GAP in Aotearoa New Zealand

The Growth Assessment Protocol (GAP) is an international, award winning program which aims to improve safety in maternity care and outcome of pregnancy, including perinatal mortality and morbidity, with the predominant focus on improving antenatal recognition of pregnancies at risk due to fetal growth restriction.

GAP consists of evidence based guidelines and risk assessment algorithms, education and accreditation of all staff involved in clinical care, and rolling audit and benchmarking of performance. For further information and links to evidence and resources, please see

In Aotearoa New Zealand, GAP is commissioned nationally by Te Whatu Ora . Thanks to a concerted effort by DHBs and clinicians including midwives, obstetricians and sonographers, all expectant mothers are now being cared for with evidence based maternity guidelines, including New Zealand antenatal growth charts which are customised according to each individual pregnancy’s characteristics. The GAP Terms of Service is detailed here: Terms of service. Resources include:

  • GAP Education - dates of forthcoming workshops are listed here.
  • Fundal Height Measurement - click here for video demonstration. (Enter password “measureright”).
  • GAP eLearning - To access eLearning please use the following link -

Recent NZ results have shown a substantial increase in the health service’s ability to detect antenatally if the baby’s growth is unsatisfactory, which allows further investigation and timely delivery if necessary. Significant progress in this regard has been made across ethnic groups in New Zealand.

GAP Team: The service is delivered by the UK Perinatal Institute GAP team led by Emily Butler, in association with the GAP NZ coordinator Judith Beattie (who recently joined the team in April 2024) and NZ Educator Jodie Rofe who has supported Districts over the past 18 months to introduce GROW 2.0.

The Perinatal Institute and Te Whatu Ora are working with various stakeholders which include representation from RANZCOG, NZCOM, RANZCR, Ministry of Health and mothers.

                     Judith Beattie                                           Jodie Rofe

                                                              Emily Butler

Plans for 2024: We are working with Te Whatu Ora and the NZ GAP Advisory Group to embed the new GROW 2.0 software which was rolled out across New Zealand in November 2023. This is the electronic version of customised charts which provides a number of features that help to further improve fetal growth surveillance. For further information, please see the GROW App 2.0 Page