In 2019 there were 8,083 live births in Norfolk. While motherhood is usually a positive and fulfilling experience, it can be associated with poor physical and mental health. Promoting healthy behaviours can give children the best start in life. Smoking in pregnancy can cause serious pregnancy-related health problems including complications during labour and an increased risk of miscarriage, stillbirth, low birthweight and sudden unexpected death in infancy.
Across the first three quarters of 2019 around 44% of babies were recorded as being breastfed at the time of their 6-8-week check-up in Norfolk. This is lower than England at 48% over the same time period. In their first-year infants are vulnerable to ill health and accidents, and consequently have a high rate of using health services and admissions to hospital.
Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. In 2019 there were 8,083 live births in Norfolk. While motherhood is usually a positive and fulfilling experience, it can be associated with ill-health. The major direct causes of maternal morbidity and mortality include haemorrhage, infection, high blood pressure and obstructed labour.
Perinatal mental illness encompasses a range of mental health conditions that mothers may experience during pregnancy or in the first year after the birth of their child. These illnesses include antenatal and postnatal depression, maternal obsessive-compulsive disorder, anxiety and psychotic disorders. These conditions may be experienced for the first time in the perinatal period, or childbirth can lead to a recurrence of existing conditions, estimated to effect 20% of women in the UK and are the leading causes of maternal death.
Experiencing mental health problems can make adjustment to motherhood and caring for new and existing children more difficult and can impact upon the mother’s self-esteem. Certain studies have shown that younger mothers are far more vulnerable to mental health issues due to the effects of childbirth. During pregnancy and a year after the birth, a significant number of women experience common mild mood changes. Some other women can be afflicted by certain common mental health problems. In the UK 13% of pregnant women or new mothers are affected by anxiety disorders and 12% by depression.
The risk of developing a more severe mental health condition such as postpartum psychosis (in the UK this effects approximately 2 in 1000 women who have recently given birth) severe depressive illness, schizophrenia and bipolar illness are currently low but this risk increases after childbirth. The impact of poor mental health can be greater during this time period, especially if left untreated.
An infant is a child aged between birth and one year. Infants are vulnerable to ill health and accidents they also make up roughly 10% of unplanned Accident and Emergency (A&E) visits.
Infant mortality represents a particularly distressing category of premature death and is an indicator of the general health of an entire population. In 2019 there were 29 infant deaths in the whole of Norfolk this represents a mortality rate of roughly 3.4 deaths per 1000 infants. This compares with England which had a rate of 3.9 deaths per 1,000 infants over the same year. In 2019 Infant deaths account for around 50% of the deaths of people aged 0-19 in Norfolk.
Breastfeeding is associated with positive health outcomes for both mother and baby in early years and later life. The NHS recommends that mothers exclusively breastfeed their baby for the first 26 weeks of life followed by a combination of breast milk and other foods. Across the first three quarters of 2019 around 44% of babies in Norfolk were recorded as being breastfed at the time of their 6-8-week check-up, this compares with England at 48% over the same time period.
Smoking & pregnancy
Smoking in pregnancy can cause serious pregnancy-related health problems, including complications during labour and an increased risk of miscarriage, premature birth, stillbirth, low birthweight and sudden unexpected death in infancy. Potential harms to the child include the increased chance of attention difficulties, breathing problems and poor educational attainment. Smoking in pregnancy is five times more likely in deprived areas and so disproportionately impacts on these communities. The Norfolk and Waveney Health and Care Partnership hospitals reported in the second quarter of 2020/21, the percentage of Women known to be smokers at time of delivery was 14%, higher than for England at 9.9%.
Teenage Pregnancy (usually defined as pregnancy in young people aged under 18) is an important health issue because most teenage pregnancies are unplanned and around half end in an abortion. While many teenagers do make excellent parents, bringing up a child as a teenager can be extremely difficult and result in poor outcomes for both the teenage parent and the child.
In 2018 the number of conceptions of young women aged under 18 in the Norfolk area was 17.1 per 1000, with 53% of these leading to abortions. This number of conceptions was higher than England at 16.7 per 1000 young women aged under 18. The rate of young women under the age of 18 giving birth has dropped 55% between 2013 and 2019 in Norfolk following the trend of England in general. The number of teenage births fell from 119 in 2013 to 55 six years later.
Parents & deprivation
Poverty causes deep material and psychological harm to those who experience it. Evidence suggests that childhood poverty leads to premature mortality and poor health outcomes as adults. Other evidence shows that children from the poorest families are four times more likely than rich ones to experience several mental health problems growing up. Households below average income are defined as having a total income lower than 60% of the median household income. In 2019 in Norfolk 20% of children were living in a household below average income compared to 21% in England. The proportion of children in this situation has been steadily increasing over the past five years in Norfolk and England.