Young mums struggle to find support

Only around 95 per cent of teenage mothers engaged a midwife or another lead maternity carer in the recommended first 10 weeks of pregnancy. Photo / iStock

Teenaged and non-European mothers take longer to find a midwife than older, European mums, new research shows.

The Growing Up in NZ study of about 7000 babies born in Auckland and the Waikato in 2009-10 has found that only 94 to 95 per cent of Maori, Pacific and Asian mothers engaged a midwife or another lead maternity carer in the recommended first 10 weeks of pregnancy, compared with 98 per cent of European mothers.

The figure for teenage mothers was also about 95 per cent. Only about 95 to 96 per cent of women living in the most deprived areas engaged a midwife in the recommended time.

Although the differences were small, study co-author Dr Cameron Grant said it was worrying that the groups taking longer to hire a midwife were also those most at risk of poor birth outcomes such as low birthweight.

"So we do have some indication that we have some health outcomes that are partly improveable by better ante-natal care, so you could say that those we know have the poorest health outcomes are the ones who should be engaged best," he said.

"If you look at immunisation in North America, they now have higher coverage in their indigenous population than in their non-indigenous population because the indigenous population has a higher burden from vaccine-preventable diseases.

"I think this is an example where you have a group who need more care, and even if they were getting equal care that would barely be sufficient."

Some of the demographic gaps narrowed by the time women were interviewed for the study later in their pregnancy. By then 99 per cent of European women and 98 per cent of Asian women had lead maternity carers. But the figures were still only 96 per cent for mothers in the most deprived areas, 95 per cent of Maori, Pacific and teenaged women, and 93 per cent for women with only primary school education.

Midwives most popular option

The study found that 80 per cent of with lead maternity carers chose sole midwives, either independent midwives (66 per cent) or hospital midwives (14 per cent). Eight per cent chose private obstetricians, 1 per cent a general practitioner (GP), 5 per cent shared care between a GP and a midwife, and 6 per cent other combinations.

Hospital midwives were much more popular for Pacific and Asian women (both 26-27 per cent) than for Europeans (8 per cent).

Most (88 per cent) said they had a choice of lead maternity carer, but again this was less common for teenaged, Maori, Pacific and Asian women.

Dr Grant said delays in engaging lead carers were longer for hospital midwives, reflecting "the volume of work they have to do and their capacity to meet demand which is limited by financial constraints".

"People know that the first 1000 days of life from conception to age 2 is the most critical part in the life pattern for determining outcomes," he said. "So if we were truly serious about addressing some of these very early life issues, it requires greater resources to be focused on maternity care."