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Childbirth

Volume 458: debated on Monday 19 March 2007

To ask the Secretary of State for Health how many and what proportion of births were classed as normal in each year since 1995. (126167)

For the years 2002-03, 2003-04 and 2004-05 the numbers of normal deliveries (defined as those without surgical intervention, use of instruments, induction, epidural or general anaesthetic before or during the birth) are set out in the table. Information for years before 2002 is not available centrally.

Number of deliveries

Number of normal deliveries

Percentage normal

2002-03

548,000

257,560

47

2003-04

575,900

264,914

46

2004-05

584,100

280,368

48

To ask the Secretary of State for Health what international comparators she uses when assessing perinatal statistics. (127278)

I have been asked to reply.

The information requested falls within the responsibility of the National Statistician who has been asked to reply.

Letter from Karen Dunnell, dated 19 March 2007:

As National Statistician, I have been asked to reply to your question asking what international comparators are used when assessing perinatal statistics. (127278)

It is difficult to make international comparisons on perinatal mortality because of different definitions used for compiling perinatal mortality statistics. These are due to differences in the legal criteria used for birth registration and inclusion criteria used for recording birth information on other data collection systems. According to the World Health Organisation (WHO), the perinatal period commences at 22 completed weeks (154 days) of gestation (when birthweight is normally 500 grams) and ends 7 completed days afterbirth1.

In England and Wales, perinatal mortality statistics (since 1992) are based on the legal definition of stillbirths registered at 24 or more weeks gestation, which are collected by the vital registration system, and includes deaths at ages up to 6 completed days of life (whatever the gestational age at live birth). Scotland, Northern Ireland and Ireland use the same stillbirth definition as England and Wales, hence perinatal mortality statistics are comparable between these countries.

Countries such as Austria, Germany, Luxembourg and Portugal collect information on births using the WHO criteria and hence perinatal mortality statistics for these countries are comparable2. But in countries such as Denmark, Spain and Sweden, only fetal deaths after 28 or more completed weeks of gestation are registered as stillbirths, and in countries which use no such criteria, regulations about stillbirth registration can affect decisions about whether an event is a late miscarriage or should be registered as a birth. Furthermore, under-reporting can be a problem, particularly where data collection systems are not statutory.

Therefore, the PERISTAT project funded by the European Union was charged with developing a set of indicators for monitoring and describing perinatal health in Europe.

With the PERISTAT indicator set, the aim is to facilitate the surveillance of perinatal health in the EU by harmonizing indicator definitions and encouraging the collection of comparable data for the following purposes:

To assess maternal and infant mortality and morbidity associated with events in the perinatal period.

To describe the evolution of risk factors for perinatal health outcomes in the population of childbearing women, including demographic, socio-economic and behavioural characteristics.

To monitor the use and consequences of medical technology in the care of women and infants during pregnancy, delivery and the postpartum period.

ONS has been providing data for England and Wales for the PERISTAT indicators, where possible.

Further details on this project can be viewed using this link:

http://europeristat.aphp.fr/en/index.html

1 International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Volume 1, page 1237.

2 European Journal of Obstetrics and Gynaecology and Reproductive Biology, volume 111, supplement 1, 2003, page SI7.