Overview of Maternity
Giving every child the best start in life is a key priority for Sandwell. This is because a healthy, happy and well-supported start in life will help to ensure that children go on to be healthy, happy adults. For those who go on to raise children of their own, the health improvement we achieve here and now with this generation will be passed on to the next.
Infant mortality is an indicator of the general health of an entire population. It reflects the relationship between causes of infant mortality and other determinants of population health such as economic, social and environmental conditions.
Reducing infant mortality overall and the gap between the richest and poorest groups are part of the Government's strategy for public health (Healthy Lives, Healthy People: Our Strategy for Public Health November 2010). In 2015 the government also announced an ambition to halve the rate of stillbirths by 2030.
Fertility and Births
The General Fertility Rate (GFR) compares births to the female population in the age range that many have babies, and so is a more meaningful rate than Crude Birth Rate which compares births to the overall population. In 2016, the GFR in Sandwell stood at 73.9 per 1,000 females aged 15 to 44 years. This is higher than both the West Midlands and England (65.1 and 62.5 per 1,000, respectively), and is statistically higher than the both the West Midlands and England throughout the 2010 - 2016 period.
Infant mortality (deaths under 1 year of age per 1,000 live births) can be an indicator of the general health of an entire population. It reflects the relationship between causes of infant mortality and other determinants of population health such as economic, social and environmental conditions. In 2015-17, at 6.5 per 1,000, infant mortality in Sandwell is statistically worse than England (3.9 per 1,000).
The English Indices of Deprivation 2015 is an official measure of deprivation and provides data at Lower Super Output Area (LSOA) level. The measure shows which of the ten national deciles (10% bands) the 186 LSOAs in Sandwell fit into.
Infant Mortality data can be split into two components; neonatal mortality (deaths under 28 days per 1,000 live births) and post-neonatal mortality (deaths between 28 days and 1 year per 1,000 live births). Neonatal mortality and stillbirths (foetal deaths occurring after 24 weeks of gestation) are important as they can reflect care during pre-pregnancy, pregnancy, birth and immediately after birth.
The rate of stillbirths in Sandwell is higher than nationally. Risk factors associated with stillbirth include maternal obesity, ethnicity, smoking, pre-existing diabetes, and history of mental health problems, antepartum haemorrhage and foetal growth restriction. The rate of some of these risk factors are also known to be higher in Sandwell than nationally.
Premature Births and Low Birthweight
Premature birth (less than 37 weeks gestation) is important to look at because pre-term birth complications are the leading global cause of death for children under the age of 5. Smoking in pregnancy is one cause of premature birth - this is discussed in the smoking needs analysis. Data is currently only available for premature births including all stillbirths.
Low birth weight can increase the risk of childhood mortality and child developmental problems, and can be associated with poorer health in later life. A high proportion of low birth weight births could indicate poor lifestyle issues of mothers, and issues with the services offered to mothers.
Although for some young women having a child when young can represent a positive turning point in their lives, for many more teenagers bringing up a child is extremely difficult and research evidence shows that teenage pregnancy is associated with poorer outcomes for both young parents and their children. Most teenage pregnancies are unplanned and around half end in an abortion which represents an avoidable cost to the NHS.
In 2016 there were 154 under 18 conceptions in Sandwell, with a rate of 27.4 per 1,000 aged 15-17, compared with 18.8 for England. For the period 2010-2016 the under 18 conception rate was statistically worse than both England and the West Midlands.
Breastfeeding is thought to reduce illness in young children, have health benefits for the infant and the mother, and result in cost savings to the NHS through reduced hospital admissions for the treatment of infection in infants.