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Women Giving Birth by Caesarian Section and Undergoing Blood Transfusion During Birth Admission, by DHB of Domicile

Basic Facts

Stage of development


Potential or current usage

This indicator is used by the Health Quality and Safety Commission for the New Zealand Atlas of Variation.

Brief overview of the measure

General description

Broad subject area: Maternity Specific aspect of care: Caesarian section and blood transfusion Population of interest: Women giving birth by Caesarian section Setting: Maternal care Level of focus: District Health Board

Rationale for selection

Excessive blood loss is a potentially life threatening complication of birth, however it is difficult to measure precisely. The requirement for blood transfusion can be used instead as a broad measure of excessive blood loss/ post-partum haemorrhage.

Type of measure


Domain(s) of quality


Application and interpretation of the measure

Stated intent of the measure

This measure can be used to compare levels of blood transfusion in mothers giving birth via Caesarian section between various District Health Boards in New Zealand. It can be used for quality improvement and benchmarking purposes regarding pregnancy complications.

Caveats - Considerations

Data includes New Zealand resident and non-resident population and is for 1 January-30 December 2009. Data source: Ministry of Health, 2012. New Zealand Maternity Clinical Indicators 2009. Please note that these data have been corrected since the initial release which erroneously included women aged 35 years in this analysis. For this reason numerators and rates will be slightly lower than those previously published.

Links to other measures

New Zealand Atlas of Variation New Zealand Maternity Clinical Indicators 2009

Level of health care delivery/setting

Maternal care settings by District Health Board

Target population

Women giving birth via Caesarian section

Calculation of the measure

Output of calculation

Data are presented as standard deviation from the mean. Standard deviation is a statistical measure of variation from a mean. Assuming that recorded instances are normally distributed (i.e. they are in the usual ‘bell-shaped curve’) 95% of all recorded instances would be expected to be within 2 standard deviations either side of the mean. The two ‘middle’ shades will be within one standard deviation of the mean.

Numerator description

Women giving birth by Caesarian section who require a blood transfusion during the same admission

Denominator description

Total number of women who undergo Caesarian section in a publicly funded hospital birth

Time period

One year

Criteria/standard for optimal performance

There are no criteria for optimal performance; this measure is intended to benchmark regional differences in birth by Caesarian section.

Data source

The data is extracted from the Ministry of Health.

Method of extraction

No information available.

Appraisal of the measure

Availability of evidence to support application of the measure

The measure has been developed or endorsed by an organization that promotes rigorous development and use of clinical performance measures (at an international, national, regional or local level).

Evidence of feasibility and reliability of implementation

Availability of data - Required data elements for the measure can be gathered during routine practice activities

Development approach

The subjects in the Atlas were chosen by a group of clinical experts and consumers based on clear criteria regarding the importance of the area and the likelihood there was unexplained variation in services.

Other items

Owner details

Reference number


Date of entry to library

2013-11-22 11:32:19

Owner (Organisation name)

Health Quality and Safety Commission

Owner (Email contact)


Creator (Organisation name)

Health Quality and Safety Commission

Creator (Email contact)