The determinants of childhood wellbeing begin before birth. This indicator looks at two measures of prenatal wellbeing that can influence whether babies get the best possible start to life – prenatal care and early exposure to toxins.
The National Institute for Health and Care Excellence (2008) recommends that antenatal care be started in the first trimester, and ideally by 10 weeks' gestation. Antenatal care helps to ensure pregnant people get the support and education they need to make positive choices for the healthy development of their baby. Early engagement with a lead maternity carer (LMC) also enables opportunities for screening, education and referral, and begins the primary continuity of care relationship between a pregnant person and their LMC.
This indicator monitors the proportion of pregnant people who registered with an LMC in the first trimester of their pregnancy, out of all of people who gave birth and had an LMC providing their primary maternity care. Those who do not access community LMC care are eligible to receive care from their DHB's Primary Maternity Service.
There are a range of toxins that are detrimental to baby's growth and development in-utero. Alcohol, tobacco and drug use are the most prevalent toxins that are harmful to babies' development - all are associated with increased miscarriage, neonatal mortality, low birthweight, sudden and unexpected death in infancy, and birth defects, developmental problems or life-long health issues. This indicator will also look at exposure to these toxins.
This indicator relates to the 'happy and healthy' outcome.
How will we measure this?
- The data for this indicator will be drawn from the Maternity Clinical Indicators https://www.health.govt.nz/publication/new-zealand-maternity-clinical-indicators-2017 It covers a range of measures including:
- the number of pregnant people registering with Lead Maternity Carers (LMCs) or accessing Primary Maternity Services in the first trimester
- the number of pregnant people registering with LMCs over the course of the pregnancy
- the proportion of people giving birth who were smoking two weeks after the birth of their child; this captures people who smoked during pregnancy plus those who did not smoke during pregnancy but started smoking immediately after the birth. Data on alcohol and drug use is not currently collected.
- Additional indicators of infant wellbeing could also eventually be reported on.
- This indicator will be updated annually in August.
For more information
For more information about the Maternity Clinical Indicators go to: https://www.health.govt.nz/publication/new-zealand-maternity-clinical-indicators-2017