RANZCOG welcomes the Maternity Clinical Indicators Report

29 February 2012

RANZCOG welcomes the Maternity Clinical Indicators Report

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) New Zealand Committee welcomes the Maternity Clinical Indicators 2009 Report launched by the Ministry of Health today as a tool to improve care and outcomes for pregnant women and their babies.

The Ministry of Health and maternity stakeholders have been working collaboratively on this first report on the New Zealand Maternity Clinical Indicators, representing consumer, midwifery, obstetric, general practice, paediatric and anaesthetic perspectives. This expert group established a set of 12 maternity clinical indicators that are relevant to New Zealand and are measurable using current data collection practices.

"It is great to see a well-rounded and experienced group in the maternity sector working together to develop a tool that will allow doctors, midwives and GPs to provide the best possible care for their patients," says Dr John Tait, Chair of the RANZCOG New Zealand Committee.

This is the first time maternity clinical data has been benchmarked in such a comprehensive way using a standardised definition and presented at the national level in New Zealand. This allows for a group of women for whom interventions and outcomes should be similar to be assessed in the same way. In addition to eight standard indicators, there are also three indicators for all women giving birth in hospital and one indicator covering all babies born in hospital. Other indicators will be added over time as improved data becomes available.

"District Health Boards (DHBs) and local maternity stakeholders will be able to add value to this process by undertaking analysis at a local level as part of Maternity Quality and Safety programmes. It also allows DHBs to compare and use the data to review practices – all of which can be fed back into subsequent Reports," says Dr Tait.

There is significant variation between DHBs and individual secondary and tertiary facilities – and these variations among a group of women who would be expected to have similar outcomes needs to be investigated (particularly around rates of spontaneous vaginal birth, instrumental vaginal birth, induction of labour and intact lower genital tract).

Dr Tait did however note that it is important to acknowledge the low rates of intervention in some areas may be detrimental to care as the mother and baby outcomes have not been cross-linked to the figures.

"Although it is hard to justify some high levels of intervention which do not have any discernible added benefit, there is evidence that low rates of intervention can be associated with poorer outcomes for the mother and baby. These low rates may reflect a lack of appropriate intervention by obstetricians, or a lack of referral to obstetricians by the lead maternity carers (LMCs), and more research is essential to identify whether or not this is a concern."

RANZCOG strongly supports a seamless collaborative model of care which sees doctors, midwives and other health professionals working together for the benefit of pregnant women and their babies.Maternity specialists welcome the information generated by this report to allow them to base treatment improvements on fact rather than 'gut-feel'.

The report can be found at www.health.govt.nz/publication/new-zealand-maternity-clinical-indicators-2009.

About RANZCOG:
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) is dedicated to maintaining the highest possible standards in obstetrics and gynaecology in Australia and New Zealand.

ENDS

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