Births and Infant Health

This topic area covers statistics and information relating to births and infant health in Hull including local strategic need and service provision. Further information is also available within Pregnancy and Maternal Health, Breastfeeding, Smoking in Pregnancy, and Stillbirths and Infant Mortality within Pregnancy and Births within Children and Young People. Information on Under 18 Conceptions is given under Health Factors within Children and Young People. Information on Sexual and Reproductive Health is given under Health Factors within Adults. Information is also available on A&E attendances and hospital admissions within A&E Attendances and Hospital Admissions under Health Factors under Children and Young People.

This page contains information from the Office for Health Improvement & Disparities’ Fingertips. Information is taken ‘live’ from the site so uses the latest available data from Fingertips and displays it on this page. As a result, some comments on this page may relate to an earlier period of time until this page is next updated (see review dates at the end of this page).

Headlines

• There were 3,079 live births to Hull residents in 2021. The number of births in Hull has been decreasing over the last decade (from a peak of 3,871 in 2012).
• One in seven deliveries in 2021/22 were to mothers from Black, Asian and Minority Ethnic groups in Hull (13.8%) which was considerably lower than England (22.9%), but a considerable increase in Hull since 2013/14 when it was 8.2%.
• The age profile of women giving birth in Hull is younger than England with the under 18 conception rate more than twice as high in Hull as England (29.1 versus 13.1 per 1,000 women aged 15-17 years for 2021), and the percentage of deliveries to women aged 35+ years in Hull considerably lower than England (14.3% versus 24.2% in 2021/22).
• The rate of caesarean sections in Hull has been increasing over time from 24.4% in 2014/15 to 32.4% in 2021/22, although the rate in Hull is statistically significantly lower than in England (34.7%).
• Overall, 11.5% of births were multiple births in Hull in 2021 which is slightly lower than England (13.7%). The rate of premature births (less than 37 weeks gestation) in Hull has been gradually increasing since 2013-15 and for 2019-21 is statistically significantly higher than England (98.2 versus 77.9 per 1,000 live births and stillbirths with 24+ weeks gestation). The percentage of all babies (live births and stillbirths) born with a low birth weight (under 2,500 grams) or very low birth weight (under 1,500 grams) is higher in Hull compared to England, possibly because the rate of premature births was higher in Hull. Among babies born to term (37+ weeks gestation), the percentage of low birth weight babies was similar in Hull compared to England (2.9% versus 2.8%).
• During 2021/22, virtually all babies in Hull had their newborn hearing test (99.8%) which was higher than England (98.7%) and among highest across the region. During 2021/22, the percentages of new birth completed within 14 days was higher in Hull compared to England (88% versus 83%) as was the percentage of infants receiving their 6-8 week check (92% versus 82%).

The Population Affected – Why Is It Important?

Good antenatal care and support can identify potential problems early, and provide information to aid informed choice. Poor care during the birth can increase the risks to both mother and baby. Good maternity services should respond to the physical, psychological, emotional and social needs of women and their family in a structured and systematic way.

Infant mortality rates are higher among babies that are sole registered than for other registration types.

There is a higher risk of adverse events in pregnancy and during the birth for women who are teenagers, who are older, who smoke, who are overweight and who have other risk factors such as diabetes. The proportion of births to older women and women who are overweight has increased giving rise to an increase in the likelihood of adverse events. This, together with the higher number of births overall, has placed additional pressure on already stretched maternity services nationally.

There are a number of screening programmes in place in the UK relating to antenatal and newborn. Tests in pregnancy and in the newborn after birth are designed to help make the pregnancy safer, check and assess the development and wellbeing of the women and her baby, and screen for particular conditions. Digitalisation of these screening tests is improving access to the results for all people involved in the care process.

Uptake rates for screening of pregnant women is available for England and for each region and not available at local authority level. Uptake rates are also not available at local authority level for the physical examination of infants after birth or the infant ‘blood spot’ screening, although information is available for the infant hearing test.

The Hull Picture

Births

Information relating to taking folic acid supplements and obesity and smoking in early pregnancy are given under Pregnancy and Maternal Health within Pregnancy and Infants within Children and Young People.

From The Office for Health Improvement & Disparities’ Fingertips, the fertility rate is given for Hull compared to other geographical areas. The general fertility rate is the number of live births occurring to females aged 11+ years per 1,000 female population aged 15-44 years. The fertility rate in Hull is slightly higher than England for 2021.

In Hull, there were almost 3,900 births in 2012, but this has been gradually reducing and there were 3,079 births in 2021. Reductions in the general fertility rate have also occurred in England and across the region over the same time period.

Hull has a relatively low percentage of deliveries to mothers from Black, Asian and Minority Ethnic groups compared to England, but the percentage in Hull is considerably higher than some local authorities across the Yorkshire and the Humber region.

The percentage of deliveries to mothers from Black, Asian and Minority Ethnic groups has been increasing in Hull, and is the highest it has been at 13.8% for the latest period 2021/22.

The percentage of caesarean sections in Hull is statistically significantly lower than England for 2021/22, although the absolute difference in the percentages is relatively small (32.4% versus 34.7%).

The percentage of caesarean sections has been increasing in Hull as it has been in England and across the region with no real change in Hull in the last year compared to a continued increase for both England and the region .

The information below gives the rate of under 18 conceptions per 1,000 women aged 15-17 years, the rate of under 16 conceptions per 1,000 women aged 13-15 years, the percentage of teenage mothers out of all deliveries, and the percentage of mothers aged 35+ years out of all deliveries.

There are more births among under 18s in Hull and fewer among women aged 35+ years in Hull compared to England. The rates of under 18 conceptions and under 16 conceptions are both more than twice as high as England, but the percentage of births to mothers aged 35+ years in Hull is 41% lower than England.

The percentage of births to mothers aged 12-17 years in Hull was three times higher than England for 2021/22 (1.8% versus 0.6%).

There has been a decreasing trend in the under 18 conception rate since 2004 with the rate in Hull decreasing by around 60% between 2004 and 2021. There were 128 conceptions among under 18s during 2020 which is around one-third the number that occurred each year between 1998 and 2008.

More detailed information on Under 18 Conceptions is given under Health Factors within Children and Young People.

The percentage of births to mothers aged 35+ years has been increasing in Hull from 11.3% in 2013/14 to 13.6% in 2020/21, although the percentage has been consistently lower in Hull compared to England and the Yorkshire and Humber region.

The age distribution of mothers in Hull calculated from the local births dataset is given below. According to this, in 2021 there were 3,065 births to Hull residents which differs slightly from Fingertips with 3,079 births in total (stillbirths and live births), but the differences are relatively small. The average age of the mother at time birth was 28.5 years old. The median (middle value when all ages are ranked in order) age at time of birth of all the mothers was 28 years old. The middle 50% of total births fell to mothers between the ages of 24 and 32 years old at time of birth. There were 22 births where the age of mother at birth was unknown/unrecorded, which are included in the total births figure but are not included in average age and age range calculations.

Mothers between the ages of 20 and 34 years account for over 80% of all live births each year, with mothers ages between 25-29 years accounting for the most births at around a third of total live births each year. Previously the second largest group was between the ages of 20 and 24 years, however this group has decreased over the years (from 28% in 2012 to 20% in 2021) with mothers ages between 30 and 34 years increasing across the same period (from 21% in 2012 to 29% in 2021) to become the second largest group each year. Mothers aged between 35-39 years has also been increasing gradually, whereas teenage mothers have shown an overall decrease during this time, with a slight increase since 2019. These trends are reflected in the average age of mothers per year increasing from 27.1 years in 2012 to 28.5 years in 2021.

The percentage of women with multiple births in Hull is lower than England. As the rate of premature births is higher in Hull compared to England, it is perhaps not surprising that the percentage of babies born with a low birth weight is higher in Hull compared to England. Among babies born to term (after 37 complete weeks of pregnancy) the percentage with a low birth weight in Hull is comparable to England.

The rate of multiple births figure is per 1,000 maternities. Premature births is the number of births with a gestational age between 24-36 weeks and all stillbirths (also 24+ weeks gestational age) given as a rate per 1,000 live births and stillbirths.

The figures relating to low birth weight are all given as percentages. The number of low birth weight (under 2,500 grams) and very low birth weight (under 1,500 grams) babies is also given for all live births and stillbirths (24+ weeks gestational age). Low birth weight of term babies is the number of live births of full-term babies (at least a gestational age of 37 complete weeks) born with a low birth weight (under 2,500 grams) out of all live full-term births.

In Hull, there has been year-on-year variability in the percentage of multiple births. The percentage in Hull has generally been between 11% and 15%, and has been consistently lower in Hull.

Over the period 2006-08 to 2013-15, the rate of premature births (after 24+ weeks of gestational age) per 1,000 live births and stillbirths has been consistently lower or comparable to England. However, the rate increased in 2014-16 becoming statistically significantly higher than England, and the rate has continued to increase in Hull increasing the inequalities gap further, although there has been a slight decrease in the last year.

The number of premature live births is the highest it has been in 2018-20 since at least 2006-08 although falling to 98.2 premature live births (gestational age between 24-36 weeks) per 1,000 live births and stillbirths (24+ weeks) for 2019-21.

During the three year period 2019-21, there were 924 premature live births to Hull mothers.

The percentage of low birth weight babies in Hull was consistently lower than England between 2010 and 2013, but increased slightly between 2014 and 2017. In the 2018, the percentage of low birth weight babies increased considerably in Hull by almost two percentage points from 8.1% in 2017 to 9.7% in 2018, and whilst the percentage in Hull has decreased between 2018 and 2021, the rate is still considerably high relative to England.

The percentage of very low birth weight babies is small being at around 1.5%, and as a result there tends to be year-on-year variability with the figures. Over the period 2010 to 2018, the percentage of very low birth weight babies in Hull has consistently been similar or slightly above the percentage in England. However, the percentage increased to a high of 1.8% for 2019 and 2020. The percentage has fallen back to 1.2% for 2021.

Among live births born to term (37+ weeks gestational age), the percentage of low birth weight babies in Hull has been relatively similar to England since 2010 at around 2-3%.

Screening and Health Checks

Fingertips presents data on the percentage uptake of the infant hearing screening test. Almost all newborn babies in Hull had their hearing screening test in 2021/22 (99.8%) which was the higher than England (98.7%) and among the highest across the Yorkshire and Humber region.

The rates have been consistently high in Hull, and remained unchanged between 2019/20 and 2020/21 when the percentage had the potential to be influenced by the COVID-19 pandemic. The percentages decreased for England and the region between 2018/19 and 2020/21.

For 2021/22, the percentage of new birth visits completed within the first 14 days and the percentage of 6-8 week visits completed within the time period are high in Hull compared to England and the Yorkshire and Humber region. These early visits are very important so that any problems can be picked up quickly especially those relating to maternal emotional and mental wellbeing.

The percentage of new birth visits completed within 14 days in Hull was significantly lower than England during 2017/18 and 2018/19, but is now statistically significantly better having increased from 82.9% in 2017/18 to 89.5% in 2020/21, and whilst the rate is statistically significantly higher in Hull compared to England during 2021/22, the rate in Hull has decreased slightly from 89.5% to 87.9%.

The percentage of infants receiving a 6-8 week review in Hull was similar to England for 2017/18 (84.6% and 84.3% respectively), but the percentage increased in Hull to 2019/20 to 93.0% whereas there was a much smaller increase for England (to 85.1%). Between 2019/20 and 2021/22, the percentage of infants receiving a 6-8 week review in England and across the region decreased by 4% and 3% respectively, whereas the decrease in Hull was smaller at 1%.

A&E Attendances and Hospital Admissions

Information is also available on A&E attendances and hospital admissions within A&E Attendances and Hospital Admissions under Health Factors under Children and Young People.

Stillbirth and Infant Mortality

Information relating to stillbirths, neonatal deaths, post-neonatal deaths and infant deaths is given under Stillbirths and Infant Mortality within Pregnancy and Infants within Children and Young People.

Strategic Need and Service Provision

The Better Births national maternity review states that “every women, every pregnancy, every baby and every family is different. Therefore, quality services (by which we mean safe, clinically effective and providing a good experience) must be personalised”. The vision for maternity services across England is “for them to become safer, more personalised, kinder, professional and more family friendly; where every woman has access to information to enable her to make decisions about her care; and where she and her baby can access support that is centred around their individual needs and circumstances. And for all staff to be supported to deliver care which is women centred, working in high performing teams, in organisations which are well led and in cultures that promote innovation, continuous learning, and break down organisational and professional boundaries”. The national Maternity Transformation Programme seeks to achieve the vision set out in Better Births vision working across nine work streams: (1) transforming the workforce; (2) sharing data and information; (3) harnessing digital technology; (4) reforming the payment system; (5) promoting good practice for safer care; (6) improving prevention; (7) improving access to perinatal mental health services; (8) supporting local transformation; (9) increasing choice and personalisation.

Work needs to continue to reduce the under 18 conception rate, as well as reduce the number of women who are obese or who smoke, with a need to provide help and advice prior to pregnancy to attempt to reduce these risks (although recognising that not all pregnancies are planned). Identifying risks and intervening early to improve maternal health and wellbeing, improving birth preparation, promoting positive parenting skills, and creating an environment for children and young people that builds self-esteem and resilience, with good emotional health. Early help and intervention for all families should be timely, accessible and appropriate for their circumstances. Hull’s Early Help and Prevention offer is focused on a whole family approach which aims to identify individuals and families with problems and brings together different services and agencies to collectively look at what support is needed and then work together to deliver the required support in an coordinated way. The strategy outlines the approach to ensure that collaboration and alignment of services, and that early help may be ‘early in life or at the earliest opportunity’ which is also part of the day job, helpful, non-stigmatising, preventative, targeted and tailored. There are four thresholds of need: (i) no additional needs which is the universal response to build resilience in children and young people; (ii) additional needs involving prevention and early help; (iii) complex needs involving a targeted response of early help and interventions; and (iv) risk of significant harm which includes child protection procedures and safeguarding services. 

Resources

The Office for Health Improvement & Disparities’ Fingertips: https://fingertips.phe.org.uk/

Maternity Services Liaison Committees, An introduction to maternity services in the NHS, 2014, The Office for Health Improvement & Disparities (formerly Public Health England): London.

Cumberlege, J. and National Maternity Review, Better Births: Improving outcomes of maternity services in England.  A Five Year Forward View for maternity care. 2016, National Maternity Review: London.

NHS England, Maternity Transformation Programme. 2016, NHS England: London.

Early Help. Service Guide and Performance Review 2019/20.

NHS Improving Care. Improving Access to Perinatal Mental Health Services in England – A Review, 2017.

Hull’s Early Help and Prevention Strategy 2021-25. https://www.hull.gov.uk/sites/hull/files/media/Hull%20Early%20Help%20and%20Prevention%20Strategy%202021-25.pdf

Updates

This page was last updated / checked on 24 May 2023.

This page is due to be updated / checked in September 2023.