Midwifery experience affects baby mortality – study
Researchers believe they have found a link between inexperienced midwives and baby mortality and want the Government to urgently overhaul maternity training in New Zealand.
The University of Otago research, published today in the International Journal of Gynecology and Obstetrics, found evidence that levels of midwifery experience are associated with baby deaths.
Lead author associate Professor Beverley Lawton is demanding an urgent review of the country's maternity training system.
She is also encouraging the Government to consider bringing in mandatory clinical supervision for newly-graduated midwives for up to two years in hospital followed by a supervised year in the community for independent midwives.
Prof Lawton estimates around 1500 pregnant women have a lead maternity caregiver who has less than one year's experience as an independent midwife.
"It's important to stress that this study points to a training issue for New Zealand midwives and the need for a system change to reduce unsupervised practice for junior midwives," she said.
The two-year study looked at Ministry of Health data of the more than 230,00 babies born between 2005-2009 to assess how the experience of midwives and related to the mortality of babies at and around the time of birth.
It found there was 30 percent higher likelihood of a baby's death if the midwife had less than a year's experience compared to the rate for other midwives.
Prof Lawton said there were 86 deaths among the group of less experienced midwives and that was 21 more deaths over the five-year period than can be expected of more experienced midwives over the same period.
"This finding for first-year direct-entry midwives is concerning and we need to be prepared to critique the training, and ensure we have a maternity system where mothers can have faith that the system they trust is the best it can possibly be," Prof Lawton said.
There is no requirement for supervision in the first years after graduation for midwife-only midwives, although a mentorship programme was introduced from 2011.