Midwives question study data

MIDWIVES have hit out at a study that shows babies are more likely to die under the care of inexperienced midwives.

The study, by researchers from Otago University, found strong evidence that levels of midwifery experience were associated with baby mortality and it called on the Government to urgently review the maternity training system.

Using Ministry of Health data, lead author, associate professor Beverley Lawton, and colleagues from Otago and Illinois University matched the years of experience of midwives to the life/death outcomes of 233,215 babies born in New Zealand from January 2005 to December 2009.

They found 83,043 of those births were cared for by midwifeonly trained midwives, and 150,172 births received care from nursemidwives. Of those, a total of 10,573 pregnancies over this fiveyear period were looked after by midwifery-only trained Lead Maternity Carers in their first year.

Researchers looked at the 86 baby deaths involving midwives with less than one year’s experience and calculated there was a 30 per cent higher likelihood of death compared to the rate of baby mortality for other nurse/midwifery trained midwives, and those midwives with 5-9 years’ experience.

‘‘The chance of the baby dying equalled two extra deaths per 1000 births compared to the pregnancies cared for by the more experienced midwife-only trained midwives with 5 to 9 years’ experience,’’ said Lawton.

‘‘With the raw figure for this group of less experienced midwives being 86 baby deaths, that amounted to 21 more deaths over this five-year period than can be expected of more experienced midwives (5-9 years) over the same period.’’

But College of Midwives chief executive Karen Guilliland said the researchers’ data was flawed.

‘‘This study assumes the midwife initially registered to work alongside a woman is the same midwife with the woman at the birth and that is not correct.

‘‘As a pregnancy progresses and risk factors are recognised by midwives, women are referred or transferred to hospitals and the caregiver can change.’’

Since 2009 the rate of baby deaths during labour had significantly reduced, Guilliland said. ‘‘This improvement has occurred during a time when the number of midwife-only Lead Maternity Carer midwives has markedly increased . . . clearly the presence of highly educated midwives has improved the birth outcomes for babies.’’

Lawton said she was disappointed in the college’s response. ‘‘We want zero mistakes, zero avoidable deaths, that’s what we should be aiming for here,’’ she said. ‘‘Let’s move forward with quality control, let’s move forward to change some of the systems.’’

Lawton said the country had a good midwifery system, but ‘‘we need to have supervision in that first year’’.

She estimated that this year there could be 1500 pregnant women for whom their LMC was an independent midwife with less than one year’s experience postgraduation.

Action to Improve Maternity spokeswoman Jenn Hooper said the findings backed up everything her group had been saying about maternity care for years. The Jerry Cans, one of Canada’s most popular folk bands, are described as part folk, part country, part reggae and part Celtic, with a unique Inuit point of difference – duet throat singing. It’s little surprise then that a band this diverse will perform at Womad. Most of their music is written and sung entirely in Inuktitut. Their uniquely different sound is executed with one goal in mind, to get the locals up on their feet and dancing. ‘‘It’s an interesting history, it’s a combination of square dancing and folk dancing,’’ says Nancy Mike, the band’s resident throat singer.