The Carosika Collaborative was established by a group of interested and passionate people in 2020. The Collaborative belongs to everyone who wants to improve preterm birth outcomes in Aotearoa. We are led by a Steering Group which includes whānau, healthcare professionals, researchers and Carosika Whānau Awhina (Whānau with Lived Experience).
The Collaborative works together to achieve equity for all whānau, aiming to reduce the number of preterm births and improve outcomes for those experiencing preterm birth in Aotearoa. We:
- Work across the spectrum of preterm birth including spontaneous and provider-initiated preterm birth and the prediction, prevention and preparation for preterm birth.
- Work through education and promotion, advocacy and community engagement, research and measurement of impact, and funding and resources.
- Provide clinical guidance for healthcare providers and healthcare services and health information for whānau and the community.
- Advocate for improved preterm birth care in Aotearoa.
- Create strong networks among community and whānau to achieve our goals.
Preterm birth in Aotearoa
Preterm birth, when pēpi are born before 37 weeks, can happen to anyone. Some people have a higher chance than others due to their personal pregnancy and health history and/or their social circumstances. About 8%, or 1 in 12 of all births occur preterm in Aotearoa, affecting more than 4500 whānau each year.
Depending on how early a pēpi is born, outcomes range from being very well with no or few ongoing effects, to requiring intensive support for many weeks or months in a neonatal intensive care unit and possible longer-term impacts. Sadly, a few pēpi who are born early do not survive. The Collaborative is working to ensure that every whānau has the best chance of avoiding preterm birth, or the best outcome when preterm birth is unavoidable.
Impacts of preterm birth
Most pēpi who survive do well after preterm birth in Aotearoa. However, preterm birth remains a leading cause of pēpi death in Aotearoa with the chance of pēpi dying after preterm birth being greatest for those few born at the limits of survival (23 weeks and 0 days to 24 weeks and 6 days).
All pēpi born preterm will require some additional care and for those born very early, this may be many months in neonatal intensive care. During this time pēpi are likely to need help with breathing and feeding and avoiding infection. Some pēpi will have complications that increase their chance of longer-term effects on their development and health and wellbeing through life.
The impact of preterm birth reaches beyond the individual born preterm with significant psychological and economic costs to whānau, community, healthcare systems and society.
Achieving equity
The Collaborative works with an overarching principle of ‘achieving equity in a culturally responsive way’ with a strong focus on making sure that all whānau impacted by preterm birth have the same opportunities for the best outcome. At present, this is not the case, often due to systemic problems that affect the health and well-being of some people and their access to consistent high-quality healthcare. These issues include the effects of colonisation, racism, geographical constraints and variation in practice, and inequity in resourcing.
We know that Asian and European whānau experience preterm birth less often than Māori, Pacific and Indian whānau, and that their pēpi are more likely to survive if born very early (before 28 weeks). We also know that the chance of preterm birth varies depending on where you live in Aotearoa and that pēpi born very early outside of metropolitan centres receive different treatment and are less likely to survive.
Other sociodemographic factors can further compound differences seen by ethnicity and geography. For example, wāhine/people who are Takatāpui/Rainbow community members or tangata whaikaha/living with disability may be further impacted by the effects of intersectional marginalisation.
These differences are unjust and unfair. We are committed to improving preterm birth care and support across Aotearoa, so that we can achieve the best outcomes for all whānau, whoever they are and wherever they live.
