We annually evaluate our statistics in order to monitor safety and quality of care.
This monitoring process is of upmost importance to us in ensuring that mothers and their babies are receiving safe and high quality care but also allows us to implement necessary changes and improvements to our services.
The most important conclusion for our 2014 data is that our midwifery care is safe, in particular homebirth.
We have compared our Ten Moons Statistics to the National Core Maternity Indicators 2009 data and the Cosmos outcomes (‘COmparing Standard Maternity care with One to one midwifery Support’, 2012) for benchmarking comparison to national and local outcomes in the maternity services industry.
National Core Maternity Indicators (Australian Institute of Health and Welfare)
The ten national core maternity indicators are:
- Developed by the Australian government to monitor the quality of maternity services in Australia
- Clinical indicators that monitor the national quality of maternity performance and outcome of care
|No.||Description||National Core Maternity Indicators (2009)||Ten Moons (2014)|
|3a||Episiotomy for women having their first baby and giving birth vaginally without instruments||15.1%||0%|
|3b||Episiotomy for women having their first baby and giving birth vaginally with instruments||58.5%||0%|
|4||Apgar Score of less than 7 at 5 minutes for births at or after term||1.1%||0%|
|5||Induction of labour for selected women giving birth for the first time||32.7%||8.3%|
|6||Caesarean section for selected women giving birth for the first time||27.1%||8.3%|
|7||Normal (non-instrumental) vaginal birth for selected women giving birth for the first time||49.6%||83.3%|
|8||Instrumental vaginal birth for selected women giving birth for the first time||23.3%||8.3%|
|9||General anaesthetic for women giving birth by caesaraen section||8.4%||0%|
|10||Small babies among births at or after 40 weeks gestation||1.8%||0%|
COSMOS (‘COmparing Standard Maternity care with One to one midwifery Support’, 2012)
- First randomised controlled trial comparing caseload midwifery care with standard options of care for women at low risk of medical complications at the Royal Women’s Hospital in Melbourne (in caseload midwifery, women are cared for by a primary midwife throughout pregnancy, birth and the early postnatal period, and care is provided by one or two back-up midwives only when needed)
- First randomised controlled trial of caseload midwifery in Australia and largest study of its kind in the world
- Caseload midwifery is a model of maternity care recommended in Victoria and throughout Australia and is often referred to as the ‘gold standard’ in maternity care
|Description||Cosmos (2012)||Ten Moons (2014)|
|Spontaneous Vaginal Birth||63%||84%|
Other Ten Moons Statistics (2014)
1. Parity (number of times that a woman has given birth)
2. Planned Place of Birth
3. Homebirth Transfers
Out of the 68% of women who planned having a homebirth, 85% gave birth at home. 15% of women got transfered to hospital non-emergently for failure to progress in the first stage of labour.
Emergency Hospital Transfers 0%!
4a. Type of Birth for all Women
Vaginal birth after caesarean (VBAC) were not included into the birthing statistics due to a small VBAC caseload (2). 1- successful VBAC, 2- repeat caesarean after attempted VBA2C
4b. Type of Birth for first time Mothers
83% of first time mothers had a normal vaginal birth.
5. Onset of Labour
6a. Perineal Injuries for all Women
67% of 1st and 2nd degree tears did not get sutured and had healed completely by 6 weeks after birth.
6b. Perineal Injuries for first time Mothers
7. Pharmacological Pain Relief
N2O= gas in air
8. Birth Positions
32% of the women having a waterbirth gave birth at home.
9. Birth of Placenta
10. Postpartum Haemorrhage (PPH)
The PPH >1L occured during a surgical birth in the hospital.
Out of the remainder 21% some occured during homebirths. None of the homebirths were transfered to hospital for PPH management and all of them got safely and appropriately managed at home with no adverse outcomes.
11. Neonatal Outcomes
- 100% were born at term (>37 weeks gestation)
- 100% had a birthweight >2500 gr
- 100% had a 5 minute Apgar of 9
- 0 SCN admissions in the homebirthing group
- 2 SCN admissions for phototherapy at 3 days and 7 days of age in the planned hospital birth group (both cases had home visits from hospital midwives only, Ten Moons had limited involvement in the immediate postnatal care)
12. Breastfeeding Rates
|Description||Australian Institute of Family Studies (2008)||Ten Moons (2014)|
|Breastfeeding Initiation Rate||92%||100%|
|Exclusive Breastfeeding Rate at 6 weeks||79%(11% partial breastfeeding rate, 11% of data incomplete at time of report)|
|Exclusive Breastfeeding Rate at 6 months||14%||58%(5% partial breastfeeding rate, 37% of data incomplete at time of report)|
The above published statistics are based on a total caseload of 19.