Urgent Action Needed To Address Ongoing Inequity In Maternity Sector

Babies of Māori, Pacific and Indian mothers are still more likely than babies of New Zealand European mothers to die in pregnancy or within the first 28 days, the Perinatal and Maternal Mortality Review Committee (PMMRC) 14th report shows.

There was an overall reduction of babies dying in pregnancy and in the first week following birth in Aotearoa New Zealand between 2007 and 2018. However, the report, released today, describes the lack of progress for some groups as ‘unacceptable’.

The PMMRC reviews deaths of mothers and babies in Aotearoa New Zealand and advises the Health Quality & Safety Commission (the Commission) on how to reduce those deaths. It also reviews cases of neonatal encephalopathy, changes in the brain that can be caused by lack of oxygen in babies during pregnancy or birth.

In the report, the Chair of the PMMRC, Mr John Tait, acknowledges the mothers and babies, as well as their families and whānau, whose lives, grief and deaths are represented there.

‘We must remember there are people behind these numbers. The changes recommended in the report are intended to help prevent further heartbreak for other families,’ says Mr Tait.

‘We must not be complacent, especially with the inequity the report shows. We are particularly concerned that inequities in access to health care and potentially to health outcomes could have worsened during the response to COVID-19.’

The report includes a wero (challenge) to decision-makers and leaders in the health system, as well as all health organisations and practitioners, to give priority to implementing previous recommendations of the PMMRC which have yet to be carried out fully.

Lisa Paraku, who stands on behalf of bereaved whānau and families as a member of the PMMRC, says we must do better.

‘We can no longer ignore the fact that, year after year, evidence-based recommendations of the PMMRC are not being prioritised and implemented.’

Around half of the recommendations made by the PMMRC over the past 13 years have yet to be implemented fully. Recommendations include investing in maternal and infant mental health and creating an appropriate and equitable national perinatal bereavement pathway. Other recommendations are organised by five target groups: health practitioners, district health boards (DHBs), colleges and regulatory bodies, government, and researchers.

‘It is important government departments, agencies and DHBs invest in developing and maintaining effective systems and processes so that health practitioners can implement these recommendations,’ says John Tait.

‘We can do this,’ says Lisa Paraku, ‘and we must, in honour of our precious babies and mothers who have gone before and in service to us all.’

Definitions:

- A maternal death is the death of a woman while pregnant or within 42 days of the end of pregnancy.

- A perinatal death is the death of a baby from 20 weeks’ gestation (pregnancy) up to 28 days after birth. This includes stillborn babies.

- A neonatal death is the death of a live born baby from 20 weeks’ gestation (pregnancy) up to 28 days after birth.

- An early neonatal death is the death of a live born baby from 20 weeks’ gestation (pregnancy) up to 28 days after birth.

- A stillbirth is a baby who is born from 20 weeks’ gestation (pregnancy) without any signs of life.

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