Perinatal, Infant Mortality Rate Continues To Fall
The Department of Health has welcomed a new report, which shows perinatal and infant mortality rates in Western Australia continue to decline.
Perinatal deaths include stillbirths and neonatal deaths, which occur in the first 28 days of life.
Chief Medical Officer Dr Simon Towler said the 12th Report of the Perinatal and Infant Mortality Committee (PIMC) reviewed cases of perinatal and infant death that occurred between 2002 and 2004 and provided valuable information, which would help WA Health as it moved to further develop and deliver maternity services throughout the State.
"Safety for women and babies is paramount," he said. "Western Australia is one of the safest places in the world to give birth and it is important to maintain this level of safety and give women choices in childbirth."
Dr Towler said it was pleasing that overall, the PIMC's recommendations endorsed the current planned direction of obstetric care in WA.
The report found that WA's perinatal and infant mortality rates had reduced from those for 2000-2001 and that the State compared favourably with national statistics. The perinatal death rate in WA in 2002-2004 was 9.8 per 1,000 births, compared to the Australian rate of 10.5 per 1,000 births over a comparable period.
There had been a reduction in deaths with preventable medical factors, and these were now at a very low level. 96 per cent of investigated stillbirth and infant deaths in Western Australia during the time period were considered unavoidable in a medical context.
Dr Towler said the report had raised three key areas of concern - the role of socioeconomic status and smoking as risk factors for stillbirth and infant death, the continuing high mortality rate of Aboriginal babies, and the relatively higher mortality rate of babies born at term to mothers who had chosen a home birth.
"The report found six unexpected deaths in planned home births during 2000-2004 which is a term perinatal death rate of 6.7 per 1,000 home births compared with 2.1 term per 1,000 in planned hospital births in the same period," he said.
"The Department is keen to examine these incidents and is in the process of commissioning an independent professional review of home births.
"A preliminary review of medical records by the Department indicates that it is likely that the setting of the birth did not affect the outcome in at least five of the six deaths."
Home births are undertaken by independent midwives and those working within the Community Midwifery Program (CMP) - a combined program between WA Health and Community Midwifery Western Australia (CMWA).
Dr Towler said the Department had worked closely in the past two years with the CMWA to enhance the standards, protocols and governance of the service and was pleased with the progress that had been achieved. To date there have been no perinatal deaths in the program in 2007.
The high Aboriginal infant mortality rate and socioeconomic status and smoking factors were being addressed in the development of the new Statewide maternity services plan.
"The Department is committed to improving maternity services for all women and improving the health and development of infants, with an emphasis on improving outcomes for Aboriginal women and their babies and providing safe and accessible community-based care," Dr Towler said.
"These key issues will be a focus of WA Health's policy framework for maternity services over the next five years -Improving Maternity Choices: Working Together Across WA, due for release in the new year."