736 995 28 1177 23 357 18 779 13,054

30–34 10,619 4431 2553 1878 46 1738 32 582 13 1111 16,834

35–39 5491 3043 1540 1503 15 862 28 303 11 520 9411

40 and over 1037 796 384 412 3 150 8 48 3 91 1986

Age g

roup

Not stated 3 0 0 0 0 0 0 0 0 0 3

Māori 8709 1748 1126 622 37 562 22 176 0 364 11,056

Pacific peoples

4237 1044 683 361 16 279 13 53 1 212 5576

Asian 2696 1337 838 499 9 624 8 155 4 457 4666

European 19,713 8305 4685 3620 53 3284 73 1159 45 2007 31,355

Other 942 444 298 146 7 191 7 45 1 138 1584 Eth

nic

gro

up

Not stated 364 151 103 48 3 94 1 27 2 64 612

Total 36,661 13,029 7733 5296 125 5034 124 1615 53 3242 54,849

29

Figure 3.2: Rate of birth type per 100 births, by ethnicity, 2005

0

10

20

30

40

50

60

70

80

90

Normal birth Caesarean section Unassisted breech birth or

assisted birth

Type of birth

Rate per 100

birthsMāori

Pacific peoples

Asian

European

The number of mothers by birth type for each District Health Board (Table 3.3) presents an

overview of the size and volume of service required. Canterbury and Southland District Health

Boards had the highest rates of caesarean section (28.3 percent and 28.2 percent respectively),

while Waikato and Northland had the lowest (17.7 percent and 16.1 percent respectively).

Auckland had the highest proportion of assisted deliveries (13.4 percent) and Tairawhiti had the

lowest (3.4 percent; Table 3.3).

30

Table 3.3: Number of mothers, by birth type and DHB region of mother’s place of residence, 2005

Caesarean section Assisted birth Total

DHB region Normal


Breech birth Total

Assisted breech

birth Forceps

Forceps and

vacuum extraction

Vacuum extraction

No. %

Northland 1474 299 199 100 5 74 3 24 1 46 1852 3.4

Waitemata 4172 1687 953 734 15 693 18 128 12 535 6567 12.0

Auckland 3509 1634 993 641 7 798 12 225 3 558 5948 10.8

Counties Manukau

5662 1488 948 540 20 659 19 111 5 524 7829 14.3

Waikato 3329 794 430 364 23 330 10 86 3 231 4476 8.2

Lakes 1138 303 168 135 4 74 1 18 4 51 1519 2.8

Bay of Plenty 1741 595 344 251 13 206 6 67 0 133 2555 4.7

Tairawhiti 566 146 81 65 4 25 0 3 0 22 741 1.4

Hawke's Bay 1487 492 309 183 11 124 5 87 0 32 2114 3.9

Taranaki 941 338 202 136 1 53 1 26 0 26 1333 2.4

MidCentral 1434 500 343 157 2 170 5 23 0 142 2106 3.8

Whanganui 587 151 90 61 2 54 1 18 1 34 794 1.4

Capital & Coast 2180 922 605 317 2 405 9 188 2 206 3509 6.4

Hutt Valley 1198 507 309 198 0 173 4 109 1 59 1878 3.4

Wairarapa 273 110 60 50 2 47 0 11 2 34 432 0.8

Nelson Marlborough

918 345 196 149 5 101 2 81 0 18 1369 2.5

West Coast 221 65 30 35 2 25 0 7 1 17 313 0.6

Canterbury 3393 1632 885 747 5 733 19 288 18 408 5763 10.5

South Canterbury 387 132 74 58 0 46 4 30 0 12 565 1.0

Otago 1144 502 296 206 1 159 1 57 0 101 1806 3.3

Southland 887 381 213 168 1 82 3 28 0 51 1351 2.5

Not stated 20 6 5 1 0 3 1 0 0 2 29 0.1

Total 36,661 13,029 7733 5296 125 5034 124 1615 53 3242 54,849 100.0

3.2 CAESAREAN SECTIONS

The rate of caesarean sections performed in New Zealand has increased steadily from 11.7

percent of mothers in 1988 to 23.8 percent in 2005. The 2005 caesarean section rate stayed at

approximately the same level as in 2004, but overall the trend is increasing, which is similar to the

trend being observed in many developed countries (Anderson 2004). In 1985, the World Health

Organization issued a consensus statement suggesting no additional health benefits were

associated with a caesarean section rate above 10–15 percent. Currently, no consensus exists in

New Zealand regarding the optimal caesarean section rate for the best health outcomes.

However, there is general consensus that the current rate is too high.

When the 2005 rate for total caesarean sections is standardised for age, it decreases to 19.3 per

100 deliveries, indicating that age is a contributing factor to the high rate. The age-standardised

rate is still above the World Health Organization 10–15 percent recommendation.

Figure 3.3 shows that the percentage of mothers who had caesarean sections increased from

20.4 percent in 1999 to 23.8 percent in 2005, while the mothers who had a breech birth or an

assisted birth decreased slightly (11.0 percent in 1999 to 9.4 percent in 2005). Figure 3.4

illustrates the rates of caesarean section for each District Health Board (standardised by age and

31

ethnicity) compared with the New Zealand average. The highest rates of caesarean section were

in Hutt Valley and Wairarapa (for the North Island; 27.3 percent and 26.1 percent respectively)

and Southland and Canterbury (for the South Island; 27.5 percent and 26.0 percent respectively),

whereas Northland, Waikato and West Coast had the lowest caesarean section rates (18.1

percent, 18.5 percent and 19.9 percent respectively).

Figure 3.3: Percentage of mothers, by year and birth type, 2005

0

10

20

30

40

50

60

70

80

1999 2000 2001 2002 2003 2004 2005

Year

Percentage Normal birth

Caesarean section

Unassisted breech birth or assisted birth

Figure 3.4: Hospital caesarean section rates (standardised by age and ethnicity) and 95 percent confidence

intervals, by DHB region of mother’s place of residence, 2005

0

5

10

15

20

25

30

35

40

Nort

hla

nd

Waite

mata

Auckla

nd

Cou

ntie

s M

anu

kau

Wa

ikato

Lakes

Bay

of

Ple

nty

Taira

whiti

Haw

ke

's B

ay

Tara

nak

i

Mid

Centr

al

Whanga

nui

Cap

ital &

Coa

st

Hu

tt V

alle

y

Waira

rapa

Ne

lso

n M

arlboro

ugh

West C

oast

Cante

rbury

South

Cante

rbury

Ota

go

Sou

thla

nd

DHB region

Rate*

NZ

* Hospital caesarean rate per 100 deliveries.

32

3.3 OTHER BIRTH INTERVENTIONS AND EVENTS

Common interventions used during childbirth include: induction3, epidural

4, episiotomy

5, manual

removal of placenta and the management of postpartum haemorrhage6 (see the Glossary for full

definitions). Tables 3.4 and 3.5 summarise the common birth-related procedures and events that

occurred during childbirth in 2005.

Postpartum haemorrhage is clinically defined as blood loss over 500mL within 24 hours of birth

(primary) or after 24 hours to six weeks post-birth (secondary) (Medsafe 1998). However,

estimating the volume of blood lost during a haemorrhage may vary in clinical practice and does

not necessarily explain the variance between DHB regions. This analysis does not differentiate

between primary and secondary postpartum haemorrhages.

Table 3.4: Number of mothers, by birth-related procedures and events, by DHB region of mother’s place of residence, 2005

DHB region Induction Epidural Episiotomy Manual

removals of placenta

Postpartum haemorrhage

Northland 339 225 53 22 224

Waitemata 1392 2275 675 107 469

Auckland 1241 2399 883 92 693

Counties Manukau 1072 1666 608 106 539

Waikato 603 699 187 58 217

Lakes 168 83 66 22 129

Bay of Plenty 450 454 158 34 207

Tairawhiti 91 63 20 8 71

Hawke's Bay 227 557 168 39 124

Taranaki 296 101 82 19 96

MidCentral 339 475 132 33 187

Whanganui 162 153 39 10 59

Capital & Coast 771 1436 473 37 279

Hutt Valley 404 537 214 25 146

Wairarapa 89 90 49 6 19

Nelson Marlborough 260 533 140 27 50

West Coast 69 26 26 6 24

Canterbury 1012 1742 789 75 508

South Canterbury 127 131 49 6 37

Otago 388 486 123 25 184

Southland 311 111 131 26 99

Not stated 4 8 2 0 3

Total 9815 14,250 5067 783 4364

The rates for inductions and epidurals are expressed per 100 deliveries (excluding elective

caesarean sections). The rates for episiotomies, manual removal of placentas and postpartum

haemorrhages are expressed per 100 vaginal deliveries (excluding caesarean sections).

3 Inductions are used to stimulate the onset of labour.

4 Epidurals are an analgesic agent injected outside the dura mater covering the spine.

5 Episiotomies are an incision of the perineal tissue surrounding the vagina at the time of birth.

6 Postpartum haemorrhages are abnormal bleeding that occurs soon after labour or childbirth.

33

In 2005, 40 hysterectomies were related to childbirth. This number is too small to allow for

meaningful comparisons between District Health Boards. Almost one in five births (17.9 percent)

in 2005 were induced, and one in four births had an epidural administered. The rate of induction

increased with the age of the mother, and was slightly higher for European mothers. Table 3.5

shows the national rate for episiotomies was 12.1 per 100 vaginal deliveries, and ranged from

20.5 per 100 vaginal deliveries (Auckland) to 3.4 per 100 vaginal deliveries (Northland and

Tairawhiti).

Table 3.5: Rate of birth-related procedures and events, by DHB region of mother’s place of residence, 2005

DHB region Induction* Epidural* Episiotomy† Manual removal

of placenta† Postpartum

haemorrhage†

Northland 19.3 12.8 3.4 1.4 14.4

Waitemata 23.9 39.0 13.8 2.2 9.6

Auckland 23.4 45.2 20.5 2.1 16.1

Counties Manukau 14.7 22.9 9.6 1.7 8.5

Waikato 14.7 17.0 5.1 1.6 5.9

Lakes 12.1 6.0 5.4 1.8 10.6

Bay of Plenty 19.5 19.7 8.1 1.7 10.6

Tairawhiti 13.5 9.3 3.4 1.3 11.9

Hawke's Bay 11.8 28.8 10.4 2.4 7.6

Taranaki 24.7 8.4 8.2 1.9 9.6

MidCentral 17.4 24.4 8.2 2.1 11.6

Whanganui 22.1 20.9 6.1 1.6 9.2

Capital & Coast 24.2 45.0 18.3 1.4 10.8

Hutt Valley 24.0 32.0 15.6 1.8 10.6

Wairarapa 23.3 23.6 15.2 1.9 5.9

Nelson Marlborough 21.3 43.7 13.7 2.6 4.9

West Coast 24.8 9.4 10.5 2.4 9.7

Canterbury 20.2 34.7 19.1 1.8 12.3

South Canterbury 25.0 25.8 11.3 1.4 8.5

Otago 24.3 30.4 9.4 1.9 14.1

Southland 26.3 9.4 13.5 2.7 10.2

Not stated 14.3 28.6 8.7 0.0 13.0

Total rate* 19.8 28.8 12.1 1.9 10.4

* Rate per 100 deliveries (excluding elective caesarean sections).

† Rate per 100 vaginal deliveries.

Table 3.7 shows that differences in epidural use exist between the ethnic groups, with rates for

Asian and European mothers being double those of Māori and Pacific mothers. This trend was

observed in mothers aged 25 years and over. Māori mothers had the lowest rates for induction

and epidural administration (14.5 and 15.9 per 100 deliveries respectively; Tables 3.6 and 3.7).

Mothers aged 40 years and over had the highest rate of inductions (31.6 per 100 deliveries), and

mothers aged between 30–39 years had the highest rate of epidural administration (32.1 per 100

deliveries).

34

Table 3.6: Use of inductions, by age group and ethnicity of the mother, 2005

Number of inductions Rate per 100 deliveries*

Age group Māori

Pacific peoples


stated Total Māori

Pacific peoples


stated Total

Under 16 11 1 0 8 0 1 21 12.6 7.7 0.0 17.4 0.0 50.0 14.0

16–19 253 68 8 300 6 7 642 13.8 16.1 17.8 20.6 10.2 14.6 16.6

20–24 390 177 94 756 41 15 1473 12.5 13.3 17.0 20.5 16.9 13.5 16.3

25–29 353 246 198 1338 85 19 2239 14.2 17.4 15.5 21.0 23.2 15.3 18.6

30–34 293 222 241 2178 85 36 3055 16.2 19.3 17.3 21.9 18.5 20.6 20.4

35–39 155 149 158 1333 71 21 1887 18.0 20.7 21.2 25.4 27.7 27.3 23.9

40 and over 55 52 51 311 22 7 498 23.6 31.1 34.7 32.9 40.0 25.9 31.6

Total 1510 915 750 6224 310 106 9815 14.5 17.5 18.0 22.4 21.6 18.8 19.8

* Rate excludes women who had an elective caesarean section.

Table 3.7: Use of epidurals, by age group and ethnicity of the mother, 2005

Number of epidurals Rate per 100 deliveries*

Age group Māori

Pacific peoples


stated Total Māori

Pacific peoples


stated Total

Under 16 22 2 1 12 0 0 37 25.3 15.4 100.0 26.1 0.0 0.0 24.7

16–19 372 105 10 450 18 10 965 20.3 24.9 22.2 30.9 30.5 20.8 25.0

20–24 510 285 182 1115 71 31 2194 16.4 21.5 32.9 30.2 29.3 27.9 24.3

25–29 342 264 469 1959 128 53 3215 13.7 18.7 36.7 30.7 35.0 42.7 26.7

30–34 265 203 537 3545 180 72 4802 14.6 17.6 38.5 35.6 39.2 41.1 32.1

35–39 119 105 276 1909 104 28 2541 13.8 14.6 37.0 36.4 40.6 36.4 32.1

40 and over 30 30 57 347 22 10 496 12.9 18.0 38.8 36.7 40.0 37.0 31.5

Total 1660 994 1532 9337 523 204 14,250 15.9 19.1 36.8 33.7 36.4 36.2 28.8

* Rate excludes women who had an elective caesarean section.

35

4 Babies This section presents the information as reported by hospitals on the outcome of births within

their facilities in 2005.

4.1 BABIES AT BIRTH

In 2005, 55,712 babies were delivered in hospital, of whom 393 (0.7 percent) were stillbirths

(Table 4.1). The majority of babies delivered in hospital were singletons (96.7 percent). The New

Zealand hospital sector reported that 55,192 live babies were born in hospital or subsequently

admitted following birth outside hospital.

Data integrity

Data on the number of live babies born are derived using the ICD codes reported to NMDS. These codes

specify the number of live babies born in hospital as well as the number delivered outside hospital but

subsequently admitted. For example, ‘Singleton, born in hospital’ or ‘Other multiple, born outside hospital’.

Data on the outcome of the mother’s delivery in hospital (that is, the number of babies delivered) are also

derived from ICD codes reported to NMDS. When an in-hospital birth results in the birth of multiple babies,

the ICD code descriptions make it difficult to ascertain the exact number of babies born. This is because

multiple births are coded under specific ICD codes that are dependent on the birth status (for example,

‘Other multiple births, some liveborn’) and the actual number of babies born is not specified. It is therefore

assumed that the birth of triplets was the reason for coding a multiple birth.

The mother identifies the newborn’s ethnicity at the time of birth.

Table 4.1: Number of babies delivered in hospital, by birth status and plurality, 2005

Plurality Birth status

Singletons Twins Triplets Not stated Total

Live births 53,514 1642 36 0 55,192

Stillbirths 358 32 3 0 393

Not stated 0 0 0 127 127

Total hospital births 53,872 1674 39 127 55,712

Figure 4.1 shows the percentage of total live births (that is, live babies born in hospital or

subsequently admitted following birth outside hospital) by ethnicity from 1999 to 2005. The

percentage of Māori and Pacific babies remained essentially unchanged over the period. The

percentage of Asian babies appears to have reached a plateau, and there has been a slight

increase in the percentage of European babies. Table 4.2 shows that the majority of liveborn

babies were male (51.2 percent).

The average birthweight of babies born in New Zealand was 3.39kg. Male babies were, on

average, heavier (3.43kg) than female babies (3.35kg; Figure 4.2 and Table 4.3). Selected

demographic characteristics of the live babies born in New Zealand are in Tables 4.3–4.5.

36

Figure 4.1: Percentage of total live births, by ethnicity, 1999–2005

0

10

20

30

40

50

60

70

1999 2001 2002 2003 2004

Year

Percentage Māori Pacific peoples

Asian European

Table 4.2: Number of liveborn babies, by sex and ethnicity, 2005

Number of babies Percentage of babies Ethnic group

Male Female Total Male Female Total

Māori 6172 5993 12,165 21.2 21.7 21.4

Pacific peoples 3011 2773 5785* 10.4 10.0 10.2

Asian 2535 2312 4847 8.7 8.4 8.5

European 16,239 15,583 31,823* 55.9 56.3 56.1

Other 802 753 1555 2.8 2.7 2.7

Not stated 302 261 564* 1.0 0.9 1.0

Total 29,061 27,675 56,739* 51.2 48.8 100.0

* Note: The total includes three babies whose sex was not reported.

Prematurity, multiple pregnancy and restricted fetal (intrauterine) growth are possible contributors

to a baby’s low weight at birth. Low birthweight (under 2500g) is associated with fetal and

neonatal mortality and morbidity, inhibited growth and cognitive development (WHO and UNICEF

2004). Figure 4.2 shows that female babies were more likely to be of low birthweight than male

babies.

Table 4.3 shows that Asian babies had the lowest average birthweight (3.24kg), while Pacific

babies had the highest (3.55kg). Pacific babies were also more likely to have a high birthweight

(of or over 4500g; 5.3 percent) compared with babies born to the other ethnic groups (from 0.9

percent to 2.2 percent; Table 4.5). The average birthweight of babies within each ethnic group

has remained fairly constant from 1999 onwards (see Appendix 8, Figures A8.1 and A8.2).

37

Figure 4.2: Percentage of liveborn babies, by birthweight and sex, 2005

0

5

10

15

20

25

30

35

40

Less than

1000

1000–1499

1500–1999

2000–2499

2500–2999

3000–3499

3500–3999

4000–4499

4500 a

nd

over

Birthweight (g)

Percentage Male

Female

Total

Table 4.3: Average birthweight of babies born in hospital, by sex and ethnicity, 2005

Average birthweight (kg) ± standard deviation (kg) Ethnic group

Male Female Total

Māori 3.40 ± 0.68 3.31 ± 0.67 3.36 ± 0.67

Pacific peoples 3.59 ± 0.65 3.52 ± 0.67 3.55 ± 0.66

Asian 3.28 ± 0.57 3.20 ± 0.61 3.24 ± 0.59

European 3.52 ± 0.66 3.40 ± 0.63 3.46 ± 0.65

Other 3.44 ± 0.62 3.34 ± 0.63 3.39 ± 0.63

Not stated 3.33 ± 0.65 3.31 ± 0.71 3.32 ± 0.68

Total 3.43 ± 0.64 3.35 ± 0.65 3.39 ± 0.65

Figure 4.3 and Table 4.4 show that 91.4 percent of births in 2005 were full-term (37 or more

weeks gestation). There was no marked variation between ethnic groups in gestational age.

Preterm babies (less than 37 weeks’ gestation) accounted for 7.2 percent of the live babies.

Babies of Māori and European mothers were more likely to be preterm (7.6 percent and 7.3

percent respectively).

38

Figure 4.3: Percentage of liveborn babies, by gestational age, 2005

0

5

10

15

20

25

30

35

<20

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

Gestational age (weeks)

Percentage

Table 4.4: Percentage of live babies born, by gestational age and ethnicity, 2005

Liveborn babies by gestational age (weeks) Total

Ethnic group Less than

20 20–23 24–27 28–31 32–36 37–41 42 43 and over Not stated No. %

Māori 0.0 0.2 0.4 1.1 5.8 87.0 2.8 0.3 2.3 12,165 100

Pacific peoples 0.0 0.2 0.2 0.8 5.2 88.2 4.0 0.6 0.9 5785 100

Asian 0.0 0.1 0.3 0.8 5.0 91.1 1.7 0.1 0.8 4847 100

European 0.0 0.1 0.4 0.8 6.1 88.6 2.6 0.1 1.4 31,823 100

Other 0.0 0.1 0.4 1.1 5.4 87.8 3.7 0.2 1.3 1555 100

Not stated 0.2 0.0 0.0 1.4 7.1 87.6 2.5 0.4 0.9 564 100

Total number 8 66 191 495 3303 50,1791548 115 834 56,739

Total percentage 0.0 0.1 0.3 0.9 5.8 88.4 2.7 0.2 1.5 100

Table 4.5 shows that, in 2005, 1.1 percent of live babies were born with a very low birthweight

(less than 1500g at birth). These babies generally have the highest mortality and morbidity, and

contribute most to the workloads of New Zealand’s neonatal units.

Table 4.5: Percentage of live babies born, by birthweight and ethnicity, 2005

Liveborn babies by birthweight (grams) Total

Ethnic group Less than 1000

1000–1499 1500–1999 2000–2499 2500–4499 4500 or more

Not stated No. %

Māori 0.6 0.7 1.4 4.6 90.5 2.2 0.0 12,165 100

Pacific peoples 0.4 0.4 1.0 3.1 89.7 5.3 0.0 5785 100

Asian 0.6 0.6 1.3 5.0 91.7 0.9 0.0 4847 100

European 0.4 0.7 1.1 3.5 91.4 2.9 0.0 31,823 100

Other 0.6 1.0 1.0 3.5 92.0 1.9 0.0 1555 100

Not stated 0.9 0.7 1.4 4.3 90.6 2.1 0.0 564 100

Total number 268 377 669 2164 51,688 1565 8 56,739

Total % 0.5 0.7 1.2 3.8 91.1 2.8 0.0 100

39

Whanganui and Waikato District Health Boards had the highest proportion of live babies born with

a very low birthweight (1.5 percent and 1.4 percent respectively), while South Canterbury had the

lowest (0.7 percent). See Appendix 8 for tables reporting gestational age and birthweight by

District Health Board.

Table 4.6: Numbers of live babies born, by gestational age and birthweight at birth, 2005

Liveborn babies by birthweight (grams) Gestational age (weeks) Less than 2500 2500 or more Not stated

Less than 37 2326 1737 0

37 and over 1045 50,797 0

Not stated 107 719 8

Total number 3478 53,253 8

Of the babies born before 37 weeks’ gestational age 57.2 percent had low birthweight, whereas

only 2.1 percent of the babies born at 37 weeks’ gestational age and over had low birthweight

(Table 4.6).

Figure 4.4: Percentage of babies, by early and late gestational age (excluding babies born between 37 and 41 weeks’ gestation), 1999–2005

0

1

2

3

4

5

6

7

8

1999 2000 2001 2002 2003 2004 2005

Year

Percentage 20–27 w eeks 28–36 w eeks 42+ w eeks

40

Figure 4.5: Percentage of live babies, by low birthweight, high birthweight, preterm and full-term low birthweight, 1999–2005

0

1

2

3

4

5

6

7

8

1999 2000 2001 2002 2003 2004 2005

Year

Percentage

Preterm birth Low birthweight

High birthweight Full-term low birthweight

Of the full-term babies born in 2005, 2.1 percent had a low birthweight. Overall, the proportion of

full-term babies with a low birthweight varied minimally from 2000 to 2005 (Table 4.7). Asian

babies had the highest proportion of small-for-date at term. Pacific and Māori babies had the

lowest birthweights and tended to be small-for-date at term.

Table 4.7: Percentage of full-term babies (37 or more weeks’ gestation) with a low birthweight (under

2500g), by year and mother’s ethnicity, 2000–2005

Year Māori Pacific

Peoples Asian European Other

Not stated

Total

2000 2.7 1.6 2.5 1.8 2.6 1.6 2.0

2001 3.2 1.2 3.0 1.8 1.9 1.8 2.1

2002 2.9 1.4 4.0 1.8 1.8 1.6 2.1

2003 2.5 1.4 3.4 1.7 1.8 1.1 2.0

2004 2.6 1.2 2.9 1.7 1.7 3.6 2.0

2005 2.9 1.5 3.7 1.7 2.0 2.1 2.1

Mothers aged under 20 years or 40 years and over or who lived in the most deprived areas

(NZDep quintile 5) were more likely to have full-term babies with a low birthweight (3.2 percent,

2.7 percent and 2.8 percent respectively; Table 4.8). The proportion of full-term babies with low

birthweight ranged from 1.3 percent for West Coast District Health Board to 4.7 percent for

Hawke’s Bay (Table 4.9).

41

Table 4.8: Proportion of full-term babies (37 or more weeks’ gestation) with a low birthweight (under 2500g), by mother’s age group, ethnicity and NZDep quintile of place of residence, 2005

Low-birthweight full-term babies

Total number of full-term babies Number Percentage

Under 16 139 2 1.4

16–19 3688 117 3.2

20–24 9030 225 2.5

25–29 12,428 233 1.9

30–34 15,875 292 1.8

35–39 8998 182 2.0

Age g

roup

40+ 1924 51 2.7

Māori 11,074 321 2.9

Pacific peoples 5374 83 1.5

Asian 4514 168 3.7

European 29,179 491 1.7

Other 1428 28 2.0 Eth

nic

gro

up

Not stated 513 11 2.1

1 7447 121 1.6

2 8183 126 1.5

3 9454 163 1.7

4 11,299 256 2.3

5 15,644 436 2.8 NZ

quin

tile

Not stated 55 0 0.0

Total 52,082 1102 2.1

42

Table 4.9: Number of full-term babies (37 or more weeks’ gestation) with a low birthweight (under 2500g),

by DHB region of mother’s place of residence, 2005

Low-birthweight full-term babies DHB region

Total number of full-term babies

Number Percentage

Northland 1810 41 2.3

Waitemata 6186 97 1.6

Auckland 5834 121 2.1

Counties Manukau 7259 174 2.4

Waikato 4466 93 2.1

Lakes 1441 33 2.3

Bay of Plenty 2375 54 2.3

Tairawhiti 703 15 2.1

Hawke's Bay 1971 92 4.7

Taranaki 1240 24 1.9

MidCentral 2000 37 1.9

Whanganui 744 23 3.1

Capital & Coast 3355 74 2.2

Hutt Valley 1748 37 2.1

Wairarapa 406 7 1.7

Nelson Marlborough 1292 19 1.5

West Coast 308 4 1.3

Canterbury 5460 99 1.8

South Canterbury 528 8 1.5

Otago 1687 27 1.6

Southland 1253 23 1.8

Not stated 16 0 0.0

Total 52,082 1102 2.1

4.2 BIRTH OUTCOMES

Rates and numbers for babies who were either born stillborn in hospital (stillbirth) or who died

while in hospital within 28 days after birth (neonatal death) are presented for 2005 in Tables

4.10–4.14 and Figures 4.6 and 4.7. See the Glossary and Appendix 9 for an explanation of the

terms used.

This section includes only fetal and neonatal deaths that occurred in hospital, for further complete

information and analyses on all newborn and infant deaths registered in New Zealand, see the

Fetal and Infant Deaths series on the New Zealand Health Information Service website7.

Data integrity

The rates presented in this section, particularly for neonatal deaths, are based on small numbers and are

subject to large annual fluctuations. Please treat this information with caution.

7 http://www.nzhis.govt.nz

43

Table 4.10 shows that, in 2005, 572 babies (1.0 percent of all births) died between 20 weeks of

pregnancy and one month of life; of these, 393 were stillbirths (7.1 stillbirths per 1000 total births).

Of the babies born in hospital in 2005, Pacific babies had the highest perinatal death rate8

(14.2

deaths per 1000 total births) and Māori babies had the highest neonatal death rate9 (4.4 deaths

per 1000 live births; Table 4.10). Figure 4.6 shows the rates of stillbirths and neonatal deaths

compared with the corresponding national rates.

Figure 4.6: Rate of in-hospital stillbirths and neonatal deaths, by ethnicity and 95 percent confidence

intervals, 2005

0

2

4

6

8

10

12

14

Stillbirths

(Rate per 1000 total births)

Early neonatal deaths

(Rate per 1000 livebirths)

Late neonatal deaths

(Rate per 1000 livebirths)

RateNational

Māori

Pacific peoples

Asian

European

Table 4.10: Number and rate of in-hospital live births, stillbirths and neonatal deaths, by ethnicity, 2005

Number Rate

Ethnic group Total births Stillbirths



Stillbirths* Early

neonatal deaths

†


†

Total perinatal deaths*

Total neonatal deaths

†

Māori 11,200 81 44 5 7.2 4.0 0.4 11.2 4.4

Pacific peoples 5650 59 21 3 10.4 3.8 0.5 14.2 4.3

Asian 4714 29 18 2 6.2 3.8 0.4 10.0 4.3

European 31,918 201 59 14 6.3 1.9 0.4 8.1 2.3

Other 1608 18 6 2 11.2 3.8 1.3 14.9 5.0

Not stated 622 5 3 2 8.0 4.9 3.2 12.9 8.1

Total 55,712 393 151 28 7.1 2.7 0.5 9.8 3.2

* Rate per 1000 total births. † Rate per 1000 live births.

8 Perinatal deaths are defined as the number of stillbirths (fetal deaths of 20 weeks’ gestation or 400g birthweight) plus early neonatal deaths. See the Glossary.

9 Neonatal deaths are defined as deaths occurring up to 27 days after birth, and are classified as early or late neonatal deaths. An early neonatal death is defined as the death of a liveborn infant dying before 168 completed hours (seven days) after birth. A late neonatal death is defined as the death of a liveborn infant dying after seven days and before 28 completed days after birth.

44

Table 4.11: Number and rate of in-hospital live births, stillbirths and neonatal deaths, by DHB region of

mother’s place of residence, 2005

Number Rate

DHB region Total births Stillbirths



Stillbirths* Early

neonatal deaths

†


†

Total perinatal deaths*

Total neonatal deaths

†

Northland 1885 11 8 1 5.8 4.3 0.5 10.1 4.8

Waitemata 6668 56 10 2 8.4 1.5 0.3 9.9 1.8

Auckland 6048 30 19 4 5.0 3.2 0.7 8.1 3.8

Counties Manukau 7935 57 38 4 7.2 4.8 0.5 12.0 5.3

Waikato 4532 31 5 4 6.8 1.1 0.9 7.9 2.0

Lakes 1536 15 7 0 9.8 4.6 0.0 14.3 4.6

Bay of Plenty 2602 24 13 1 9.2 5.0 0.4 14.2 5.4

Tairawhiti 752 9 2 0 12.0 2.7 0.0 14.6 2.7

Hawke's Bay 2159 11 6 3 5.1 2.8 1.4 7.9 4.2

Taranaki 1357 6 2 3 4.4 1.5 2.2 5.9 3.7

MidCentral 2144 16 4 0 7.5 1.9 0.0 9.3 1.9

Whanganui 806 6 2 0 7.4 2.5 0.0 9.9 2.5

Capital & Coast 3566 22 8 1 6.2 2.3 0.3 8.4 2.5

Hutt Valley 1909 11 6 0 5.8 3.2 0.0 8.9 3.2

Wairarapa 440 3 0 0 6.8 0.0 0.0 6.8 0.0

Nelson Marlborough 1392 10 4 0 7.2 2.9 0.0 10.1 2.9

West Coast 315 3 0 0 9.5 0.0 0.0 9.5 0.0

Canterbury 5860 49 9 0 8.4 1.5 0.0 9.9 1.5

South Canterbury 572 3 5 0 5.2 8.8 0.0 14.0 8.8

Otago 1830 15 1 3 8.2 0.6 1.7 8.7 2.2

Southland 1375 4 2 2 2.9 1.5 1.5 4.4 2.9

Not stated 29 1 0 0 34.5 0.0 0.0 34.5 0.0

Total 55,712 393 151 28 7.1 2.7 0.5 9.8 3.2

* Rate per 1000 total births. † Rate per 1000 live births.

Mothers at either end of the reproductive age spectrum were more likely to experience a stillbirth

than women in the middle age groups. However, women aged 40 years and over had almost

double the risk of having a stillbirth than those aged under 20 years (Table 4.12).

The stillbirth rate is also highest (8.4 per 1000 live births) for the mothers with a place of

residence in the most deprived (New Zealand Index of Deprivation decile 10) areas, compared

with 5.4 per 1000 live births for mothers with a place of residence in decile 3 areas (the lowest

rate) and 7.1 per 1000 live births for the New Zealand average (Table 4.12).

45

Table 4.12: Stillbirth rate, by mother’s age group and NZDep decile of mother’s place of residence, 2005

Mother's age group (years) NZDep decile Total stillbirths

<20 20–24 25–29 30–34 35–39 40 and over Total

1 (least deprived) 24 29.1 3.8 8.5 3.1 5.6 13.5 6.0

2 31 16.7 12.6 9.6 4.3 9.0 5.1 7.6

3 23 6.3 5.0 5.7 3.8 6.9 10.2 5.4

4 32 8.9 9.3 11.8 3.0 8.4 0.0 7.0

5 29 0.0 6.3 3.6 5.5 9.2 21.1 6.2

6 30 2.7 4.4 4.4 6.2 6.5 12.0 5.5

7 40 11.5 7.8 6.6 7.3 7.9 6.2 7.6

8 54 6.7 10.6 6.3 8.5 4.1 17.8 7.9

9 59 8.3 5.9 5.7 8.7 7.5 11.8 7.2

10 (most deprived) 69 6.9 9.5 6.8 7.5 5.1 37.7 8.4

Not stated 2 0.0 71.4 0.0 0.0 71.4 0.0 26.0

Total rate* … 7.7 8.0 6.6 5.9 7.1 14.3 7.1

Total number 393 32 76 87 101 68 29 …

* Rate per 1000 live births.

As explained in the Fetal and Infant Deaths series, New Zealand counts all babies as liveborn if

they show any signs of life, irrespective of the newborn’s viability (chance of survival). Figure 4.7

shows that the neonatal death rates for babies under 37 weeks’ gestation was higher than those

born at 37 or more weeks’ gestation. Note that these rates are based on small numbers and are

subject to large year-on-year fluctuations.

Tables 4.13 and 4.14 show that neonatal deaths (particularly early neonatal deaths) tended to

occur at lower birthweights and gestational ages. Nearly 68 percent of these neonatal deaths

occurred at birthweights under 2500g and gestational ages of less than 37 weeks (67.6 percent).

Figure 4.7 presents the proportions of in-hospital neonatal deaths by gestational age group (less

than 37 and 37 and over weeks’ gestation). See Appendix 8 for in-hospital neonatal deaths by

gestational age group and ethnicity (Appendix 8, Figure A8.3).

Of the babies that died in the early neonatal period 70.2 percent were preterm and of low

birthweight, compared with 53.6 percent in the late neonatal period (Table 4.14).

46

Figure 4.7: Rate of in-hospital neonatal deaths, by gestational age (under 37 weeks and 37 or more weeks), 2000–2005

0.0

0.5

1.0

1.5

2.0

2.5

3.0

2000 2001 2002 2003 2004 2005

Year

Rate per 1000

live births

Under 37 w eeks

37 or more w eeks

Table 4.13: Number and rate of in-hospital neonatal deaths, by birthweight and gestational age, 2005

Number Rate per 1000 live births



Early neonatal

deaths Late neonatal

deaths

Less than 1000 90 8 335.8 29.9

1000–1499 8 2 21.2 5.3

1500–1999 8 3 12.0 4.5

2000–2499 9 3 4.2 1.4

2500–4499 25 11 0.5 0.2

4500 and over 6 0 3.8 0.0 Birth

weig

ht (g

)

Not stated 5 1 625.0 125.0

Less than 20 6 0 750.0 0.0

20–23 55 0 833.3 0.0

24–27 26 8 136.1 41.9

28–31 12 2 24.2 4.0

32–36 11 6 3.3 1.8

37–41 27 9 0.5 0.2

42 and over 0 0 0.0 0.0 Gesta

tional age

(w

eeks)

Not stated 14 3 16.8 3.6

Total 151 28 2.7 0.5

47

Table 4.14: Number of in-hospital neonatal deaths, by gestational age and birthweight, 2005

Number Total

Gestational age (weeks) Birthweight (g) Early neonatal deaths


Number Percent

less than 2500 106 15 121 67.6 Less than 37

2500 and over 4 1 5 2.8

less than 2500 4 1 5 2.8 37 and over

2500 and over 26 9 35 19.6

less than 2500 5 0 5 2.8

2500 and over 1 1 2 1.1 Not stated

Not stated 5 1 6 3.4

Total 151 28 179 100.0

48

5 Postnatal Period This section describes the services and care provided to the mother and baby in the days

following the baby’s birth.

5.1 POSTNATAL HOSPITAL ADMISSIONS OF THE MOTHER AND BABY

A maternal hospital readmission is defined as a readmission of the mother to hospital within 42

days (six weeks) of a hospital birth. A postnatal admission is defined as the admission to hospital

of a liveborn baby in the first three months after birth. Transfers between facilities are excluded

from this analysis.

In 2005, there were 2789 readmissions to hospital for postpartum and post-abortion diagnoses (DRGs O04Z and O61Z). The majority of these mothers were readmitted for ‘postpartum care and examination’ and ‘infection of breast associated with childbirth’ (29.5 percent and 14.6 percent respectively; Table 5.1). The average length of stay for mothers readmitted to hospital was 2.4 days.

There was wide variation in rates between District Health Boards, particularly for maternal readmissions. This variation may reflect several different practices (for example, admission criteria, coding practices) between District Health Boards, therefore further investigation is required.

Figure 5.1: Rate of hospital readmission of mothers (standardised by age and ethnicity) with 95 percent

confidence intervals, by DHB of mother’s place of residence, 2005

NZ

0

50

100

150

200

250

300

Nort

hla

nd

Wa

item

ata

Auck

land

Co

untie

s M

anukau

Waik

ato

Lake

s

Ba

y o

f P

lenty

Ta

iraw

hiti

Ha

wke's

Bay

Ta

ran

aki

Mid

Ce

ntr

al

Whang

anui

Capita

l & C

oast

Hutt V

alle

y

Wa

irara

pa

Nels

on M

arlboro

ug

h

Wes

t C

oast

Cante

rbury

Sou

th C

an

terb

ury

Ota

go

So

uth

land

DHB region

Rate*

* Standardised readmission rate per 1000 hospital deliveries.

49

Table 5.1: Postnatal readmissions for mothers with problems relating to pregnancy, by principal diagnosis

(DRGs O04Z and O61Z), 2005

Readmissions Principal diagnosis

Number %

Average length of stay

(days)

Rate per 1000 hospital deliveries

Complications following abortion and ectopic and molar pregnancy

5 0.2 2.0 0.1

Complications of anaesthesia during labour and delivery

3 0.1 2.0 0.1

Complications of anaesthesia during the puerperium

28 1.0 1.0 0.5

Complications of the puerperium, not elsewhere classified

105 3.8 2.1 1.9

Diabetes mellitus in pregnancy 4 0.1 3.0 0.1

Eclampsia 9 0.3 2.3 0.2

Gestational (pregnancy-induced) hypertension with significant proteinuria

26 0.9 3.6 0.5

Gestational (pregnancy-induced) hypertension without significant proteinuria

41 1.5 2.3 0.7

Gestational (pregnancy-induced) oedema and proteinuria without hypertension

1 0.0 1.0 0.0

Infections of breast associated with childbirth 406 14.6 2.3 7.4

Infections of genitourinary tract in pregnancy 3 0.1 2.3 0.1

Labour and delivery complicated by intrapartum haemorrhage, not elsewhere classified

1 0.0 2.0 0.0

Maternal care for known or suspected abnormality of pelvic organs

2 0.1 4.5 0.0

Maternal care for known or suspected fetal abnormality and damage

1 0.0 1.0 0.0

Maternal care for other conditions predominantly related to pregnancy

5 0.2 3.6 0.1

Maternal care for other known or suspected fetal problems

1 0.0 1.0 0.0

Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

9 0.3 3.9 0.2

Mental and behavioural disorders associated with the puerperium, not elsewhere classified

10 0.4 6.3 0.2

Obstetric embolism 11 0.4 4.6 0.2

Other complications of labour and delivery, not elsewhere classified

3 0.1 3.0 0.1

Other disorders of amniotic fluid and membranes 2 0.1 3.0 0.0

Other disorders of breast and lactation associated with childbirth

57 2.0 1.8 1.0

Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

242 8.7 1.8 4.4

Other obstetric trauma 7 0.3 2.9 0.1

Other puerperal infections 346 12.4 2.7 6.3

Perineal laceration during delivery 4 0.1 2.0 0.1

Placental disorders 1 0.0 1.0 0.0

Postpartum care and examination 823 29.5 2.9 15.0

Postpartum haemorrhage 229 8.2 1.5 4.2

50

Table 5.1 (continued): Postnatal readmissions for mothers with problems relating to pregnancy, by principal

diagnosis (DRGs O04Z and O61Z), 2005

Readmissions Principal diagnosis

Number %

Average length of stay

(days)


Pre-existing hypertension complicating pregnancy, childbirth and the puerperium

12 0.4 2.5 0.2

Pre-existing hypertensive disorder with superimposed proteinuria

2 0.1 1.0 0.0

Puerperal sepsis 267 9.6 2.2 4.9

Retained placenta and membranes, without haemorrhage

45 1.6 1.3 0.8

Unspecified maternal hypertension 22 0.8 1.8 0.4

Venous complications in pregnancy 1 0.0 7.0 0.0

Venous complications in the puerperium 55 2.0 2.2 1.0

Total 2789 100.0 2.4 50.8

The number of maternal and baby readmissions by District Health Board are presented in Table

5.2. Figure 5.1 illustrates the rates of readmission for mothers by District Health Board compared

with the New Zealand average of 80.8 readmissions per 1000 hospital deliveries. As in 2004,

Taranaki had the highest maternal readmission rate in 2005 (218.3 readmissions per 1000

hospital deliveries in 2005; 210.8 readmissions per 1000 hospital deliveries in 2004).

51

Table 5.2: Number and rate of hospital readmissions for mothers and babies, by the District Health Board

region of mother’s and baby’s place of residence, 2005

Mother Baby

DHB region Number


Number Rate per 1000

live births

Northland 247 133.4 246 131.3

Waitemata 337 51.3 518 78.3

Auckland 363 61.0 529 87.9

Counties Manukau 510 65.1 829 105.2

Waikato 497 111.0 580 128.9

Lakes 188 123.8 225 147.9

Bay of Plenty 222 86.9 371 143.9

Tairawhiti 91 122.8 112 150.7

Hawke's Bay 69 32.6 187 87.1

Taranaki 291 218.3 235 173.9

MidCentral 97 46.1 193 90.7

Whanganui 93 117.1 102 127.5

Capital & Coast 239 68.1 396 111.7

Hutt Valley 58 30.9 247 130.1

Wairarapa 36 83.3 44 100.7

Nelson Marlborough 159 116.1 101 73.1

West Coast 36 115.0 27 86.5

Canterbury 463 80.3 598 102.9

South Canterbury 70 123.9 74 130.1

Otago 227 125.7 183 100.8

Southland 134 99.2 152 110.9

Not stated 7 241.4 3 107.1

Total 4434 80.8 5952 107.6

Of the 55,192 live babies born in 2005, 5952 (10.8 percent) required postnatal admission (as

shown in Table 5.2). Taranaki and Tairawhiti had the highest admission rates of all the District

Health Boards, while Nelson Marlborough and Waitemata had the lowest.

52

Figure 5.2: Rate of hospital admission of babies (standardised by age and ethnicity) with 95 percent

confidence intervals, by DHB of baby’s place of residence, 2005

NZ

40

60

80

100

120

140

160

180

200

Nort

hla

nd

Wa

item

ata

Auck

land

Co

untie

s M

anukau

Waik

ato

Lake

s

Ba

y o

f P

lenty

Ta

iraw

hiti

Ha

wke's

Bay

Ta

ran

aki

Mid

Ce

ntr

al

Whang

anui

Capita

l & C

oast

Hutt V

alle

y

Wa

irara

pa

Nels

on M

arlboro

ug

h

Wes

t C

oast

Cante

rbury

Sou

th C

an

terb

ury

Ota

go

So

uth

land

DHB region

Rate*

* Standardised admission rate per 1000 live births.

53

6 Maternity Facility The summary information presented in this section is by the type of maternity facility and has

been collated from data reported by the individual facilities to the National Minimum Dataset.

Detailed tables by individual facility are presented in Appendix 10.

A maternity facility is a place that mothers attend, or are resident in, for the primary purpose of

receiving maternity care. The maternity facility types presented are primary, secondary and

tertiary. Primary facilities also include birthing units (see Glossary).

Table 6.1: Total live and stillbirths delivered in hospital, by facility type, 2005

Live births Stillbirths

Facility type Number Percentage

Number

Rate per 1000 total

births

Tertiary 23,349 42.2 244 10.3

Secondary 22,958 41.5 147 6.4

Primary 9012 16.3 2 0.2

Total 55,319 100.0 393 7.1

Figure 6.1: Use of primary, secondary and tertiary facilities, by ethnicity, 2005

0

10

20

30

40

50

60

70

80

90

100

Māori Pacific peoples Asian European

Ethnic group

Percentage Tertiary Secondary Primary

In 2005, 42.2 percent of all live births occurred in one of the six large tertiary facilities. The largest

maternity unit is Auckland City Hospital (previously called National Women’s), where almost a

third of all births at tertiary facilities took place (see Appendix 10; Table A10.1). Just over 16

percent of live births occurred in primary facilities (16.3 percent), while 41.5 percent occurred in

secondary facilities.

In 2005, the majority of stillbirths occurred in tertiary or secondary facilities (62.1 percent and 37.4

percent respectively), while only two stillbirths occurred in primary facilities (Appendix 10; Table

A10.1). This is to be expected because, if the Lead Maternity Carers screen women

appropriately, high-risk births should be referred to secondary or tertiary facilities.

Of the mothers who gave birth in hospital, Pacific and Asian mothers were more likely to give

birth in a tertiary facility (62.8 percent and 59.6 percent respectively; Figure 6.1). This may be

because the District Health Board region in which the majority of Pacific and Asian mothers

54

resided had fewer primary units than other regions. In comparison, 49.9 percent of Māori mothers

used secondary facilities, while European mothers were split between secondary and tertiary

facilities (44.6 percent and 40.3 percent respectively), as presented in Figure 6.1. Tables 6.2–6.4

present the number of antenatal admissions, types of births and birth interventions required in

2005.

Table 6.2: Antenatal hospital admissions and average length of stay, by facility type, 2005

Facility type Number Percentage Average

length of stay (days)

Tertiary 10,094 54.9 1.5

Secondary 6880 37.4 1.4

Primary 1269 6.9 0.4

Total 18,372 100.0 1.4

Table 6.3: Type of hospital birth (rate per 100 deliveries), by facility type, 2005


Facility type

Normal birth Total Acute Elective

Breech birth Total

Assisted breech

birth Forceps

Forceps and

vacuum extraction

Vacuum extraction

Total

Tertiary 58.6 28.4 17.9 10.5 0.3 12.7 0.3 4.1 0.1 8.1 100

Secondary 67.1 24.8 14.5 10.2 0.2 7.9 0.2 2.6 0.1 5.0 100

Primary 87.5 9.2 3.1 6.1 0.1 3.3 0.1 0.7 0.0 2.5 100

Total 66.8 23.8 14.1 9.7 0.2 9.2 0.2 2.9 0.1 5.9 100

Table 6.4: Number and rate of inductions, epidurals and episiotomies, by facility type, 2005

Number Rate Facility type

Induction Epidural Episiotomy Induction* Epidural* Episiotomy†

Tertiary 5027 8220 2876 24.3 39.7 17.4

Secondary 4427 5427 1809 21.7 26.6 10.6

Primary 361 603 382 4.3 7.1 4.7

Total 9815 14,250 5067 19.8 28.8 12.1

* Rate per 100 deliveries (excluding elective caesarean sections). † Rate per 100 vaginal deliveries.

55

The patient clinical complexity level (PCCL) measures the complexity of the co-morbid and

complicating conditions for each woman relative to all other women with the same condition. The

classification ‘PCCL 0’ indicates no complicating diagnoses or co-morbidities. Some Diagnosis

Related Groups do not have a severity split, so are reported under ‘PCCL 0’. The majority of

women had few or no co-morbid or complicating conditions at the time of birth. Table 6.5 shows

that the average length of stay increased with the level of complexity.

Table 6.5: Number and percentage of mothers and average length of stay, by PCCL and facility type, 2005

Percentage Average length of stay (days) Facility type

Total number PCCL

0 PCCL

1 PCCL

2 PCCL

3 PCCL

4 PCCL

0 PCCL

1 PCCL

2 PCCL

3 PCCL

4

Tertiary 23,109 74.4 0.0 14.5 8.9 2.2 2.0 4.8 3.6 5.0 9.8

Secondary 22,758 81.1 0.0 11.8 6.1 1.1 2.3 3.5 3.5 4.6 7.5

Primary 8982 93.5 0.0 4.2 2.1 0.2 2.2 0.0 3.5 4.2 6.9

Total 54,849 80.3 0.0 11.7 6.6 1.4 2.1 4.3 3.6 4.8 9.0

Babies were most likely to be born at 37–41 weeks’ gestation in secondary or tertiary facilities.

Babies of less than 37 weeks’ gestation tended to be born in tertiary facilities, while babies born

at 42 and over weeks’ gestation tended to be born in secondary or tertiary facilities (Table 6.6).

Table 6.6: Numbers of live babies born, by gestational age and facility type, 2005

Gestational age (weeks) Facility type

Less than 37 37–41 42 and over Not stated Total

Tertiary 2387 21,026 722 176 24,311

Secondary 1511 20,678 697 381 23,267

Primary 165 8474 244 276 9159

Total 4063 50,179 1663 834 56,739

56

Appendix 1 The New Zealand Index of Deprivation The New Zealand Index of Deprivation (NZDep) is an index of neighbourhood deprivation

generated from data from the 2001 Census of Populations and Dwellings. The index combines

nine socioeconomic variables from the census, reflecting eight domains of material and economic

deprivation (Table A1.1; Salmond and Crampton 2002a, 2002b). The index scores are grouped

into 10 deciles, with each decile representing equal or similar size in terms of the New Zealand

population.

Variables included in the construction of the NZDep have been shown through international

literature to be associated with mortality, morbidity and other socioeconomic disadvantages. On

the whole, neighbourhoods in high NZDep deciles are more deprived and likely to demonstrate

greater need for health services compared with areas in low NZDep deciles.

Table A1.1: Nine socioeconomic variables in the New Zealand Index of Deprivation

Name of variable Description of variable

Communication People with no access to a telephone

Income People aged 18–59 receiving a means-tested benefit

Income Equivalised* household income below an income threshold

Transport People with no access to a car

Living space Equivalised* household below a bedroom occupancy threshold

Owned home People not living in own home

Employment Unemployed people aged 18–59

Qualifications People aged 18–59 without any qualifications

Support People aged <60 living in a single-parent family

Source: Salmond and Crampton 2002

* Equivalisation: methods used to control for household composition.

57

Appendix 2 Diagnosis Related Group (DRG)

The Australian Refined Diagnosis Related Groups (AR-DRGs) is a patient classification scheme

that provides a clinically meaningful way of relating the number and types of patients treated in

hospital to the resources required by the hospital. DRGs are allocated by ‘grouper’ software

based on the patient’s diagnosis and procedure codes, and age. Clinical coding staff assign the

appropriate diagnosis and procedure codes. Version 4.2 of the AR-DRG was used in this paper.

The grouper software evaluates the following decisions to allocate events into DRGs. This section

looks specifically at the four DRG codes analysed in this paper:

• O62Z – Threatened abortion

• O64Z – False labour

• O65A – Other antenatal admission with severe complicating diagnosis

• O65B – Other antenatal admission with moderate or no complicating diagnosis.

For an event to be classified in one of these four DRGs, it must pass through the following steps.

1. The principal diagnosis relates to pregnancy, childbirth and the puerperium.

2. The patient is female.

3. The procedure and diagnoses are not about a normal birth.

4. The procedure and diagnoses are not about a caesarean birth.

5. The procedure or principal diagnosis does not describe an ectopic pregnancy.

6. The diagnoses and procedures do not describe postpartum or post-abortion procedures.

7. The diagnoses and procedures do not describe an abortion with dilation and curettage,

aspiration curettage or hysterectomy.

8. The diagnoses and procedures do not describe postpartum or post-abortion operating room

procedures.

9. If the diagnosis describes a threatened abortion, assign DRG O62Z (if this is not the case, go

to 10).

10. The patient did not have an abortion.

11. If the diagnosis is for false labour, assign DRG O64Z (if this is not the case, go to 12).

12. The diagnosis is for another antenatal admission.

13. If there is a severe or complicating principal diagnosis, assign DRG O65A (if this is not the

case, go to 14).

14. If the principal diagnosis does not describe a severe or complicating condition, assign DRG

O65B.

O62Z – Threatened abortion

Events are given DRG O62Z when they have any of the following principal diagnosis codes:

• O200 – Threatened abortion

• O208 – Other haemorrhage in early pregnancy

• O209 – Haemorrhage in early pregnancy, unspecified.

58

O64Z – False labour

Events are given DRG O64Z when they have any of the following principal diagnosis codes:

• O470 – False labour <37 weeks’ gestation

• O140 – False labour ≥37 completed weeks’ gestation

• O479 – False labour unspecified.

This includes any labour pains that did not lead to a birth in this hospital event.

O65A – Other antenatal admission with severe complicating diagnosis

Events are given DRG O65A when the principal diagnosis is one of a large number of codes,

including such conditions as:

• pre-existing hypertension

• gestational oedema

• late vomiting in pregnancy

• infections in kidney or urinary tract or genital tract

• malnutrition

• twins or triplets

• suspected damaged fetus due to alcohol, drugs or radiation.

This list includes admissions where pre-existing conditions complicate the pregnancy or

childbirth, for example an obstetric patient admitted for an asthma-complicating pregnancy.

O65B – Other antenatal admission with moderate or no complicating diagnosis

Events are given DRG O65B when any diagnosis code (but not the principal diagnosis) is among

a large number of codes, including such conditions as:

• gestational proteinuria

• pre-eclampsia or eclampsia

• diabetes

• pre-existing insulin-dependent diabetes mellitus or non-insulin-dependent diabetes mellitus

• poor fetal growth.

59

Appendix 3 Ethnicity The National Minimum Dataset (NMDS) records up to three different ethnicities. For ease of

analysis, the multiple ethnic groups recorded for individuals are prioritised as one ethnic group

using the system shown in Table A3.1 below. This is the standard prioritisation of ethnicity used

by the New Zealand Health Information Service.

Table A3.1: Standard prioritisation of ethnicity

Ethnicity Prioritisation order

Māori 1

Pacific peoples 2

South East Asian 3

Indian 4

Chinese 5

Other Asian 6

Other 7

Other European 8

European/Pākehā 9

Not reported 10

60

Appendix 4 Population Data The 2001 Census of Population and Dwellings was used to calculate all population rates in this

paper.

Table A4.1: Prioritised usually resident female population by ethnicity and age for New Zealand, as at 6

March 2001

Female population Age group (years) European Māori

Pacific peoples

Asian Other Not

Specified Total

0–4 Years 73,491 32,865 11,982 7983 1053 4761 132,135

5–9 Years 81,915 31,983 11,472 8205 957 4518 139,050

10–14 Years 86,361 31,047 10,572 8754 1074 4272 142,080

15–19 Years 78,171 24,789 9138 12,720 1167 4182 130,167

20–24 Years 72,387 22,038 8973 11,721 882 4941 120,942

25–29 Years 82,995 21,501 8589 9516 900 5346 128,847

30–34 Years 98,820 21,111 8835 11,202 1026 6090 147,084

35–39 Years 107,178 20,370 7929 12,252 987 6063 154,779

40–44 Years 105,951 17,409 6249 10,836 876 5715 147,036

45–49 Years 96,312 13,023 4878 8340 627 5124 128,304

50–54 Years 94,017 10,038 3954 5862 414 4905 119,190

55–59 Years 74,334 7086 2817 3678 264 3912 92,091

60–64 Years 63,615 6000 2331 3156 183 3489 78,774

65–69 Years 54,465 4083 1707 2256 162 2811 65,484

70–74 Years 53,913 2742 1233 1344 78 2751 62,061

75–79 Years 47,967 1524 753 822 60 2616 53,742

80–84 Years 34,710 783 375 417 42 2061 38,388

85 and over 31,206 495 219 321 51 1827 34,119

Total 1,337,808 268,887 102,006 119,385 10,803 75,384 1,914,273

Data source: Statistics New Zealand

Note: Because of rounding, individual figures in this table do not always sum to the stated totals. Ethnic data in this table are based on prioritised self-identified ethnicity (‘mixed ethnicity’), where individuals select up to three ethnic groups to which they feel they belong.

Many of the calculations in this paper are based on women of reproductive age. For the purposes

of this paper, women of reproductive age are those aged 15–44 years.

61

Appendix 5 District Health Board regions

62

Appendix 6 Catchment Areas

DHB region Tertiary maternity and level III specialist neonatal services

Secondary maternity and level II specialist neonatal services

Primary maternity

Auckland Birthcare Auckland

Bay of Islands (Kawakawa)

Dargaville

Kaitaia Northland Whangarei

Hokianga

Wellsford

Warkworth Waitemata

Auckland City

North Shore, Waitakere

Helensville

Pukekohe

Papakura Counties Manukau Middlemore

Botany Downs

Waihi

Birthcare Huntly

Thames

Rhoda Read (Morrinsville)

Matariki (Te Awamutu)

Te Kuiti

Taumarunui

Tokoroa

Pohlen (Matamata)

River Ridge East Birthing Centre

Waikato

Waterford Birthing Centre

Lakes Rotorua Taupo

Opotiki Bay of Plenty Tauranga, Whakatane

Murupara

Tairawhiti Gisborne Te Puia Springs

Hawera Taranaki

Waikato

Taranaki Base (New Plymouth)

Elizabeth R (Stratford)

63

Catchment areas continued

DHB region Tertiary Maternity and Level III Specialist Neonatal Services

Secondary Maternity and Level II Specialist Neonatal services

Primary Maternity

Waimarino (Raetihi)

Marton Wanganui Wanganui

Taihape

Wairoa

Chatham Islands

Napier Hawke’s Bay Hastings

Waipukurau

Wairarapa Masterton

Otaki

Horowhenua (Levin)

Fielding MidCentral Palmerston North

Dannevirke

Hutt Valley Hutt

Paraparaumu Capital & Coast Kenepuru (Porirua)

Motueka Nelson Marlborough

Wellington

Wairau (Blenheim), Nelson

Golden Bay (Takaka)

Kaikoura

St Georges (Christchurch)

Avonlea (Christchurch)

Burwood

Darfield

Akaroa

Waikari

Lincoln

Rangiora

Canterbury

Ashburton

West Coast Greymouth Buller (Westport)

South Canterbury

Christchurch Women's

Timaru

Oamaru

Charlotte Jean (Alexandra)

Dunstan

Maniototo Health Services (Ranfurly)

Otago

Clutha Health First (Balclutha)

Gore

Lakes District (Queenstown)

Tuatapere

Northern Southland (Lumsden)

Southland

Dunedin

Southland (Invercargill)

Winton

64

Appendix 7 Standardisation The purpose of standardisation

10 is to control for potential confounding by outside factors, like

age and/or ethnic structure, when making comparisons. For example, the interest may be in

whether one region has a rate higher than the national average. However, if the region has a

particular age structure of its population that strongly influences the observed result, the effect of

age should be removed before making the comparison.

Indirect, rather than direct, standardisation is used for comparisons between District Health Board

regions. The principal reason for this choice is that indirect standardisation is less sensitive to

large differences in the age and/or ethnic specific rates than direct standardisation. This implies

that the standard deviation of an indirectly standardised rate is generally smaller than the directly

standardised equivalent. Therefore, the confidence intervals generated around an indirectly

standardised rate are narrower (implying that the rate is more precise) than those found through

direct standardisation.

Two forms of standardisation have been used in this paper.

1) Standardising for age and ethnicity is used for comparing outcomes by District Health

Board region.

2) Standardising for age only (age-standardised).

Rates standardised by age and ethnicity

The standardisation methodology used to standardise for age and ethnicity is as follows:

Step 1: Calculate the age-ethnicity-specific rates for each age group in each ethnicity group in each District Health Board population of women of reproductive age (15–44 years). Step 2: Multiply these rates by the number of women of reproductive age in each age group in each ethnicity group in the New Zealand population. Step 3: Sum the numbers obtained from Step 2 to derive the total expected number of cases in each District Health Board. Step 4: Divide the observed number of cases (including birth events to females aged 45 years or over or aged less than 15 years) in each District Health Board by the expected number obtained from Step 3. This is the standardised prevalence ratio. Step 5: Multiply the standardised prevalence ratio by the national rate, to obtain the standardised rate for each District Health Board. Algebraically, the standardised rate for each District Health Board (SRDHB) is expressed as:

NRExpected

ObservedSR

DHB

DHB

DHB *= (Steps 4 and 5)

Where:

ObservedDHB is the total number of observed events in the DHB region (including birth events to

females aged 45 years or over or aged less than 15 years).

∑ ×=i

i

i

iDHBp

PNExpected (Steps 1 to 3)

10

Ministry of Health 2004.

65

Ni is the number of observed events in each age group in each ethnicity group within

the DHB

pi is the number of women of reproductive age (15–44 years) in each age group in each

ethnicity group within the DHB.

Pi is the number of women of reproductive age (15–44 years) in each age group in each

ethnicity group within the New Zealand population.

National Rate or vPopulation

ObservedNR

National

National*=

ObservedNational is the number of events (including birth events to females aged 45 years or

over or aged less than 15 years).

PopulationNational is the number of women of reproductive age in New Zealand.

v a rate value. For example, 1000 if the rate is per 1000 live births.

Age groups: 15–24, 25–44.

Ethnicity: Māori, Pacific, Other.

Age-standardised rates

Age-standardised rates are calculated by multiplying age-specific rates by a standard population.

The standard population used in these calculations is World Health Organization (WHO) world

population (see below).

An age-specific rate is the rate at which a particular health event (for example, birth event, death

or disease incidence) occurs in each age group of a population as some unit of the population-at-

risk or person-years-at-risk.

An age-specific rate is simply the crude rate for the specific age group. For example, to calculate

the age-specific rate of caesarean sections for women aged 20–24, the total number of cases in

the age group is divided by the population in that age group and multiplied by a constant (a unit of

population, such as 1000 or, as in the present report, 100). This process produces birth rates

showing the number of caesarean sections per 100 deliveries in each age group in a particular

year (PHC 1995).

Further information on age-specific and age-standardised rates can be found in the Ministry of

Health and Public Health Commission document Standardising Rates of Disease (available

online from the Ministry of Health (http://www.moh.govt.nz/library)).

66

Table A7.1: World Health Organisation (WHO) world population weight

Age group Weight

0–4 8.86

5–9 8.69

10–14 8.60

15–19 8.47

20–24 8.22

25–29 7.93

30–34 7.61

35–39 7.15

40–44 6.59

45–49 6.04

50–54 5.37

55–59 4.55

60–64 3.72

65–69 2.96

70–74 2.21

75–79 1.52

80–84 0.91

85+ 0.63

Total 100.00

Source: WHO 2001

67

Appendix 8 Statistical tables of babies These tables relate to Chapter 4: Babies. Data on the number of babies born in New Zealand

were extracted from the National Minimum Dataset (NMDS).

Table A8.1: Percentage of liveborn babies, by birthweight and DHB region of mother’s place of residence,

2005

Live babies by birthweight (grams) Total

DHB region Less than 1000

1000–1499

1500–1999

2000–2499

2500–4499

4500 or more

Not stated

No. %

Northland 0.4 0.7 1.4 4.0 91.1 2.4 0.1 1970 100.0

Waitemata 0.5 0.6 1.2 3.5 91.6 2.5 0.0 6740 100.0

Auckland 0.6 0.5 0.9 3.9 91.6 2.5 0.0 6276 100.0

Counties Manukau 0.5 0.6 1.1 4.2 90.4 3.2 0.0 7891 100.0

Waikato 0.6 0.8 0.8 3.5 91.5 2.8 0.0 4833 100.0

Lakes 0.7 0.4 1.6 4.0 90.8 2.5 0.0 1564 100.0

Bay of Plenty 0.6 0.7 1.6 4.6 89.8 2.6 0.0 2626 100.0

Tairawhiti 0.7 0.7 1.4 3.8 90.5 2.9 0.0 760 100.0

Hawke's Bay 0.5 0.8 1.3 5.1 89.8 2.6 0.0 2141 100.0

Taranaki 0.3 0.9 1.6 4.2 90.4 2.5 0.0 1369 100.0

MidCentral 0.3 0.8 1.2 4.4 90.4 2.8 0.1 2180 100.0

Whanganui 0.2 1.2 1.3 5.0 90.7 1.5 0.0 817 100.0

Capital & Coast 0.4 0.6 1.0 3.4 91.1 3.6 0.0 3673 100.0

Hutt Valley 0.2 1.0 1.6 3.7 91.1 2.4 0.0 1935 100.0

Wairarapa 0.0 0.9 0.9 2.5 93.8 1.8 0.0 437 100.0

Nelson Marlborough

0.5 0.3 0.9 2.7 92.9 2.7 0.0 1410 100.0

West Coast 0.0 0.9 0.9 2.4 94.5 1.2 0.0 330 100.0

Canterbury 0.4 0.8 1.3 3.2 91.4 3.0 0.0 5926 100.0

South Canterbury 0.7 0.0 1.5 3.3 92.3 2.2 0.0 584 100.0

Otago 0.5 0.5 1.0 4.0 91.1 2.9 0.0 1847 100.0

Southland 0.6 0.7 1.1 3.6 91.3 2.6 0.1 1410 100.0

Not stated 0.0 5.0 5.0 0.0 80.0 10.0 0.0 20 100.0

Total number 268 377 669 2164 51,688 1565 8 56,739

Total percentage 0.5 0.7 1.2 3.8 91.1 2.8 0.0 100.0

68

Table A8.2: Percentage of liveborn babies, by gestational age and DHB region of mother’s place of residence, 2005

Live babies by gestational age (weeks) Total DHB region Less than

20 20–23 24–27 28–31 32–36 37–41 42

43 and over

Not stated No. %

Northland 0.1 0.1 0.3 1.0 5.9 88.9 2.7 0.1 1.0 1970 100.0

Waitemata 0.0 0.1 0.3 0.9 6.4 89.6 2.1 0.1 0.5 6740 100.0

Auckland 0.0 0.1 0.3 0.7 5.4 90.1 2.7 0.2 0.5 6276 100.0

Counties Manukau 0.1 0.2 0.2 1.0 5.6 88.6 3.1 0.3 1.0 7891 100.0

Waikato 0.0 0.1 0.6 0.7 5.2 85.7 5.9 0.5 1.3 4833 100.0

Lakes 0.0 0.1 0.5 0.8 5.6 88.3 3.5 0.0 1.2 1564 100.0

Bay of Plenty 0.0 0.2 0.3 1.1 6.5 85.0 2.6 0.0 4.3 2626 100.0

Tairawhiti 0.0 0.4 0.3 1.3 4.7 90.3 2.1 0.1 0.8 760 100.0

Hawke's Bay 0.0 0.1 0.4 0.7 5.4 81.1 4.0 1.6 6.8 2141 100.0

Taranaki 0.0 0.0 0.5 1.0 5.8 86.9 3.5 0.1 2.2 1369 100.0

MidCentral 0.0 0.0 0.3 1.0 6.3 88.8 2.8 0.1 0.6 2180 100.0

Whanganui 0.0 0.0 0.2 1.3 5.9 87.6 3.4 0.0 1.5 817 100.0

Capital & Coast 0.0 0.1 0.2 0.8 5.8 90.1 1.3 0.0 1.8 3673 100.0

Hutt Valley 0.0 0.0 0.5 1.4 6.5 87.5 2.5 0.2 1.4 1935 100.0

Wairarapa 0.0 0.0 0.0 0.2 5.7 92.2 0.7 0.0 1.1 437 100.0

Nelson Marlborough 0.0 0.1 0.2 0.5 6.5 89.2 2.3 0.0 1.1 1410 100.0

West Coast 0.0 0.0 0.0 0.9 3.9 86.7 1.8 0.0 6.7 330 100.0

Canterbury 0.0 0.1 0.4 0.8 5.7 90.4 1.7 0.1 0.9 5926 100.0

South Canterbury 0.0 0.3 0.3 0.5 6.5 86.6 3.8 0.0 1.9 584 100.0

Otago 0.0 0.1 0.2 1.0 6.6 90.0 1.3 0.1 0.9 1847 100.0

Southland 0.0 0.1 0.5 1.0 6.0 87.7 1.1 0.0 3.7 1410 100.0

Not stated 0.0 0.0 0.0 10.0 10.0 80.0 0.0 0.0 0.0 20 100.0

Total number 8 66 191 495 3303 50,179 1548 115 834 56,739

Total percentage 0.0 0.1 0.3 0.9 5.8 88.4 2.7 0.2 1.5 100.0

69

Figure A8.1: Average birthweight of female babies by ethnicity, 1999–2005

2.7

2.8

2.9

3.0

3.1

3.2

3.3

3.4

3.5

3.6

3.7

1999 2000 2001 2002 2003 2004 2005

Year

Average

birthweight (kg)

Māori Pacific peoples

Asian European

Figure A8.2: Average birthweight of male babies by ethnicity, 1999–2005

2.7

2.8

2.9

3.0

3.1

3.2

3.3

3.4

3.5

3.6

3.7

1999 2000 2001 2002 2003 2004 2005

Year

Average

birthweight (kg)

Māori Pacific peoples

Asian European

70

Figure A8.3: Rate of in-hospital neonatal deaths, by gestational age (under 37 weeks and 37 or more

weeks) and ethnicity, 2000–2005

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0

2000

2001

2002

2003

2004

2005

2000

2001

2002

2003

2004

2005

2000

2001

2002

2003

2004

2005

2000

2001

2002

2003

2004

2005

Māori Pacif ic peoples Asian European

Rate per 1000

live births37 or more w eeks

Less than 37 w eeks

71

Appendix 9 Fetal and Infant Mortality The three main sources of information for fetal and infant mortality data are medical certificates

from doctors or coroners, post-mortem reports from private pathologists and hospitals and death

registration forms which are usually completed by the funeral directors.

Figure A9.1: Classification of fetal and infant mortality

20 weeks or moreor 0-<7days 7-27 days 28 days-<1 year

400 grams birthweight

Early LateFetal deaths neonatal neonatal Post-neonatal

deaths deaths deaths

Neonatal deaths

Perinatal deaths

Infant deaths

Gestation Birth 7 days 28 days One year

Data source: NZHIS

Implications of the Births, Deaths, and Marriages Registration Act 1995 on the recording of fetal and infant deaths

The Births and Deaths Act 1951 was repealed on 31 August 1995 and replaced by the Births,

Deaths, and Marriages Act 1995 (the 1995 Act). The change in legislation fundamentally altered

the definition of ‘stillborn child’ (fetal death).

Before 1 September 1995, the legislation required that a certificate of cause of death be issued

for any fetal death of 20 or more weeks’ gestation, but a registration form was not required.

Registration forms were required only for fetuses of 28 or more weeks’ gestation. Fetal deaths of

20–27 weeks’ gestation were termed ‘intermediate fetal deaths’, and fetal deaths of 28 or more

weeks’ gestation were termed ‘late fetal deaths’ or ‘stillbirths’.

The 1995 Act (section 2) defines ‘stillborn child’ as:

a dead fetus that—

(a) Weighed 400g or more when it issued from its mother; or

(b) Issued from its mother after the 20th week of pregnancy.

Under the 1995 Act, a medical certificate of cause of death and a birth registration form must be

completed in respect of each ‘stillborn child’.

Further information on fetal and infant mortality can be found in the annual New Zealand Health

Information Service publication Fetal and Infant Deaths.

72

Appendix 10 Statistical Tables of Maternity Facilities Data on maternal facilities are extracted from the National Minimum Dataset (NMDS). Facilities

are grouped into tertiary, secondary and primary maternity facilities.

Data integrity

Any hospital that does not have a designated maternity contract and reported data in 2005 has been

reported in the ‘Other facilities’ group.

Note: Any facilities that did not have an event have not been presented.

Table A10.1: Number of total live and stillbirths, by facility, 2005


Facility No. %

No.

Rate per 1000 total births

Auckland City Hospital 7025 30.1 65 9.2

Christchurch Women's 4762 20.4 48 10.0

Dunedin 1654 7.1 16 9.6

Middlemore 4127 17.7 48 11.5

Waikato 2534 10.9 37 14.4

Wellington 3247 13.9 30 9.2

Tertiary Total 23,349 42.2 244 10.3

Gisborne 739 3.2 4 5.4

Grey Base Hospital 261 1.1 2 7.6

Hastings Memorial 1870 8.1 12 6.4

Hutt 1925 8.4 8 4.1

Masterton 413 1.8 2 4.8

Nelson 850 3.7 4 4.7

North Shore 3381 14.7 27 7.9

Palmerston North 1990 8.7 13 6.5

Rotorua 1341 5.8 15 11.1

Southland 1111 4.8 4 3.6

Taranaki Base 1114 4.9 5 4.5

Tauranga 1807 7.9 16 8.8

Timaru 577 2.5 3 5.2

Wairau 451 2.0 5 11.0

Waitakere 2471 10.8 7 2.8

Wanganui 648 2.8 5 7.7

Whakatane 676 2.9 4 5.9

Whangarei Area Hospital 1333 5.8 11 8.2

Secondary Total 22,958 41.5 147 6.4

Akaroa Community Hospital .. .. .. ..

Ashburton 163 1.8 0 0.0

Bay of Islands 223 2.5 0 0.0

Birthcare Auckland 272 3.0 0 0.0

Birthcare Huntly 163 1.8 0 0.0

Botany Downs Maternity Hospital 1568 17.4 0 0.0

Buller 26 0.3 0 0.0

Burwood 201 2.2 0 0.0

Charlotte Jean Maternity Unit 93 1.0 0 0.0

Clutha Health First 42 0.5 0 0.0

Dannevirke Community Hospital 72 0.8 0 0.0

Darfield 5 0.1 0 0.0

Dargaville 81 0.9 0 0.0

Elizabeth R Hospital and Rest Home 82 0.9 0 0.0

73

Table A10.1 (continued): Number of total live and stillbirths, by facility, 2005


Facility No. % No.

Rate per 1000 total births

Golden Bay Community Hospital 21 0.2 0 0.0

Gore Health Centre 64 0.7 0 0.0

Hawera 105 1.2 0 0.0

Helensville Birthing Unit 53 0.6 0 0.0

Hokianga 41 0.5 0 0.0

Horowhenua 114 1.3 0 0.0

Kaikoura .. .. .. ..

Kaitaia 162 1.8 0 0.0

Kapiti Medical Centre 105 1.2 0 0.0

Kenepuru 263 2.9 0 0.0

Lakes District 39 0.4 0 0.0

Lincoln 90 1.0 0 0.0

Matariki 135 1.5 0 0.0

Maternity Services Ltd 47 0.5 0 0.0

Murupara 18 0.2 0 0.0

Napier 155 1.7 0 0.0

Northern Southland Birthing Centre 42 0.5 0 0.0

Oamaru 70 0.8 0 0.0

Opotiki 49 0.5 0 0.0

Papakura Obstetric 1035 11.5 0 0.0

Pohlen Trust 116 1.3 0 0.0

Pukekohe 675 7.5 1 1.5

Rangiora 84 0.9 0 0.0

Rhoda Read 115 1.3 0 0.0

River Ridge (East) Birthing Centre 581 6.4 0 0.0

St Georges 543 6.0 0 0.0

Taihape 30 0.3 0 0.0

Taumarunui 83 0.9 0 0.0

Taupo General 204 2.3 0 0.0

Te Kuiti 60 0.7 0 0.0

Te Whare Hauora O Ngati Porou 23 0.3 0 0.0

Thames 106 1.2 0 0.0

Tokoroa 86 1.0 0 0.0

Tuatapere Maternity Hospital 18 0.2 0 0.0

Waihi Hospital 40 0.4 0 0.0

Waikari .. .. .. ..

Waimarino Health Centre 14 0.2 0 0.0

Waipukurau 20 0.2 0 0.0

Wairoa 43 0.5 0 0.0

Warkworth Birthing Centre 50 0.6 0 0.0

Waterford Birth Centre 474 5.3 0 0.0

Wellesford Birthing Unit 10 0.1 0 0.0

Winton Birthing Centre/Central Southland Birthing Unit 34 0.4 0 0.0

Primary Total 9012 16.3 2 0.2

Total 55,319 100.0 393 7.1

.. = data suppressed due to confidentiality reasons.

74

Table A10.2: Number and percentage of mothers, by mother’s ethnicity and facility, 2005

Percentage Facility Total number

Māori Pacific peoples Asian European Other Not stated Total %

Auckland City Hospital 6916 7.1 13.2 22.1 47.6 7.2 2.8 100

Christchurch Women’s 4718 7.7 3.3 5.7 80.6 2.1 0.6 100

Dunedin 1642 7.4 1.9 2.6 84.2 2.6 1.3 100

Middlemore 4119 24.0 49.8 12.4 9.5 3.3 1.1 100

Waikato 2508 23.5 2.1 5.8 65.2 3.0 0.4 100

Wellington 3206 12.0 9.2 9.1 66.5 2.9 0.2 100

Tertiary Total 23,109 12.7 15.2 12.0 54.7 4.1 1.3 100

Gisborne 735 54.8 3.7 2.0 36.6 2.0 0.8 100

Grey Base Hospital 261 11.1 0.4 1.5 85.1 1.1 0.8 100

Hastings Memorial 1841 38.6 5.5 2.5 51.6 1.0 0.8 100

Hutt 1906 20.9 10.3 7.3 59.8 1.4 0.3 100

Masterton 408 24.8 2.2 1.0 70.6 1.5 0.0 100

Nelson 837 8.7 1.6 3.9 85.2 0.4 0.2 100

North Shore 3353 8.7 5.6 15.7 66.7 3.0 0.4 100

Palmerston North 1963 16.8 3.0 3.2 75.4 1.0 0.6 100

Rotorua 1339 50.6 2.6 2.6 42.4 1.1 0.6 100

Southland 1094 11.9 2.1 2.4 80.4 2.6 0.6 100

Taranaki Base 1096 18.7 1.5 1.6 69.3 7.3 1.6 100

Tauranga 1795 24.4 2.1 4.4 66.6 0.8 1.7 100

Timaru 574 6.6 1.0 3.3 88.2 0.9 0.0 100

Wairau 452 11.3 2.7 3.1 82.3 0.2 0.4 100

Waitakere 2474 18.4 20.5 12.4 46.0 2.5 0.1 100

Wanganui 646 39.9 2.0 0.9 56.5 0.5 0.2 100

Whakatane 666 59.6 0.6 2.1 36.6 0.0 1.1 100

Whangarei Area Hospital 1318 40.2 1.0 2.7 50.8 1.7 3.6 100

Secondary Total 22,758 24.2 5.5 6.1 61.5 1.9 0.8 100

Akaroa Community Hospital 2 0.0 0.0 0.0 100.0 0.0 0.0 100

Ashburton 163 5.5 1.8 1.8 87.7 1.8 1.2 100

Bay of Islands 223 67.7 2.2 1.8 27.4 0.0 0.9 100

75

Table A10.2 (continued): Number and percentage of mothers, by mother’s ethnicity and facility, 2005



Birthcare Auckland 272 9.2 14.7 4.8 67.6 3.7 0.0 100

Birthcare Huntly 163 63.2 2.5 0.6 31.3 0.0 2.5 100

Botany Downs Maternity Hospital 1557 17.2 26.5 16.5 33.8 4.3 1.6 100

Buller 26 15.4 0.0 0.0 84.6 0.0 0.0 100

Burwood 201 18.4 6.0 2.0 70.6 2.0 1.0 100

Charlotte Jean Maternity Unit 93 8.6 1.1 1.1 87.1 0.0 2.2 100

Clutha Health First 42 21.4 0.0 2.4 71.4 2.4 2.4 100

Dannevirke Community Hospital 72 36.1 0.0 0.0 63.9 0.0 0.0 100

Darfield 5 0.0 0.0 0.0 100.0 0.0 0.0 100

Dargaville 81 42.0 3.7 1.2 50.6 0.0 2.5 100

Elizabeth R Hospital and Rest Home 82 22.0 0.0 2.4 74.4 0.0 1.2 100

Golden Bay Community Hospital 21 4.8 0.0 0.0 90.5 0.0 4.8 100

Gore Health Centre 64 20.3 0.0 0.0 78.1 0.0 1.6 100

Hawera 105 30.5 0.0 0.0 56.2 11.4 1.9 100

Helensville Birthing Unit 53 24.5 0.0 0.0 73.6 0.0 1.9 100

Hokianga 41 87.8 0.0 0.0 12.2 0.0 0.0 100

Horowhenua 114 28.1 9.6 0.9 51.8 0.0 9.6 100

Kaikoura 1 0.0 0.0 0.0 100.0 0.0 0.0 100

Kaitaia 159 69.2 0.6 0.6 29.6 0.0 0.0 100

Kapiti Medical Centre 105 21.0 1.9 2.9 73.3 0.0 1.0 100

Kenepuru 263 35.4 27.0 2.7 34.6 0.0 0.4 100

Lakes District 39 2.6 0.0 10.3 87.2 0.0 0.0 100

Lincoln 90 8.9 2.2 0.0 83.3 1.1 4.4 100

Matariki 135 26.7 0.7 2.2 63.0 3.7 3.7 100

Maternity Services Ltd 47 12.8 0.0 2.1 66.0 0.0 19.1 100

Murupara 18 88.9 0.0 0.0 11.1 0.0 0.0 100

Napier 154 27.9 4.5 1.9 63.6 1.3 0.6 100

Northern Southland Birthing Centre 42 4.8 0.0 2.4 88.1 4.8 0.0 100

Oamaru 70 2.9 2.9 1.4 91.4 1.4 0.0 100

Opotiki 49 81.6 6.1 0.0 8.2 0.0 4.1 100

76

Table A10.2 (continued): Number and percentage of mothers, by mother’s ethnicity and facility, 2005



Papakura Obstetric 1030 43.4 12.5 5.5 33.6 4.1 0.9 100

Pohlen Trust 116 28.4 0.0 0.0 63.8 0.0 7.8 100

Pukekohe 669 22.9 4.3 4.2 64.7 3.3 0.6 100

Rangiora 84 10.7 0.0 1.2 86.9 0.0 1.2 100

Rhoda Read 115 18.3 0.0 0.9 71.3 3.5 6.1 100

River Ridge (East) Birthing Centre 581 27.0 4.0 5.5 60.8 1.7 1.0 100

St Georges 538 5.4 2.0 5.6 84.8 1.9 0.4 100

Taihape 30 36.7 3.3 0.0 53.3 3.3 3.3 100

Taumarunui 83 51.8 0.0 0.0 43.4 3.6 1.2 100

Taupo General 204 48.0 3.4 2.9 42.6 2.9 0.0 100

Te Kuiti 60 53.3 0.0 0.0 45.0 0.0 1.7 100

Te Whare Hauora O Ngati Porou 23 91.3 4.3 0.0 4.3 0.0 0.0 100

Thames 106 33.0 0.0 4.7 59.4 0.9 1.9 100

Tokoroa 86 69.8 14.0 0.0 16.3 0.0 0.0 100

Tuatapere Maternity Hospital 18 38.9 0.0 0.0 61.1 0.0 0.0 100

Waihi Hospital 40 42.5 0.0 2.5 47.5 0.0 7.5 100

Waikari 2 50.0 0.0 0.0 50.0 0.0 0.0 100

Waimarino Health Centre 14 78.6 0.0 0.0 21.4 0.0 0.0 100

Waipukurau 20 55.0 0.0 0.0 45.0 0.0 0.0 100

Wairoa 43 74.4 0.0 0.0 18.6 4.7 2.3 100

Warkworth Birthing Centre 50 16.0 2.0 4.0 74.0 0.0 4.0 100

Waterford Birth Centre 474 32.7 4.0 5.3 56.3 1.7 0.0 100

Wellesford Birthing Unit 10 70.0 0.0 0.0 30.0 0.0 0.0 100

Winton Birthing Centre/Central Southland Birthing Unit 34 11.8 0.0 0.0 88.2 0.0 0.0 100

Primary Total 8982 28.9 9.1 5.6 52.6 2.4 1.4 100

Total 54,849 20.2 10.2 8.5 57.2 2.9 1.1 100

77

Table A10.3: Live births, by facility and DHB region of mother’s place of residence, 2005

DHB region

Facility

Nort

hla

nd

Waitem

ata

Auckla

nd

Counties M

anukau

Waik

ato

Lakes

Bay o

f P

lenty

Tair

aw

hiti

Haw

ke’s

Bay

Tara

naki

Mid

Centr

al

Whanganui

Capital &

Coast

Hutt V

alle

y

Wairara

pa

Nels

on M

arl

boro

ugh

West C

oast

Cante

rbury

South

Can

terb

ury

Ota

go

South

land

Not sta

ted

Tota

l

Auckland City Hospital 24 943 4887 1070 20 4 7 1 2 3 40 3 4 4 0 3 0 1 0 1 5 3 7025

Christchurch Women's 1 0 0 0 1 0 0 0 3 2 0 1 1 0 0 7 25 4685 7 9 20 0 4762

Dunedin 0 2 1 1 0 0 0 0 0 0 1 0 0 0 0 0 2 12 3 1567 55 10 1654

Middlemore 5 14 478 3612 8 3 0 0 1 1 3 0 1 0 0 0 0 0 0 0 0 1 4127

Waikato 2 2 5 7 2429 34 38 7 0 8 0 1 1 0 0 0 0 0 0 0 0 0 2534

Wellington 0 1 1 0 0 0 2 1 24 1 37 10 3022 121 16 9 0 1 0 0 0 1 3247

Tertiary Total 32 962 5372 4690 2458 41 47 9 30 15 81 15 3029 125 16 19 27 4699 10 1577 80 15 23,349

Gisborne 0 1 0 1 0 1 1 709 25 0 0 1 0 0 0 0 0 0 0 0 0 0 739

Grey Base Hospital 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 256 1 0 0 0 2 261

Hastings Memorial 0 0 1 1 0 0 0 0 1860 0 7 1 0 0 0 0 0 0 0 0 0 0 1870

Hutt 0 0 0 0 0 0 0 0 0 0 1 0 140 1768 15 1 0 0 0 0 0 0 1925

Masterton 0 0 0 0 0 0 0 0 1 0 15 0 1 1 395 0 0 0 0 0 0 0 413

Nelson 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 846 0 1 0 0 0 0 850

North Shore 14 3224 100 23 4 2 2 0 2 0 0 1 1 0 0 0 0 4 0 1 1 2 3381

Palmerston North 0 4 3 3 4 2 1 1 6 5 1817 120 9 0 10 1 0 2 0 2 0 0 1990

Rotorua 9 0 2 3 17 1243 61 0 2 0 0 2 0 1 0 0 0 0 0 0 1 0 1341

Southland 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 3 0 17 1087 2 1111

Taranaki Base 0 0 0 0 3 0 0 0 1 1108 0 0 1 0 0 0 0 0 0 0 0 1 1114

Tauranga 0 2 1 2 69 6 1726 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1807

Timaru 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 9 553 12 1 0 577

Wairau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444 0 6 0 0 0 1 451

Waitakere 4 2245 206 9 4 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 2471

Wanganui 0 0 0 0 1 1 0 0 1 32 5 607 1 0 0 0 0 0 0 0 0 0 648

Whakatane 1 1 1 2 1 7 661 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 676

Whangarei Area Hospital 1305 9 6 7 2 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 1333

Secondary Total 1333 5487 320 53 105 1262 2452 711 1901 1147 1846 733 154 1770 420 1294 258 28 553 32 1091 8 22,958

Akaroa Community Hospital 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 2

78

Table A10.3 (continued): Live births, by facility and DHB region of mother’s place of residence, 2005

DHB region

Facility

Nort

hla

nd

Waitem

ata

Auckla

nd

Counties M

anukau

Waik

ato

Lakes

Bay o

f P

lenty

Tair

aw

hiti

Haw

kes B

ay

Tara

naki

Mid

Centr

al

Whanganui

Capital &

Coast

Hutt V

alle

y

Wairara

pa

Nels

on M

arl

boro

ugh

West C

oast

Cante

rbury

South

Can

terb

ury

Ota

go

South

land

Not sta

ted

Tota

l

Ashburton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 1 0 0 0 163

Bay of Islands 218 1 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 223

Birthcare Auckland 1 55 190 25 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272

Birthcare Huntly 0 0 0 1 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 163

Botany Downs Maternity Hospital 1 3 121 1433 2 2 0 0 0 2 1 1 0 0 0 0 0 0 0 0 0 2 1568

Buller 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 2 26

Burwood 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 201

Charlotte Jean Maternity Unit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 5 0 93

Clutha Health First 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 42

Dannevirke Community Hospital 0 0 0 0 0 0 0 0 1 0 71 0 0 0 0 0 0 0 0 0 0 0 72

Darfield 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 5

Dargaville 79 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 81

Elizabeth R Hospital and Rest Home 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 82

Golden Bay Community Hospital 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 21

Gore Health Centre 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 60 0 64

Hawera 0 0 0 0 0 0 0 0 0 104 0 1 0 0 0 0 0 0 0 0 0 0 105

Helensville Birthing Unit 1 50 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53

Hokianga 40 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 41

Horowhenua 0 0 0 1 0 0 0 0 0 0 112 0 1 0 0 0 0 0 0 0 0 0 114

Kaitaia 161 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162

Kapiti Medical Centre 0 0 0 0 0 0 0 0 0 0 8 0 97 0 0 0 0 0 0 0 0 0 105

Kenepuru 0 0 0 0 1 0 0 0 0 0 1 0 259 2 0 0 0 0 0 0 0 0 263

Lakes District 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 38 0 39

Lincoln 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 1 0 90

Matariki 0 0 0 0 134 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 135

Maternity Services Ltd 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 47

Murupara 0 0 0 0 0 1 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18

79


DHB region

Facility

Nort

hla

nd

Waitem

ata

Auckla

nd

Counties M

anukau

Waik

ato

Lakes

Bay o

f P

lenty

Tair

aw

hiti

Haw

kes B

ay

Tara

naki

Mid

Centr

al

Whanganui

Capital &

Coast

Hutt V

alle

y

Wairara

pa

Nels

on M

arl

boro

ugh

West C

oast

Cante

rbury

South

Can

terb

ury

Ota

go

South

land

Not sta

ted

Tota

l

Napier 0 0 1 0 0 0 0 0 153 0 1 0 0 0 0 0 0 0 0 0 0 0 155

Northern Southland Birthing Centre 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 39 0 42

Oamaru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 67 0 0 70

Opotiki 0 0 0 1 0 1 46 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 49

Papakura Obstetric 2 0 10 1017 3 1 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1035

Pohlen Trust 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116

Pukekohe 0 0 1 651 14 0 0 0 0 0 2 6 0 0 0 0 0 0 0 0 0 1 675

Rangiora 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 1 0 84

Rhoda Read 0 1 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115

River Ridge (East) Birthing Centre 0 0 1 1 573 2 1 0 0 0 0 0 1 0 0 0 0 2 0 0 0 0 581

St Georges 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 536 0 3 2 0 543

Taihape 0 0 0 0 0 0 0 0 0 0 1 29 0 0 0 0 0 0 0 0 0 0 30

Taumarunui 0 0 0 0 80 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 83

Taupo General 0 0 0 0 3 198 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 204

Te Kuiti 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60

Te Whare Hauora O Ngati Porou 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23

Thames 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106

Tokoroa 0 0 0 0 76 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86

Tuatapere Maternity Hospital 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 18

Waihi Hospital 0 0 0 0 27 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40

Waikari 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 2

Waimarino Health Centre 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 14

Waipukurau 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 20

Wairoa 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 43

Warkworth Birthing Centre 4 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50

Waterford Birth Centre 0 0 0 1 465 1 0 0 0 1 0 0 0 0 0 1 0 1 2 1 1 0 474

80


DHB region

Facility

Nort

hla

nd

Waitem

ata

Auckla

nd

Counties M

anukau

Waik

ato

Lakes

Bay o

f P

lenty

Tair

aw

hiti

Haw

kes B

ay

Tara

naki

Mid

Centr

al

Whanganui

Capital &

Coast

Hutt V

alle

y

Wairara

pa

Nels

on M

arl

boro

ugh

West C

oast

Cante

rbury

South

Can

terb

ury

Ota

go

South

land

Not sta

ted

Tota

l

Wellesford Birthing Unit 2 7 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 10Winton Birthing Centre/Central Southland Birthing Unit

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 34

Primary Total 509 163 326 3135 1938 218 79 23 217 189 201 52 361 3 1 69 27 1084 6 206 200 5 9012

Total 1874 6612 6018 7878 4501 1521 2578 743 2148 1351 2128 800 3544 1898 437 1382 312 5811 569 1815 1371 28 55,319

81

Table A10.4: Number of antenatal hospital admissions and average length of stay, by facility, 2005

Facility Number of antenatal

admissions Average length of

stay (days)

Auckland City Hospital 2775 1.2

Christchurch 132 1.4

Christchurch Women’s 1375 1.7

Dunedin 543 1.9

Middlemore 3094 1.1

Waikato 1514 2.4

Wellington 661 2.4

Tertiary Total 10,094 1.5

Gisborne 268 1.6

Grey Base Hospital 106 1.3

Hastings Memorial 574 1.9

Hutt 528 1.0

Masterton 150 0.8

Nelson 204 2.0

North Shore 1005 1.1

Palmerston North 622 1.8

Rotorua 429 1.2

Southland 334 1.4

Taranaki Base 351 1.4

Tauranga 532 1.4

Timaru 311 1.5

Wairau 111 0.9

Waitakere 443 0.6

Wanganui 207 1.4

Whakatane 254 1.2

Whangarei Area Hospital 451 1.7

Secondary Total 6880 1.4

Akaroa Community Hospital .. ..

Ashburton 86 0.6

Bay of Islands 116 0.4

Birthcare Auckland 20 0.2

Birthcare Huntly 6 0.3

Botany Downs Maternity Hospital 7 0.4

Buller 15 0.2

Burwood 53 0.2

Charlotte Jean Maternity Unit 5 0.2

Clutha Health First 11 0.6

Dannevirke Community Hospital 38 0.6

Darfield 1 1.0

Dargaville 48 0.5

Golden Bay Community Hospital 6 0.3

Gore Health Centre 20 0.5

Hawera 21 0.4

Hokianga 9 0.9

82

Table A10.4 (continued): Number of antenatal hospital admissions and average length of stay, by facility,

2005

Facility Number of antenatal

admissions Average length of

stay (days)

Horowhenua 39 0.3

Kaikoura .. ..

Kaitaia 52 0.4

Kapiti Medical Centre 21 0.3

Kenepuru 54 0.6

Lakes District 24 0.5

Lincoln 19 0.1

Matariki 30 1.3

Maternity Services Ltd 1 0.0

Northern Southland Birthing Centre 13 0.1

Oamaru 51 0.4

Opotiki 9 0.7

Otaki Birthing Centre 1 0.0

Papakura Obstetric 12 0.5

Pohlen Trust 27 0.1

Pukekohe 5 0.8

Rangiora 22 0.4

Rhoda Read 42 0.2

River Ridge (East) Birthing Centre 25 0.3

St Georges 54 0.5

Taihape 13 0.8

Taumarunui 15 0.5

Taupo General 79 0.3

Te Kuiti 7 1.0

Te Whare Hauora O Ngati Porou 2 0.0

Thames 68 0.4

Tokoroa 82 0.2

Tuatapere Maternity Hospital 4 0.8

Waimarino Health Centre 1 1.0

Waipukurau 2 0.0

Wairoa 16 0.6

Waterford Birth Centre 2 2.5

Winton Birthing Centre/Central Southland Birthing Unit 11 0.5

Primary Total 1269 0.4

Other facilities Total 129 8.4

Total 18,372 1.4


83

Table A10.5: Number and percentage of mothers, by type of hospital birth and facility, 2005


Facility Total

number Normal


Breech birth Total

Assisted breech

birth Forceps

Forceps and

vacuum extraction

Vacuum extraction

Total %

Auckland City Hospital 6916 53.7 31.4 18.9 12.5 0.2 14.8 0.4 4.2 0.0 10.1 100

Christchurch Women’s 4718 56.4 28.2 18.8 9.4 0.1 15.3 0.4 6.1 0.4 8.4 100

Dunedin 1642 58.2 31.8 18.6 13.2 0.1 9.9 0.1 3.5 0.0 6.3 100

Middlemore 4119 73.5 18.6 13.4 5.1 0.5 7.4 0.2 1.0 0.0 6.1 100

Waikato 2508 54.6 31.9 17.6 14.4 0.9 12.6 0.4 3.3 0.1 8.7 100

Wellington 3206 56.6 30.7 20.4 10.3 0.1 12.6 0.3 5.9 0.1 6.4 100

Tertiary Total 23,109 58.6 28.4 17.9 10.5 0.3 12.7 0.3 4.1 0.1 8.1 100

Gisborne 735 75.9 20.1 10.9 9.3 0.4 3.5 0.0 0.3 0.0 3.3 100

Grey Base Hospital 261 69.3 22.6 11.1 11.5 0.4 7.7 0.0 1.9 0.4 5.4 100

Hastings Memorial 1841 69.0 24.3 15.4 8.9 0.5 6.2 0.3 4.5 0.0 1.5 100

Hutt 1906 64.8 25.8 15.2 10.6 0.0 9.3 0.2 5.8 0.1 3.3 100

Masterton 408 64.2 25.2 14.0 11.3 0.2 10.3 0.0 2.2 0.5 7.6 100

Nelson 837 65.7 26.2 14.1 12.1 0.2 7.9 0.1 7.0 0.0 0.7 100

North Shore 3353 59.7 28.2 14.8 13.5 0.2 11.9 0.2 1.8 0.4 9.5 100

Palmerston North 1963 64.7 26.1 17.8 8.3 0.1 9.1 0.3 1.2 0.0 7.6 100

Rotorua 1339 71.9 22.3 12.2 10.1 0.3 5.5 0.1 1.4 0.3 3.7 100

Southland 1094 61.7 32.1 18.3 13.8 0.1 6.1 0.1 2.1 0.0 3.9 100

Taranaki Base 1096 65.8 29.8 17.6 12.2 0.1 4.3 0.1 2.0 0.0 2.2 100

Tauranga 1795 65.4 25.3 14.8 10.5 0.2 9.1 0.4 2.6 0.0 6.2 100

Timaru 574 68.3 23.2 12.7 10.5 0.0 8.5 0.7 5.7 0.0 2.1 100

Wairau 452 64.6 27.7 17.3 10.4 0.4 7.3 0.2 4.4 0.0 2.7 100

Waitakere 2474 72.2 20.0 12.4 7.6 0.1 7.7 0.0 1.2 0.1 6.4 100

Wanganui 646 76.2 16.9 9.6 7.3 0.3 6.7 0.2 2.3 0.2 4.0 100

Whakatane 666 71.9 19.7 11.1 8.6 1.2 7.2 0.0 3.2 0.0 4.1 100

Whangarei Area Hospital 1318 72.9 21.5 14.5 7.0 0.2 5.4 0.2 1.7 0.1 3.3 100

Secondary Total 22,758 67.1 24.8 14.5 10.2 0.2 7.9 0.2 2.6 0.1 5.0 100

Akaroa Community Hospital .. .. .. .. .. .. .. .. .. .. .. ..

84

Table A10.5 (continued): Number and percentage of mothers, by type of hospital birth and facility, 2005


Facility Total

number Normal


Breech birth Total

Assisted breech

birth Forceps

Forceps and

vacuum extraction

Vacuum extraction

Total %

Ashburton 163 87.1 0.0 0.0 0.0 0.0 12.9 0.0 2.5 0.0 10.4 100

Bay of Islands 223 99.6 0.0 0.0 0.0 0.4 0.0 0.0 0.0 0.0 0.0 100

Birthcare Auckland 272 99.6 0.0 0.0 0.0 0.0 0.4 0.4 0.0 0.0 0.0 100

Birthcare Huntly 163 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Botany Downs Maternity Hospital 1557 77.0 15.0 8.5 6.4 0.0 8.0 0.1 1.5 0.1 6.3 100

Buller 26 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Burwood 201 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Charlotte Jean Maternity Unit 93 98.9 0.0 0.0 0.0 0.0 1.1 0.0 0.0 0.0 1.1 100

Clutha Health First 42 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Dannevirke Community Hospital 72 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Darfield 5 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Dargaville 81 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Elizabeth R Hospital and Rest Home 82 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Golden Bay Community Hospital 21 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Gore Health Centre 64 95.3 0.0 0.0 0.0 0.0 4.7 3.1 1.6 0.0 0.0 100

Hawera 105 96.2 0.0 0.0 0.0 0.0 3.8 0.0 3.8 0.0 0.0 100

Helensville Birthing Unit 53 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Hokianga 41 97.6 0.0 0.0 0.0 0.0 2.4 0.0 2.4 0.0 0.0 100

Horowhenua 114 99.1 0.0 0.0 0.0 0.0 0.9 0.0 0.9 0.0 0.0 100

Kaikoura .. .. .. .. .. .. .. .. .. .. .. ..

Kaitaia 159 99.4 0.0 0.0 0.0 0.6 0.0 0.0 0.0 0.0 0.0 100

Kapiti Medical Centre 105 98.1 1.0 1.0 0.0 0.0 1.0 0.0 1.0 0.0 0.0 100

Kenepuru 263 98.9 1.1 1.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Lakes District 39 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Lincoln 90 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Matariki 135 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Maternity Services Ltd 47 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

85



Facility Total

number Normal


Breech birth Total

Assisted breech

birth Forceps

Forceps and

vacuum extraction

Vacuum extraction

Total %

Murupara 18 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Napier 154 80.5 14.3 7.8 6.5 0.6 4.5 0.0 4.5 0.0 0.0 100

Northern Southland Birthing Centre 42 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Oamaru 70 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Opotiki 49 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Papakura Obstetric 1030 81.8 11.6 6.2 5.3 0.0 6.6 0.1 1.0 0.1 5.4 100

Pohlen Trust 116 94.8 0.0 0.0 0.0 0.9 4.3 0.0 0.9 0.0 3.4 100

Pukekohe 669 73.4 19.0 9.4 9.6 0.0 7.6 0.1 0.6 0.3 6.6 100

Rangiora 84 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Rhoda Read 115 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

River Ridge (East) Birthing Centre 581 99.7 0.0 0.0 0.0 0.0 0.3 0.0 0.0 0.0 0.3 100

St Georges 538 41.1 58.7 0.0 58.7 0.0 0.2 0.0 0.2 0.0 0.0 100

Taihape 30 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Taumarunui 83 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Taupo General 204 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Te Kuiti 60 98.3 0.0 0.0 0.0 0.0 1.7 0.0 0.0 0.0 1.7 100

Te Whare Hauora O Ngati Porou 23 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Thames 106 99.1 0.0 0.0 0.0 0.0 0.9 0.0 0.0 0.0 0.9 100

Tokoroa 86 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Tuatapere Maternity Hospital 18 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Waihi Hospital 40 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Waikari .. .. .. .. .. .. .. .. .. .. .. ..

Waimarino Health Centre 14 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Waipukurau 20 95.0 5.0 0.0 5.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Wairoa 43 95.3 0.0 0.0 0.0 0.0 4.7 0.0 0.0 0.0 4.7 100

Warkworth Birthing Centre 50 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Waterford Birth Centre 474 99.6 0.0 0.0 0.0 0.4 0.0 0.0 0.0 0.0 0.0 100

86



Facility Total

number Normal


Breech birth Total

Assisted breech

birth Forceps

Forceps and

vacuum extraction

Vacuum extraction

Total %

Wellesford Birthing Unit 10 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Winton Birthing Centre/Central Southland Birthing Unit 34 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100

Primary Total 8982 87.5 9.2 3.1 6.1 0.1 3.3 0.1 0.7 0.0 2.5 100

Total 54,849 66.8 23.8 14.1 9.7 0.2 9.2 0.2 2.9 0.1 5.9 100

.. = data suppressed because of confidentiality reasons.

87

Table A10.6: Number and rate of inductions, epidurals and episiotomies, by facility, 2005

Number Rate Facility

Inductions Epidurals Episiotomies Inductions* Epidurals* Episiotomies†

Auckland City Hospital 1684 3126 1108 27.8 51.7 23.4

Christchurch Women's 1000 1733 774 23.4 40.5 22.9

Dunedin 395 492 125 27.7 34.5 11.2

Middlemore 577 724 257 14.8 18.5 7.7

Waikato 576 684 145 26.8 31.8 8.5

Wellington 795 1461 467 27.6 50.8 21.0

Tertiary Total 5027 8220 2876 24.3 39.7 17.4

Gisborne 88 63 20 13.2 9.4 3.4

Grey Base Hospital 62 18 21 26.8 7.8 10.4

Hastings Memorial 215 515 159 12.8 30.7 11.4

Hutt 401 545 220 23.5 32.0 15.6

Masterton 83 74 44 22.9 20.4 14.4

Nelson 155 322 97 21.1 43.8 15.7

North Shore 717 1272 343 24.7 43.8 14.3

Palmerston North 341 487 127 18.9 27.1 8.8

Rotorua 167 76 62 13.9 6.3 6.0

Southland 295 94 105 31.3 10.0 14.1

Taranaki Base 281 92 72 29.2 9.6 9.4

Tauranga 347 363 131 21.6 22.6 9.8

Timaru 128 134 53 24.9 26.1 12.0

Wairau 105 211 42 25.9 52.1 12.8

Waitakere 454 722 208 19.9 31.6 10.5

Wanganui 148 125 32 24.7 20.9 6.0

Whakatane 112 95 27 18.4 15.6 5.0

Whangarei Area Hospital 328 219 46 26.8 17.9 4.4

Secondary Total 4427 5427 1809 21.7 26.6 10.6

Ashburton 9 20 7 5.5 12.3 4.3

Bay of Islands 2 0 0 0.9 0.0 0.0

Birthcare Auckland 0 1 10 0.0 0.4 3.7

Botany Downs Maternity Hospital 157 272 140 10.8 18.7 10.6

Buller 0 1 1 0.0 3.8 3.8

Burwood 0 0 3 0.0 0.0 1.5

Dannevirke Community Hospital 0 0 1 0.0 0.0 1.4

Gore Health Centre 4 0 14 6.3 0.0 21.9

Hawera 0 0 9 0.0 0.0 8.6

Hokianga 0 0 1 0.0 0.0 2.4

Horowhenua 1 0 2 0.9 0.0 1.8

Kaitaia 0 0 3 0.0 0.0 1.9

Kapiti Medical Centre 1 2 4 1.0 1.9 3.8

Kenepuru 1 2 5 0.4 0.8 1.9

Lincoln 0 0 3 0.0 0.0 3.3

Napier 7 30 8 4.9 20.8 6.1

Northern Southland Birthing Centre 0 0 1 0.0 0.0 2.4

Oamaru 1 0 0 1.4 0.0 0.0

Opotiki 0 0 3 0.0 0.0 6.1

88

Table A10.6 (continued): Number and rate of inductions, epidurals and episiotomies, by facility, 2005

Number Rate Facility

Inductions Epidurals Episiotomies Inductions* Epidurals* Episiotomies†

Papakura Obstetric 97 150 68 9.9 15.4 7.5

Pohlen Trust 4 0 6 3.4 0.0 5.2

Pukekohe 62 125 44 10.2 20.7 8.1

Rangiora 0 0 2 0.0 0.0 2.4

River Ridge (East) Birthing Centre 0 0 16 0.0 0.0 2.8

St Georges 10 0 11 4.5 0.0 5.0

Taupo General 0 0 6 0.0 0.0 2.9

Waterford Birth Centre 5 0 11 1.1 0.0 2.3

Winton Birthing Centre/Central Southland Birthing Unit 0 0 3

0.0 0.0 8.8

Primary Total 361 603 382 4.3 7.1 4.7

Total 9,815 14,250 5067 19.8 28.8 12.1

* Rate per 100 deliveries (excluding elective caesarean sections). † Rate per 100 vaginal deliveries.

89

Table A10.7: Number and percentage of mothers, by patient clinical complexity level (PCCL) and facility,

2005

Percentage Facility

Total number PCCL

0 PCCL

1 PCCL

2 PCCL

3 PCCL

4

Auckland City Hospital 6916 68.5 0.0 16.8 11.3 3.3

Christchurch Women’s 4718 75.5 0.0 15.2 7.6 1.8

Dunedin 1642 78.6 0.1 11.8 7.8 1.8

Middlemore 4119 78.6 0.0 11.7 8.1 1.6

Waikato 2508 72.8 0.0 15.5 9.7 2.0

Wellington 3206 79.2 0.0 12.5 6.8 1.4

Tertiary Total 23,109 74.4 0.0 14.5 8.9 2.2

Gisborne 735 83.3 0.0 10.5 5.4 0.8

Grey Base Hospital 261 87.7 0.0 7.7 4.2 0.4

Hastings Memorial 1841 85.2 0.0 8.3 5.7 0.9

Hutt 1906 81.8 0.0 11.7 5.8 0.7

Masterton 408 91.9 0.0 5.1 2.7 0.2

Nelson 837 84.7 0.0 9.8 4.7 0.8

North Shore 3353 77.4 0.0 14.9 6.6 1.1

Palmerston North 1963 82.0 0.0 9.7 6.5 1.8

Rotorua 1339 80.4 0.0 11.7 7.2 0.7

Southland 1094 77.7 0.0 14.2 6.9 1.3

Taranaki Base 1096 78.9 0.0 13.3 5.7 2.0

Tauranga 1795 80.2 0.1 11.9 7.0 0.9

Timaru 574 84.5 0.0 10.1 4.5 0.9

Wairau 452 80.3 0.0 13.9 4.6 1.1

Waitakere 2474 82.1 0.0 12.2 5.1 0.6

Wanganui 646 79.3 0.0 11.8 7.0 2.0

Whakatane 666 80.8 0.0 11.6 6.9 0.8

Whangarei Area Hospital 1318 78.3 0.0 12.5 7.1 2.0

Secondary Total 22,758 81.1 0.0 11.8 6.1 1.1

Akaroa Community Hospital .. .. .. .. .. ..

Ashburton 163 88.3 0.0 9.2 2.5 0.0

Bay of Islands 223 94.6 0.0 3.6 1.8 0.0

Birthcare Auckland 272 99.3 0.0 0.4 0.4 0.0

Birthcare Huntly 163 98.2 0.0 0.6 1.2 0.0

Botany Downs Maternity Hospital 1557 88.1 0.0 8.2 3.2 0.4

Buller 26 88.5 0.0 3.8 7.7 0.0

Burwood 201 99.0 0.0 1.0 0.0 0.0

Charlotte Jean Maternity Unit 93 98.9 0.0 1.1 0.0 0.0

Clutha Health First 42 100.0 0.0 0.0 0.0 0.0

Dannevirke Community Hospital 72 100.0 0.0 0.0 0.0 0.0

Darfield 5 100.0 0.0 0.0 0.0 0.0

Dargaville 81 93.8 0.0 6.2 0.0 0.0

Elizabeth R Hospital and Rest Home 82 100.0 0.0 0.0 0.0 0.0

Golden Bay Community Hospital 21 100.0 0.0 0.0 0.0 0.0

Gore Health Centre 64 96.9 0.0 0.0 3.1 0.0

Hawera 105 89.5 0.0 9.5 1.0 0.0

Helensville Birthing Unit 53 100.0 0.0 0.0 0.0 0.0

90

Table A10.7 (continued): Number and percentage of mothers, by patient clinical complexity level (PCCL)

and facility, 2005

Percentage Facility

Total number PCCL

0 PCCL

1 PCCL

2 PCCL

3 PCCL

4

Hokianga 41 95.1 0.0 2.4 2.4 0.0

Horowhenua 114 98.2 0.0 1.8 0.0 0.0

Kaikoura .. .. .. .. .. ..

Kaitaia 159 91.8 0.0 6.9 1.3 0.0

Kapiti Medical Centre 105 98.1 0.0 1.9 0.0 0.0

Kenepuru 263 98.9 0.0 1.1 0.0 0.0

Lakes District 39 94.9 0.0 5.1 0.0 0.0

Lincoln 90 100.0 0.0 0.0 0.0 0.0

Matariki 135 98.5 0.0 0.7 0.7 0.0

Maternity Services Ltd 47 100.0 0.0 0.0 0.0 0.0

Murupara 18 94.4 0.0 0.0 5.6 0.0

Napier 154 98.1 0.0 1.3 0.6 0.0

Northern Southland Birthing Centre 42 97.6 0.0 2.4 0.0 0.0

Oamaru 70 97.1 0.0 1.4 1.4 0.0

Opotiki 49 98.0 0.0 2.0 0.0 0.0

Papakura Obstetric 1030 89.6 0.0 5.0 5.0 0.5

Pohlen Trust 116 99.1 0.0 0.9 0.0 0.0

Pukekohe 669 84.5 0.0 10.2 4.8 0.6

Rangiora 84 95.2 0.0 3.6 1.2 0.0

Rhoda Read 115 98.3 0.0 1.7 0.0 0.0

River Ridge (East) Birthing Centre 581 99.0 0.0 0.5 0.5 0.0

St Georges 538 89.0 0.0 7.1 3.5 0.4

Taihape 30 96.7 0.0 3.3 0.0 0.0

Taumarunui 83 98.8 0.0 1.2 0.0 0.0

Taupo General 204 99.0 0.0 0.5 0.5 0.0

Te Kuiti 60 100.0 0.0 0.0 0.0 0.0

Te Whare Hauora O Ngati Porou 23 100.0 0.0 0.0 0.0 0.0

Thames 106 96.2 0.0 1.9 1.9 0.0

Tokoroa 86 94.2 0.0 4.7 1.2 0.0

Tuatapere Maternity Hospital 18 100.0 0.0 0.0 0.0 0.0

Waihi Hospital 40 97.5 0.0 2.5 0.0 0.0

Waikari .. .. .. .. .. ..

Waimarino Health Centre 14 92.9 0.0 7.1 0.0 0.0

Waipukurau 20 95.0 0.0 0.0 5.0 0.0

Wairoa 43 100.0 0.0 0.0 0.0 0.0

Warkworth Birthing Centre 50 100.0 0.0 0.0 0.0 0.0

Waterford Birth Centre 474 98.7 0.0 0.4 0.8 0.0

Wellesford Birthing Unit 10 100.0 0.0 0.0 0.0 0.0

Winton Birthing Centre/Central Southland Birthing Unit 34 100.0 0.0 0.0 0.0 0.0

Primary Total 8982 93.5 0.0 4.2 2.1 0.2

Total 54,849 44,039 6 6400 3636 768


91

Table A10.8: Average length of stay (days) for mothers, by patient clinical complexity level (PCCL) and

facility, 2005

Average length of stay (days) Facility PCCL

0 PCCL

1 PCCL

2 PCCL

3 PCCL

4 Total

Auckland City Hospital 1.8 4.7 3.8 5.2 12.4 2.9

Christchurch Women's 1.6 0.0 3.4 5.3 8.2 2.3

Dunedin 2.7 5.0 4.9 6.6 9.5 3.4

Middlemore 1.9 0.0 3.5 4.4 7.2 2.4

Waikato 1.6 0.0 2.4 3.5 4.8 2.0

Wellington 2.7 0.0 3.8 5.4 8.7 3.1

Tertiary Total 2.0 4.8 3.6 5.0 9.8 2.6

Gisborne 1.8 0.0 3.5 3.6 6.7 2.1

Grey Base Hospital 3.2 0.0 4.3 4.6 7.0 3.3

Hastings Memorial 2.7 0.0 4.6 5.9 16.4 3.2

Hutt 2.1 0.0 3.6 4.7 5.3 2.5

Masterton 2.5 0.0 3.4 3.7 3.0 2.6

Nelson 2.4 0.0 3.7 7.0 7.9 2.8

North Shore 2.1 4.0 3.0 3.8 5.3 2.4

Palmerston North 2.1 0.0 3.5 4.7 8.0 2.5

Rotorua 1.8 0.0 3.1 4.8 7.2 2.2

Southland 2.4 0.0 3.5 4.0 7.4 2.8

Taranaki Base 2.6 0.0 3.6 4.5 6.7 2.9

Tauranga 2.4 3.0 4.1 5.0 9.0 2.8

Timaru 2.8 0.0 4.6 5.8 12.2 3.2

Wairau 2.8 0.0 4.0 4.2 6.0 3.1

Waitakere 2.1 0.0 3.3 3.8 3.9 2.3

Wanganui 2.4 0.0 3.7 4.4 7.8 2.8

Whakatane 2.1 0.0 4.2 5.3 2.6 2.6

Whangarei Area Hospital 2.1 0.0 3.0 4.4 8.3 2.5

Secondary Total 2.3 3.5 3.5 4.6 7.5 2.6

Akaroa Community Hospital 6.0 0.0 0.0 0.0 0.0 6.0

Ashburton 2.5 0.0 2.3 2.8 0.0 2.5

Bay of Islands 1.3 0.0 1.3 0.5 0.0 1.3

Birthcare Auckland 2.6 0.0 2.0 3.0 0.0 2.6

Birthcare Huntly 1.8 0.0 2.0 2.0 0.0 1.8

Botany Downs Maternity Hospital 2.5 0.0 3.7 5.2 9.3 2.7

Buller 2.5 0.0 0.0 0.0 0.0 2.2

Burwood 1.9 0.0 3.5 0.0 0.0 2.0

Charlotte Jean Maternity Unit 2.3 0.0 0.0 0.0 0.0 2.3

Clutha Health First 2.2 0.0 0.0 0.0 0.0 2.2

Dannevirke Community Hospital 2.7 0.0 0.0 0.0 0.0 2.7

Darfield 2.8 0.0 0.0 0.0 0.0 2.8

Dargaville 2.3 0.0 1.0 0.0 0.0 2.3

Elizabeth R Hospital and Rest Home 3.6 0.0 0.0 0.0 0.0 3.6

Golden Bay Community Hospital 1.5 0.0 0.0 0.0 0.0 1.5

Gore Health Centre 1.9 0.0 0.0 3.0 0.0 2.0

Hawera 2.5 0.0 2.8 0.0 0.0 2.5

Helensville Birthing Unit 1.9 0.0 0.0 0.0 0.0 1.9

92

Table A10.8 (continued): Average length of stay (days) for mothers, by patient clinical complexity level

(PCCL) and facility, 2005

Average length of stay (days) Facility PCCL

0 PCCL

1 PCCL

2 PCCL

3 PCCL

4 Total

Hokianga 1.8 0.0 3.0 4.0 0.0 1.9

Horowhenua 1.6 0.0 1.0 0.0 0.0 1.6

Kaikoura 0.0 0.0 0.0 0.0 0.0 0.0

Kaitaia 2.1 0.0 1.2 4.0 0.0 2.1

Kapiti Medical Centre 1.1 0.0 1.0 0.0 0.0 1.1

Kenepuru 1.4 0.0 1.3 0.0 0.0 1.4

Lakes District 1.5 0.0 1.5 0.0 0.0 1.5

Lincoln 1.9 0.0 0.0 0.0 0.0 1.9

Matariki 2.0 0.0 0.0 0.0 0.0 2.0

Maternity Services Ltd 1.6 0.0 0.0 0.0 0.0 1.6

Murupara 0.2 0.0 0.0 0.0 0.0 0.2

Napier 2.6 0.0 2.5 6.0 0.0 2.6

Northern Southland Birthing Centre 2.9 0.0 5.0 0.0 0.0 2.9

Oamaru 3.1 0.0 1.0 0.0 0.0 3.0

Opotiki 0.7 0.0 2.0 0.0 0.0 0.7

Papakura Obstetric 2.5 0.0 3.8 4.3 5.0 2.7

Pohlen Trust 3.8 0.0 3.0 0.0 0.0 3.8

Pukekohe 3.1 0.0 5.0 5.6 6.5 3.4

Rangiora 2.8 0.0 1.3 1.0 0.0 2.7

Rhoda Read 2.5 0.0 0.0 0.0 0.0 2.4

River Ridge (East) Birthing Centre 0.2 0.0 0.0 0.0 0.0 0.2

St Georges 3.5 0.0 4.3 4.4 4.5 3.6

Taihape 2.6 0.0 3.0 0.0 0.0 2.6

Taumarunui 1.2 0.0 4.0 0.0 0.0 1.3

Taupo General 1.5 0.0 0.0 1.0 0.0 1.5

Te Kuiti 1.4 0.0 0.0 0.0 0.0 1.4

Te Whare Hauora O Ngati Porou 1.9 0.0 0.0 0.0 0.0 1.9

Thames 1.5 0.0 0.5 0.5 0.0 1.4

Tokoroa 1.1 0.0 1.3 0.0 0.0 1.1

Tuatapere Maternity Hospital 2.1 0.0 0.0 0.0 0.0 2.1

Waihi Hospital 6.0 0.0 0.0 0.0 0.0 5.9

Waikari 0.0 0.0 0.0 0.0 0.0 0.0

Waimarino Health Centre 0.1 0.0 0.0 0.0 0.0 0.1

Waipukurau 1.6 0.0 0.0 0.0 0.0 1.6

Wairoa 2.0 0.0 0.0 0.0 0.0 2.0

Warkworth Birthing Centre 2.7 0.0 0.0 0.0 0.0 2.7

Waterford Birth Centre 2.0 0.0 1.0 0.8 0.0 2.0

Wellesford Birthing Unit 1.3 0.0 0.0 0.0 0.0 1.3

Winton Birthing Centre/Central Southland Birthing Unit 3.6 0.0 0.0 0.0 0.0 3.6

Primary Total 2.2 0.0 3.5 4.2 6.9 2.3

Total 2.1 4.3 3.6 4.8 9.0 2.6

93

Table A10.9: Number of live babies born, by gestational age at birth and facility type, 2005


Facility Less than 20

20–23 24–27 28–31 32–36 37–41 42 and over

Not stated

Total

Auckland City Hospital 0 13 47 134 508 6423 161 15 7301

Christchurch Women’s 0 7 26 49 328 4340 93 37 4880

Dunedin 0 1 8 29 130 1485 24 18 1695

Middlemore 6 12 15 61 291 3568 191 40 4184

Waikato 1 7 42 63 264 2252 211 15 2855

Wellington 0 7 31 61 246 2958 42 51 3396

Tertiary Total 7 47 169 397 1767 21,026 722 176 24,311

Gisborne 0 2 0 5 35 683 16 7 748

Grey Base Hospital 0 0 0 1 7 238 6 13 265

Hastings Memorial 0 2 1 9 107 1501 110 135 1865

Hutt 0 0 1 5 115 1736 55 27 1939

Masterton 0 0 0 1 21 381 3 4 410

Nelson 0 0 2 2 59 778 17 5 863

North Shore 0 4 2 5 243 3115 58 9 3436

Palmerston North 0 0 1 19 145 1775 57 8 2005

Rotorua 0 2 1 1 83 1200 55 11 1353

Southland 0 0 1 10 76 1032 13 8 1140

Taranaki Base 0 0 3 14 74 977 44 20 1132

Tauranga 0 4 1 4 105 1619 48 45 1826

Timaru 0 2 1 0 37 511 22 8 581

Wairau 0 0 0 0 25 410 15 9 459

Waitakere 0 0 3 6 83 2310 86 14 2502

Wanganui 0 0 0 1 37 581 29 7 655

Whakatane 0 0 0 5 40 581 18 39 683

Whangarei Area Hospital 0 1 2 4 91 1250 45 12 1405

Secondary Total 0 17 19 92 1383 20,678 697 381 23,267

Akaroa Community Hospital 0 0 0 0 0 2 0 0 2

Ashburton 0 0 0 0 3 156 1 1 161

Bay of Islands 0 0 0 0 6 213 3 5 227

Birthcare Auckland 0 0 0 0 1 265 5 13 284

Birthcare Huntly 1 0 0 0 1 162 5 4 173

Botany Downs Maternity Hospital 0 0 2 2 39 1468 50 17 1578

Buller 0 0 0 0 0 19 0 7 26

Burwood 0 0 0 0 0 199 3 1 203

Charlotte Jean Maternity Unit 0 0 0 0 1 91 2 0 94

Clutha Health First 0 0 0 0 1 42 0 0 43

Dannevirke Community Hospital 0 0 0 0 1 70 1 3 75

Darfield 0 0 0 0 0 4 1 0 5

Dargaville 0 0 0 0 1 80 0 0 81

Elizabeth R Hospital and Rest Home 0 0 0 0 2 82 1 1 86

Golden Bay Community Hospital 0 0 0 0 1 19 0 0 20

Gore Health Centre 0 0 0 0 1 61 0 1 63

Hawera 0 0 0 0 0 96 4 7 107

Helensville Birthing Unit 0 0 0 0 0 53 1 0 54

Hokianga 0 0 0 0 1 40 0 3 44

Horowhenua 0 0 0 1 0 107 3 2 113

Kaitaia 0 0 0 0 13 145 2 1 161

Kapiti Medical Centre 0 0 0 0 0 109 0 3 112

Kenepuru 0 0 0 0 1 257 3 13 274

Lakes District 0 0 0 0 0 0 0 42 42

94

Table A10.9 (continued): Number of live babies born, by gestational age at birth and facility type, 2005


Facility Less than 20

20–23 24–27 28–31 32–36 37–41 42 and over

Not stated

Total

Lincoln 0 0 0 0 0 90 0 7 97

Matariki 0 0 0 0 1 129 5 1 136

Maternity Services Ltd 0 0 0 0 0 46 0 1 47

Murupara 0 0 0 0 0 0 0 20 20

Napier 0 0 0 1 0 144 7 2 154

Northern Southland Birthing Centre 0 0 0 0 0 38 0 0 38

Oamaru 0 0 0 0 0 65 0 3 68

Opotiki 0 0 0 0 1 41 0 7 49

Papakura Obstetric 0 0 0 0 32 985 23 14 1054

Pohlen Trust 0 0 0 0 0 113 0 0 113

Pukekohe 0 1 0 1 20 621 28 12 683

Rangiora 0 0 0 0 1 81 1 2 85

Rhoda Read 0 0 0 0 2 111 2 8 123

River Ridge (East) Birthing Centre 0 0 0 0 8 506 52 17 583

St Georges 0 0 0 0 8 528 5 9 550

Taihape 0 0 0 0 0 30 0 2 32

Taumarunui 0 1 0 0 3 76 3 0 83

Taupo General 0 0 1 1 2 193 2 9 208

Te Kuiti 0 0 0 0 0 60 0 0 60

Te Whare Hauora O Ngati Porou 0 0 0 0 0 22 1 0 23

Thames 0 0 0 0 1 98 5 6 110

Tokoroa 0 0 0 0 1 81 1 4 87

Tuatapere Maternity Hospital 0 0 0 0 0 18 0 0 18

Waihi Hospital 0 0 0 0 0 37 3 1 41

Waikari 0 0 0 0 0 2 0 0 2

Waimarino Health Centre 0 0 0 0 0 14 0 0 14

Waipukurau 0 0 0 0 0 22 0 5 27

Wairoa 0 0 0 0 0 38 2 7 47

Warkworth Birthing Centre 0 0 0 0 0 43 2 6 51

Waterford Birth Centre 0 0 0 0 0 458 17 8 483

Wellesford Birthing Unit 0 0 0 0 0 10 0 1 11 Winton Birthing Centre/Central Southland Birthing Unit

0 0 0 0 0 34 0 0 34

Primary Total 1 2 3 6 153 8474 244 276 9159

Other facilities Total 0 0 0 0 0 1 0 1 2

Total 8 66 191 495 3303 50,179 1663 834 56,739

95

Table A10.10: Percentage of total caesarean sections performed, by facility, 2005

Facility Number Percentage of

total caesareans

Percentage of caesareans in facility's

births

Auckland City Hospital 2171 33.0 31.4

Christchurch Women's 1331 20.2 28.2

Dunedin 522 7.9 31.8

Middlemore 766 11.7 18.6

Waikato 801 12.2 31.9

Wellington 983 15.0 30.7

Tertiary Total 6574 50.5 28.4

Gisborne 148 2.6 20.1

Grey Base Hospital 59 1.0 22.6

Hastings Memorial 447 7.9 24.3

Hutt 492 8.7 25.8

Masterton 103 1.8 25.2

Nelson 219 3.9 26.2

North Shore 946 16.8 28.2

Palmerston North 513 9.1 26.1

Rotorua 298 5.3 22.3

Southland 351 6.2 32.1

Taranaki Base 327 5.8 29.8

Tauranga 454 8.1 25.3

Timaru 133 2.4 23.2

Wairau 125 2.2 27.7

Waitakere 495 8.8 20.0

Wanganui 109 1.9 16.9

Whakatane 131 2.3 19.7

Whangarei Area Hospital 283 5.0 21.5

Secondary Total 5633 43.2 24.8

Botany Downs Maternity Hospital 233 28.3 15.0

Kapiti Medical Centre 1 0.1 1.0

Kenepuru 3 0.4 1.1

Napier 22 2.7 14.3

Papakura Obstetric 119 14.5 11.6

Pukekohe 127 15.5 19.0

St Georges 316 38.4 58.7

Waipukurau 1 0.1 5.0

Primary Total 822 6.3 9.2

Total 13,029 100 23.8

96

Glossary

Abortion, induced

An abortion brought about intentionally. Also called an artificial or therapeutic abortion, as

opposed to a spontaneous abortion (a miscarriage). See also Abortion, spontaneous;

Miscarriage.

Abortion, spontaneous

The spontaneous expulsion of a fetus of less than 20 weeks’ gestation and a birthweight of

less than 400g. Also referred to as a miscarriage. See also Abortion, induced; Birthweight;

Miscarriage.

Admission

The documentation process, which may include entry on to the National Health Index, by

which a person becomes resident in a health care facility. Health care users who attend a

health care facility for more than three hours should be admitted. See also National Health

Index (NHI) number.

Antenatal hospital events

The admission to a hospital of a woman before the date of the baby’s birth, irrespective of

any diagnosis. In this report, events where the admission was a transfer from another

facility have been excluded. See also Admission.

AR-DRG code

See Diagnosis Related Groups, Australian Refined (AR-DRG) code.

Assisted vaginal birth

A vaginal birth that needs assistance, for example, forceps.

Assisted vaginal birth, forceps

An assisted vaginal birth using a metallic obstetric instrument. See also Assisted vaginal

birth.

Assisted vaginal birth, vacuum extraction

An assisted vaginal birth using a suction cap applied to the baby’s head. See also Assisted

vaginal birth.

Assisted vaginal birth, vaginal breech birth

An assisted vaginal birth of a baby by the buttocks or lower limbs first rather than the head.

See also Assisted vaginal birth.

Bacterial meningitis

Inflammation of the meninges due to a bacterial infection, often with the streptococcus B

bacteria.

Birth

The birth of a baby (or babies for a multiple birth) after a minimum of 20 weeks’ gestation

and/or with a birthweight of more than 400g. See also Birthweight.

97

Birthing unit

A facility that has a contract for labour and birth but not for inpatient postnatal care. It also

does not provide support staff during the labour and birth (Health Funding Authority 2000).

See also Inpatient postnatal care.

Birthweight

The first weight of the baby obtained after birth (usually measured to the nearest 5g and

obtained within one hour of birth).

Birthweight, low

A birthweight of less than 2500g. See also Birthweight.

Birthweight, very low


Birthweight, extremely low


Birthweight, low for gestation

The newborn is 37 weeks’ gestation or over and their birthweight is less than 2500g. See

also Birthweight; Newborn.

Caesarean section

An operative birth through an abdominal incision.

Caesarean section, acute

A caesarean section performed urgently for clinical reasons (such as the health of the

mother or baby) once labour has started. See also Caesarean section.

Caesarean section, elective

A caesarean section performed as a planned procedure before or following the onset of

labour when the decision to have a caesarean section was made before labour. See also

Caesarean section.

Crude birth rate per 1000 women of reproductive age

1000*

rP

nCBR =

Where:

n = total number of mothers giving birth and

Pr = the total number of women of reproductive age.

See also Reproductive age.

Diagnosis Related Groups, Australian Refined (AR-DRG)

Diagnosis Related Groups are produced by invoking a programme that compares all

diagnostic and procedure codes in a health event and assigns a code based on a complex

series of decision trees. This provides another way of analysing event information by

classifying episodes of inpatient care into clinically meaningful groups that use similar

amounts of resources.

98

District Health Board (DHB)

An organisation established as such by or under section 19 of the New Zealand Public

Health and Disability Act 2000.

Domicile code

A code representing the mother’s or baby’s usual residential address.

Epidural

An injection of analgesic agent outside the dura mater that covers the spinal canal; includes

lumbar, spinal (inside dura mater) and epidural anaesthetics.

Episiotomy

An incision of the perineal tissue surrounding the vagina at the time of birth.

Ethnic code

The code that defines the mother’s or baby’s ethnic group.

Facility

The place mothers attend or are resident in for the primary purpose of receiving maternity

care.

Fetal death

Death prior to the complete expulsion or extraction from its mother of a product of

conception irrespective of the duration of pregnancy; the death is indicated by the fact that

after separation the fetus does not breathe or show any other evidence of life such as

beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary

muscles (WHO 1975).

Fetal death, stillbirth

Death prior to the complete expulsion or extraction from its mother of a baby of 20 or more

completed weeks of gestation or of 400g or more birthweight. Death is indicated after

separation either when the fetus does not breathe or show any other evidence of life such

as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary

muscles.

Full-term birth, full-term labour

Birth or labour at 37 or more weeks’ gestation.

Gestational age

The duration of pregnancy in completed weeks, calculated from the date of the first day of a

woman’s last menstrual period and her infant’s date of birth, or derived from clinical

assessment during pregnancy, or derived from an examination of the infant after birth.

Hospital antenatal events

Hospital admissions during a women’s pregnancy prior to delivery in a particular year,

irrespective of the diagnosis.

Hospital readmission

The readmission of the mother to hospital in the six weeks after an in-hospital birth or the

admission of a baby up to three months after the date of birth, irrespective of the diagnosis.

99

Hypertension

A repeatedly elevated blood pressure exceeding 140 over 90mm Hg – a systolic pressure

above 140 with a diastolic pressure above 90. Also called high blood pressure.

Hysterectomy

A surgical operation to remove the uterus and sometimes the cervix. The removal of the

body of the uterus without removing the cervix is a subtotal hysterectomy. The removal of

the entire uterus and the cervix is a total hysterectomy.

Induced abortion

See Abortion, induced.

Induction (of labour)

An intervention to stimulate the onset of labour by pharmacological or other means.

Infant death

Death of a liveborn infant before the first year of life is completed (WHO 1975), consisting

of early neonatal deaths, late neonatal deaths and post-neonatal deaths. See also

Liveborn; Neonatal death.

Inpatient postnatal care

A woman remains in the facility for 12 hours or more.

International Statistical Classification of Diseases and Related Health Problems, 10th Revision,

Australian Modification (ICD-10-AM) clinical codes

Codes based on the official version of the World Health Organization’s International

Classification of Diseases. They are designed for classifying morbidity and mortality

information for statistical purposes, and for indexing hospital records by disease and

operations for data storage and retrieval. The codes are used to classify the clinical

description of a condition, the cause of intentional and unintentional injury, an underlying

cause of death or the pathological nature of a tumour.

International Statistical Classification of Diseases and Related Health Problems, 10th Revision,

Australian Modification – Australian Classification of Health Interventions (ICD-10-AM ACHI)

codes

Codes based on the official version of the World Health Organization’s International

Classification of Diseases. They are designed for classifying interventions for statistical

purposes. The codes are used to classify the operation or procedure performed.

Lead Maternity Carer (LMC)

An authorised practitioner who is a general practitioner with a Diploma of Obstetrics (or

equivalent, as determined by the New Zealand College of General Practitioners); a midwife

or an obstetrician that a woman has selected to provide her lead maternity care.

Length of stay

The number of nights a woman spends in a facility. See also Facility.

100

Live birth

The complete expulsion or extraction from its mother of a product of conception,

irrespective of duration of pregnancy, which, after such separation, breathes or shows any

other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or

definite movement of voluntary muscles, whether or not the umbilical cord has been cut or

the placenta is attached. Each product of such a birth is considered liveborn (WHO 1975).

See also Liveborn.

Liveborn

A product of conception, irrespective of duration of pregnancy, which, after expulsion or

extraction from its mother, breathes or shows any other evidence of life, such as beating of

the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles.

Major surgery

Any surgery that requires opening a body cavity.

Maternity facility

A facility that provides labour and birth services and inpatient postnatal care, as described

in the relevant service specification issued by the Ministry of Health. See also Facility.

Median

The middle data point if the data were ranked from the lowest to the highest. It is used

instead of the mean when the data are not normally distributed.

Ministry of Health

The Government’s principal advisor on health and disability in New Zealand.

Miscarriage

A pregnancy that ends spontaneously before 20 weeks’ gestation. A ‘hospital miscarriage’

occurs when a woman is referred to a hospital during a miscarriage.

National Health Index (NHI) number

A unique identifier number allocated by the National Health Index and managed by the New

Zealand Health Information Service. See also New Zealand Health Information Service

(NZHIS).

National Minimum Dataset (NMDS)

An integrated collection of health data that are collected routinely from all people

discharged from a hospital in New Zealand.

Newborn

A baby from birth to four weeks of life.

Neonatal deaths

A death occurring up to 27 days after birth.

Neonatal deaths, early

Death of a liveborn infant dying before 168 completed hours (seven days) after birth (WHO

1975). See also Liveborn.

Neonatal deaths, late

Death of a liveborn infant dying after seven days and before 28 completed days after birth

(WHO 1975). See also Liveborn.

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New Zealand Health Information Service (NZHIS)

A business unit within the Ministry of Health responsible for collecting and disseminating

health-related data. The goal of the NZHIS is to make accurate information readily available

and accessible in a timely manner throughout the health sector.

New Zealand Index of Deprivation (NZDep)

An index generated from data from the 2001 Census of Population and Dwellings to

measure special health needs. Scores on the index vary from 1 (least deprived) to 10 (most

deprived). An area with a high NZDep score is more likely to need health services than one

with a low NZDep score.

Patient clinical complexity level (PCCL)

A measure of the complexity and/or severity of each woman’s co-morbidities and

complications compared with other women in the same Diagnosis Related Groups. See

also Diagnosis Related Groups, Australian Refined (AR-DRG).

Perinatal deaths

A category that includes fetal deaths of 20 weeks’ gestation or 400g birthweight (stillbirth)

plus infant deaths within less than 168 completed hours (seven days) after birth (early

neonatal death) (WHO 1975).

Plurality

The number of births resulting from a pregnancy.

Postnatal

All pregnancy-related events following birth.

Postnatal admission, baby

Admission to hospital of a liveborn baby in the first three months after birth.

Postpartum haemorrhage (PPH)

Abnormal bleeding experienced by the mother soon after labour or childbirth.

Postpartum haemorrhage, primary

A blood loss of greater than 500ml from the genital tract within 24 hours of delivery.

Postpartum haemorrhage, secondary

A blood loss of greater than 500ml from the genital tract after 24 hours following delivery,

until six weeks after delivery.

Preterm birth, preterm labour

Birth or labour before 37 completed weeks’ gestation.

Primary maternity facility

A primary maternity facility is a facility that does not have inpatient secondary maternity services or 24-hour on-site availability of specialist obstetricians, paediatricians and anaesthetists. This includes birthing units. See also Birthing unit; Facility.

Post-term birth

A birth at 42 or more completed weeks’ gestation.

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Readmissions, mother

The admission to hospital of a mother up to six weeks after an in-hospital birth, irrespective

of the diagnosis.

Reproductive age

Women aged from 15 to 44 years.

Rural area

A census area unit (domicile) located in an area with fewer than 10,000 people.

Secondary maternity care facility

A facility that provides additional care during the antenatal, labour and birth and postnatal

periods for women and babies who experience complications and who have a clinical need

for either consultation or transfer (Health Funding Authority 2000). See also Facility.

Spontaneous abortion

See Abortion, spontaneous.

Stillbirth

See Fetal death, stillbirth.

Stillborn

Death prior to the complete expulsion or extraction from its mother of a baby of 20 or more

completed weeks of gestation or of 400g or more birthweight. Death is indicated after

separation either when the fetus does not breathe or show any other evidence of life such

as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary

muscles. See also Fetal death, stillbirth.

Tertiary maternity care facility

A facility that provides a multidisciplinary specialist team for women and babies with

complex and/or rare maternity needs who require access to such a team, including

neonatal intensive care units. For example, babies with major fetal disorders requiring

prenatal diagnostic and fetal therapy services or women with obstetric histories that

significantly increase the risks during pregnancy, labour and delivery (for example, two

placental abruptions). See also Facility.

Three-year moving average

A way to ‘smooth out’ large variations in a set of data caused by the effect of small

numbers. In this report, the Prior Moving Average method was used to calculate the three-

year moving average.

ttt

ttt

PPP

MMM

++

++

−−

−−

12

12

Where:

Mt = deaths

t = calendar years

Pt = population

Urban area

A census area unit (domicile) located in an area with more than 10,000 people.

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Vacuum extraction

See Assisted vaginal birth, vacuum extraction.

Vaginal birth

The birth of a baby without obstetric intervention. Also called a normal birth.

Vaginal breech birth

See Assisted vaginal birth, vaginal breech birth.

Well Child provider

A health care provider that provides health education and support for babies and children

as described in the Well Child Tamariki Ora National Schedule produced by the Ministry of

Health.

World Health Organization (WHO)

The United Nations’ specialised agency for health. It was established in 1948 with an

objective of having all peoples attain the highest possible level of health. The WHO's

constitution defines health as a state of complete physical, mental and social wellbeing and

not merely the absence of disease or infirmity.

104

References

Anderson GM. 2004. Making sense of rising caesarean section rates. British Medical Journal 329:

696–7.

Medsafe. 1998. Management of Postpartum Haemorrhage. Prescriber Update (No.16:4-9) April

1998. http://www.medsafe.govt.nz/profs/puarticles/mpph.htm#Act (accessed 20 November 2007).

NCCH. 1998. The International Statistical Classification of Diseases and Related Health

Problems, 10th Revision, Australian Modification (ICD-10-AM), first edition. Sydney: National

Centre for Classification in Health.

NCCH. 2000. The International Statistical Classification of Diseases and Related Health

Problems, Australian Modification (ICD-10-AM) – Australian Classification of Health Interventions

(ACHI), second edition. Sydney: National Centre for Classification in Health.

New Zealand Health Information Service. Fetal and Infant Deaths series. Wellington: Ministry of

Health. Available from URL: http://www.nzhis.govt.nz/publications/index.html

PHC, Ministry of Health. 1995. Standardising Rates of Disease. Wellington: Public Health Commission.

Salmond C, Crampton P. 2002a. NZDep2001 Index of Deprivation. Wellington: Wellington School

of Medicine and Health Sciences.

Salmond C, Crampton P. 2002b. NZDep2001 Index of Deprivation: User Manual. Wellington:

Wellington School of Medicine and Health Sciences.

Statistics New Zealand. 2006. Demographic Trends 2005. Wellington: Statistics New Zealand.

WHO, 1975. International Classification of Diseases (Vol 1) 1975 revision. Geneva: World Health

Organization.

WHO, 1985. Appropriate technology for birth. Lancet 1985; 2: 436–7.

WHO. 2001. Age standardization of rates: a new WHO Standard. Geneva: World Health

Organization.

WHO. 2005. Maternal and Newborn Health in the WHO European Region: The Challenges and

the Way Forward. Factsheet Euro/03/05, Copenhagen: World Health Organization.

WHO & UNICEF. 2004. Low Birthweight: Country, regional and global estimates. New York:

United Nations Children’s Fund.

statistical data on maternity 2005 v5

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