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.’
See also: Information about deaths of babies and mothers in Aotearoa New Zealand (lay summary)
Komiti Arotake Pūtake Mate Wahine me te Whakawhānau Pēpi
Ka hiahiatia ngā mahi kōhukihuki ki te whakakore i te ōritenga kore e haere tonu ana i te rāngai whakawhānau
Ka kaha tonu ake te tūponotanga ka mate ngā pēpi o ngā whaea Māori, Pasifika, me Īniana i ō ngā whaea Pākehā i te hapūtanga, i roto rānei i ngā rā tuatahi e 28 whai muri i te whānautanga, te whakaaturanga o te pūrongo tekau mā whā o te Komiti Arotake Pūtake Mate Wahine me te Whakawhānau Pēpi (Perinatal and Maternal Mortality Review Committee (PMMRC)).
Ka kitea tētahi whakahekenga o te maha o ngā pēpi e mate ana i te hapūtanga, i roto hoki i te wiki tuatahi whai muri i te whānautanga i roto i Aotearoa i waenga i ngā tau 2007 ki te 2018. Heoi anō, ko tā te pūrongo nei, kua tukuna i tēnei rā, he whakaahua i te korenga e koke mō ētahi rōpū hei mea 'tē hiahiatia mārikatia'.
Ko tā te PMMRC he arotake i ngā matenga o ngā whaea me ngā pēpi i Aotearoa me te tohutohu atu i te Kupu Taurangi Hauora o Aotearoa (arā, te Kōmihana) ki ngā huarahi whakaiti i aua matenga. Ko tāna anō hoki, he arotake i ngā kēhi o ngā panoni ki te roro whai muri i te whānautanga (neonatal encephalopathy), ko te pūtake pea ko te hapa hāora i te wā o te hapūtanga, i te whānautanga rānei.
E āhukahuka ana te Heamana o te PMMRC, a John Tait, i te ora o ngā whaea, te auhi ka pā kino nā ngā pēpi kua mate, i ngā pēpi anō kua mate, me ō rātou whānau.
'Me maumahara rawa tonu ko aua whika he tāngata. Ko te pūtake o ngā tūtohutanga o te pūrongo ko te āwhina ki te karo i te pōuri nui ki ētahi atu whānau,' te kī a Tait.
'Kia kaua tātou e noho kiriora tonu, ina koa ki te ōritenga kore e whakaaturia nei e tēnei pūrongo. E tino āwangawanga ana mātou ki ngā ōritenga kore i te whai wāhi ki te tiaki hauora me te tūponotanga kua kino ake ngā putanga hauora i te wā e urupare atu ana tātou ki te KOWHEORI-19.'
He wero kei tēnei pūrongo ki ngā kaiwhakatau me ngā kaihautū i te pūnaha hauora, me ngā whakahaere hauora me ngā kaimahi hauora, ki te whakaarotau i ngā tūtohutanga tōmua a te PMMRC kāore anō kia āta whakatinanatia.
E kī ana a Lisa Paraku, mō ngā whānau pani, hei mema hoki o te PMMRC, me tino pai ake ā tātou mahi ka tika.
'Kua kore e taea te whakatūturi tonu ia tau, ia tau, ki ērā tūtohutanga whai taunakitanga a te PMMRC kāore i te whakaarotautia, kāore hoki i te whakatinanatia.'
Kāore anō ki whakatinana katoatia tata ki te haurua o ngā tūtohutanga nā te PMMRC i te 13 tau kua hori. Kei roto i aua tūtohutanga ko ērā mō te haumi ki te hauora hinengaro o te whaea me te pēpi me te hanga i tētahi ara tōtika me te ōrite mō te pōuri nui nā te matenga o te pēpi hou. Ka whakarōpūhia ētahi atu tūtohutanga e ai ngā ētahi rōpū ūnga e rima: ngā kaimahi hauora, ngā poari hauora ā-rohe (DHB), ngā kāreti me ngā rōpū ture, te kawanatanga, me ngā kairangahau.
'He mea nui kia haumi ngā tari kāwanatanga, ngā umanga me ngā poari hauora ki te whakawhanake me te tautiaki i ngā pūnaha me ngā tukanga tōtika kia taea ai e ngā kaimahi hauora ēnei tūtohutanga te whakatinana,' te kī a John Tait.
'Tūturu ka taea tēnei,' ka kī a Lisa Paraku, 'ā, me mātua mahi i aua mahi hei whakahōnore i ā tātou pēpi me ō tātou whaea tongarewa kua haere ki tua o te ārai mō tātou katoa.' Tirohia hoki: He mōhiohio mō ngā matenga o ngā pēpi me ngā whaea i Aotearoa (whakarāpopotonga ngaio-kore).