PART 4: FORMAL AND INFORMAL SUPPORTS
Antenatal Care
Failure to receive appropriate antenatal care during pregnancy can lead to undesirable outcomes for both mother and infant; including maternal morbidity, low birth weight or even maternal and perinatal mortality. 67
Measure
The distribution of timing of 1st antenatal visit by trimester
(1st trimester = <15 weeks; 2nd trimester = 15-27 weeks; and
3rd trimester = >28 weeks) for all women delivering live or stillborn babies.
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Key findings
- In 2005, 72.3% of women presented for antenatal care in the 1st trimester, 19.9% in the 2nd trimester and 3.9% in the 3rd trimester (see Table 99).
Table 99: Percentage distribution of timing of 1st antenatal visit, by trimester and mother's age (2001-2005)
| 2001 | 2002 | 2003 | 2004 | 2005 | ||||||||||||||||
| Age | 1st | 2nd | 3rd | Not stated | 1st | 2nd | 3rd | Not stated | 1st | 2nd | 3rd | Not stated | 1st | 2nd | 3rd | Not stated | 1st | 2nd | 3rd | Not stated |
| <15 years | 50.0 | 33.3 | 16.7 | 0.0 | 30.0 | 50.0 | 10.0 | 10.0 | 26.7 | 46.7 | 20.0 | 6.7 | 50.0 | 33.3 | 16.7 | 0.0 | 33.3 | 66.7 | 0.0 | 0.0 |
| 15-19 years | 52.4 | 34.4 | 10.9 | 2.7 | 52.5 | 35.0 | 11.0 | 1.5 | 53.9 | 33.1 | 11.5 | 1.6 | 57.3 | 31.3 | 9.1 | 2.4 | 61.9 | 28.1 | 8.8 | 1.2 |
| 20-24 years | 55.7 | 28.8 | 12.4 | 3.1 | 55.7 | 29.5 | 12.7 | 2.2 | 58.0 | 28.9 | 11.4 | 1.7 | 62.7 | 27.9 | 7.2 | 2.3 | 66.6 | 25.4 | 6.3 | 1.7 |
| 25-29 years | 61.4 | 22.5 | 10.3 | 5.8 | 60.6 | 22.7 | 11.9 | 4.8 | 62.6 | 22.3 | 10.7 | 4.4 | 67.8 | 22.2 | 6.4 | 3.7 | 71.9 | 20.4 | 4.9 | 2.8 |
| 30-34 years | 66.3 | 19.3 | 6.4 | 8.1 | 65.7 | 19.8 | 6.7 | 7.8 | 68.2 | 19.7 | 6.1 | 6.0 | 72.5 | 18.7 | 3.6 | 5.3 | 75.0 | 17.4 | 3.0 | 4.6 |
| 35-39 years | 66.4 | 19.3 | 5.6 | 8.7 | 66.0 | 21.0 | 5.2 | 7.9 | 68.7 | 20.0 | 4.6 | 6.7 | 72.1 | 18.9 | 2.9 | 6.1 | 73.9 | 18.3 | 2.4 | 5.5 |
| 40-44 years | 62.9 | 22.9 | 5.9 | 8.3 | 65.3 | 22.5 | 5.8 | 6.5 | 66.5 | 21.0 | 5.2 | 7.3 | 69.2 | 21.6 | 2.7 | 6.5 | 71.1 | 22.0 | 2.6 | 4.4 |
| 45 and over | 52.5 | 28.8 | 8.8 | 10.0 | 55.9 | 23.5 | 11.8 | 8.8 | 65.3 | 20.8 | 8.3 | 5.6 | 69.8 | 23.8 | 1.6 | 4.8 | 64.6 | 22.0 | 6.1 | 7.3 |
| Not stated | 13.6 | 22.7 | 18.2 | 45.5 | 25.5 | 27.5 | 13.7 | 33.3 | 39.3 | 18.0 | 11.5 | 31.2 | 46.6 | 17.3 | 6.0 | 30.1 | 47.5 | 20.3 | 3.4 | 28.8 |
| Total | 62.7 | 22.4 | 8.3 | 6.6 | 62.4 | 23.0 | 8.7 | 5.9 | 64.8 | 22.2 | 7.9 | 5.1 | 69.2 | 21.4 | 4.8 | 4.7 | 72.3 | 19.9 | 3.9 | 3.9 |
Source: National Perinatal Reporting System, ESRI
Differences by age and social class
- Antenatal visits in the 1st trimester are lowest among the lower socio-economic groups, such as the 'unemployed' (59.5%) (see Figure 40). Women who are primarily engaged in home duties also have one of the lowest proportions of antenatal visits in the 1st trimester (65.5%).
- The highest proportion of women attending for antenatal care in the 1st trimester are those whose occupations are categorised as 'salaried employees' (81.4%) and 'managers' (79.2%).
Figure 40: Percentage of mothers attending for antenatal care in the 1st trimester of pregnancy, by occupation of mother (2005)*
* Occupation categories where percentages are based on less than 100 births have been omitted in this figure (i.e. 'Unskilled Manual Workers', 'Other Agricultural Occupations and Fishermen' and 'Farmers and Farm Managers').
Source: National Perinatal Reporting System, ESRI
Differences by geographic area
- In 2005, 89.9% of mothers in Donegal attended for antenatal care in the 1st trimester, compared with 19% in Mayo (see Figure 41). This may be due, in part at least, to some differences in recording first contact with general practitioner services.
Figure 41: Percentage of mothers attending for antenatal care in the 1st trimester of pregnancy, by county of residence of mother (2005)
Source: National Perinatal Reporting System, ESRI
Technical notes
The National Perinatal Reporting System (NPRS) dataset provides details of national statistics on perinatal events (live births, late foetal deaths or still births). Information on every birth that occurs either in hospital or at home is returned to the NPRS. The information collected includes data on pregnancy outcomes, with particular reference to perinatal mortality and important aspects of perinatal care. The period to which the information applies is from 22 weeks' gestation to the first week of life. In addition, descriptive social and biological characteristics of mothers giving birth and their babies are recorded. The Economic and Social Research Institute (ESRI) is contracted by the Department of Health and Children to manage the NPRS system.
The collection of data on timing of first antenatal contact variable attempts to capture important information on Irish women's first contact with the healthcare services during pregnancy. This variable acts as an indicator of the length of antenatal care each mother has received and can be examined with birth, still birth and mortality rates. The completion of this indicator at present, however, may not provide an accurate estimation of this information. If the data are examined more closely, it is seen that in 2005, for example, 77% of all babies born had antenatal care recorded as 'combined care'. Of these, over 40% of patient records have recorded 'date of first visit to the hospital' only. If hospitals are not recording the mother's first antenatal visit to their GP or any other healthcare provider, the NPRS is effectively only reporting on time of first visit to the hospital. As a result, the percentage of mothers attending antenatal care during the 1st trimester is an underestimate and is very low at 72% of all births. This is much lower than other European countries, where the percentage of mothers attending antenatal care during the 1st trimester is in the region of 90%.