Media Release

31 October 2007

First report from committee looking at deaths of mothers and babies

A committee charged with reviewing the deaths of newborn babies, as well as pregnant and new mothers, has released its first report.

The Perinatal and Maternal Mortality Review Committee (PMMRC) was set up in 2005 to advise the Minister of Health about the best way reduce the numbers of preventable perinatal and maternal deaths, says PMMRC chair Professor Cynthia Farquhar.

“We feel really encouraged and well supported by everyone who is working to improve maternity care and the health of newborn infants in New Zealand.”

The first two years of work for the committee have involved setting-up New Zealand wide systems to collect information about perinatal and maternal deaths. This has included deciding what kind of information is going to be useful by looking at systems overseas and talking to professional groups like the medical colleges.

“This is an impressive achievement that has only been fulfilled because of the work of local co-ordinators at each District Health Board (DHB) and of all the midwives, nurses and doctors across New Zealand who have entered information onto our purpose built database.

National Co-ordinator Vicki Masson, a midwife with a special interest in high-risk pregnancies, was appointed in 2006.

“She is responsible for following up on all the missing perinatal and maternal deaths information and ensuring that the data is complete. She supports all the local co-ordinators and acts as a first point of contact for any lead maternity carers with queries.”

The report makes seven recommendations to the Minister, five of them suggesting actions.

The report recommends improvements to perinatal pathology services, as they are an important way of establishing why a baby has died, and if the death was preventable.

“There are only four practising perinatal pathologists in New Zealand, and while we recognise there is a worldwide shortage of these professionals, we need to make sure we are making the best possible use of this resource and that there is fair access to a quality service across the whole country.

“As this is a workforce, resourcing and training issue there is no quick fix. However, the committee has organised a workshop in October, with support from the Ministry of Health, to review the current perinatal pathology services in New Zealand as a first step.”

Providing bereaved families with better support, including information, counselling and clinical follow-up if required, is one of the report’s main recommendations.

“We can all appreciate the huge grief and shock families go through when they lose a mother or baby.

“While many providers go out of their way to help families at such a sad time, our committee plans to help all providers to give support by developing resources such as leaflets to assist their work,” says Professor Cynthia Farquhar.

The Ministry of Health will look at ways to help all DHBs organise support services.

For more information see: www.pmmrc.health.govt.nz.

ENDS

Background

What is the perinatal period?
Perinatal refers to the time between 20 weeks of pregnancy and one month after birth.

What is the PMMRC?
The Perinatal and Maternal Mortality Review Committee (PMMRC) is an independent committee that advises the Minster of Health on how to reduce the number of deaths of babies and mothers in New Zealand.

When was it set up?
PMMRC was established in June 2005 under sections 11 and 18 of the New Zealand Health and Disability Act 2000. The Committee met for the first time in August 2005.

Who are the committee members?
The Committee has ten members appointed by the Minister of Health. The Committee members are:

• Professor Cynthia Farquhar (chair)
• Jacqueline Anderson
• Vicki Culling
• Dr Dawn Elder
• Deborah Harris
• Associate Professor Lesley McCowan
• Dr Stephanie Palmer
• Mollie Wilson
• Dr Jane Zuccollo
• Dr Ted Hughes

Profiles of the members are available at www.pmmrc.health.govt.nz

What are the report’s recommendations?
The PMMRC recommends that the Minister of Health:

1. note that the PMMRC has established a national perinatal database and DHB system of perinatal mortality data collection
2. note the importance of accurate, robust and timely clinical data on all pregnancies and establish a national perinatal database so that perinatal mortality rates can be calculated and comparisons can be made between babies who die and those who survive the perinatal period
3. require DHBs to ensure that all providers of maternity services provide support to parents, families and whānau who have experienced perinatal or maternal loss, including providing access to information, counselling and clinical follow-up
4. develop and improve the provision of perinatal pathology services for accessibility, training and appropriateness and to ensure quality and equitable services are available across the country
5. approve the establishment of a neonatal encephalopathy working group included in the PMMRC 2007/08 work plan
6. note that there are significant challenges to auditing and reviewing perinatal mortality and morbidity given the current, limited information systems available
7. require health professionals to recommend a post-mortem examination following a maternal mortality when a coronial investigation is not undertaken.

When will the PMMRC’s 2007 annual report be available?
The first full annual report for 2007 will be available by September 2008 and will contain data about perinatal and maternal deaths in New Zealand.

Why is it taking until 2008 to provide this data?
It is not just a case of gathering numbers. We also need to pin down an exact cause of death, whether it is through a coroner’s report, post-mortem or medical advice. For example, when a pregnant woman dies in a car accident, we need to find out if she died from injuries from the accident, or whether the accident was caused by another health condition that may or may not be related to the pregnancy, or if there was another cause for the accident such as suicide.

For further information, please contact
Michael Flyger
Media Advisor
Ph: 04 496 2265