australia’s mothers and babies
TRANSCRIPT
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
Australiarsquos mothers and babies
2017in brief
The Australian Institute of Health and Welfare is a major national agency whose purpose is to create authoritative and accessible information and statistics
that inform decisions and improve the health and welfare of all Australians
copy Australian Institute of Health and Welfare 2019
This product excluding the AIHW logo Commonwealth Coat of Arms and any material owned by a third party or protected by a trademark has been released under a Creative Commons BY 30 (CC‑BY 30) licence Excluded material owned by third parties may include for example design and layout images obtained under licence from third parties and signatures We have made all reasonable efforts to identify and label material owned by third parties
You may distribute remix and build upon this work However you must attribute the AIHW as the copyright holder of the work in compliance with our attribution policy available at ltwwwaihwgovaucopyrightgt The full terms and conditions of this licence are available at ltcreativecommonsorglicensesby30augt
ISBN 978‑1‑76054‑553‑6 (Online)ISBN 978‑1‑76054‑554‑3 (Print)
ISSN 1321‑8336 (Online)ISSN 2205‑5134 (Print)
Suggested citationAustralian Institute of Health and Welfare 2019 Australiarsquos mothers and babies 2017mdashin brief Perinatal statistics series no 35 Cat no PER 100 Canberra AIHW
Australian Institute of Health and WelfareBoard Chair Mrs Louise Markus
Director Mr Barry Sandison
Any enquiries relating to copyright or comments on this publication should be directed to Australian Institute of Health and Welfare GPO Box 570 Canberra ACT 2601 Tel (02) 6244 1000 Email infoaihwgovau
Published by the Australian Institute of Health and Welfare
Please note that there is the potential for minor revisions of data in this report Please check the online version at ltwwwaihwgovaugt for any amendments
Australiarsquos mothers and babies 2017mdashin brief iii
Contents1 At a glance 1
Mothers at a glance 1Babies at a glance 4
2 Mothers 5Antenatal care 5Smoking during pregnancy 10Maternal health 12Place of birth 14Onset of labour 15Method of birth 17
3 Babies 22Gestational age 22Birthweight 24Low birthweight 25Small for gestational age 27Baby presentation and method of birth 31Apgar scores 33Resuscitation 34Hospital births and length of stay 35Admission to special care nurseries and neonatal intensive care units 36Perinatal deaths 37
4 Aboriginal and Torres Strait Islander mothers and their babies 42Indigenous mothers 43Babies of Indigenous mothers 48Comparisons with non-Indigenous mothers and babies 51
5 Key statistics and trends 52
Appendixes 59Acknowledgments 59Abbreviations 60Glossary 61References 64Related publications 65
Chapter X Xiv
AIHW information on mothers and babiesAustraliarsquos mothers and babies 2017mdashin brief presents an overview of the key statistics from the Australian Institute of Health and Welfare (AIHW) National Perinatal Data Collection The corresponding online data visualisations complement this report and are available at lthttpswwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑data‑visualisationsgt
Detailed data tables including state and territory data are also available online at ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
This report and the online data visualisations are part of a comprehensive program of AIHW work in relation to maternal and perinatal care and outcomes Other major projects includebull National Core Maternity Indicators (NCMIs) data visualisations available at lthttpswww
aihwgovaureportsmothers-babiesncmi-data-visualisationsgt The NCMIs monitor the safety and quality of maternity care to ensure there is continual improvement following the introduction of the National Maternity Services Plan (AHMC 2011)
bull National Maternity Data Development Project (NMDDP) latest report available at lthttpswwwaihwgovaureportsmothers‑babiesenhancing‑maternity‑data‑collection‑reporting‑nmddgt The NMDDP aims to build a more comprehensive and consistent national data collection for maternal and perinatal health including development of clinical data items and maternity models of care and the establishment of ongoing national maternal and perinatal mortality data collection and reporting
bull geographic reporting of maternal and perinatal indicators from the Performance Accountability Framework latest report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt This publication presents detailed geographic data for indicators on antenatal care in the first trimester smoking during pregnancy and low birthweight
The National Perinatal Data CollectionThe National Perinatal Data Collection (NPDC) began in 1991 and is a collaborative effort by the AIHW and state and territory health departments
Perinatal data are collected for each birth in each state and territory usually by midwives and other birth attendants The data are collated by the relevant state or territory health department and a standard de‑identified extract is provided annually to the AIHW to form the NPDC
The NPDC covers both live births and stillbirths where gestational age is at least 20 weeks or birthweight is at least 400 grams except in Victoria and Western Australia where births are included if gestational age is at least 20 weeks or if gestation is unknown birthweight is at least 400 grams
See Appendix A for more information about the NPDC
Australiarsquos mothers and babies 2017mdashin brief 1
At a glance
Mothers at a glanceMore women are giving birth but the birth rate is falling bull In 2017 301095 women gave birth in Australiamdashan increase of 40 since 2007
(289499 women)
bull The rate of women giving birth has decreased between 2007 and 2017 with a rate of 60 per 1000 women of reproductive age (15ndash44 years) in 2017 down from 66 per 1000 women in 2007
Rate of women of reproductive age giving birth 2007 to 2017
Women are giving birth later in lifebull The average age of all women who gave birth continues to rise It was 306 in 2017
compared with 299 in 2007 The median age was slightly higher at 31 years in 2017
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Year
Number per 1000 women aged 15ndash44
1
299years
301years
306years
2007 2012 2017
Average age of all mothers 2007 to 2017
Chapter X X2
Trend in births to younger and older mothers in Australia 2007 to 2017
The rate of multiple pregnancies has fallenIn 2017 multiple pregnancies represented 15 of all pregnancies Almost all multiple pregnancies (988) were twins while a small proportion (12) were other multiples (triplets quadruplets or higher)
The proportion of multiple pregnancies was lowest among mothers aged under 20 (08) and highest among mothers aged 40 and over (27)
Between 2007 and 2017 the number of multiple pregnancies increased slightly from 4634 in 2007 to a peak of 4703 in 2008 and then declined to 4516 in 2017 The rate decreased slightly over this time from 16 per 1000 mothers to 15 per 1000
Most mothers live in Major cities and were born in AustraliaMost mothers lived in Major cities (72) and most were themselves born in Australia (64)mdashsimilar to the proportions of all women of reproductive age in the population
Over one‑quarter (27) of mothers who gave birth in 2017 were born in a main non‑English‑speaking country (see Glossary) compared with 25 of women of reproductive age in the population The proportion of mothers born in a main non‑English‑speaking country has increased from 18 in 2007
0
5
10
15
20
25
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Younger than 25 35 and older
Chapter 1 At a glance
bull The average age also increased for Aboriginal and Torres Strait Islander mothers from 252 in 2007 to 260 in 2017 with a median of 25 years
bull The proportion of mothers aged 35 and over increased from 22 in 2007 to 24 in 2017 while the proportion of mothers aged under 25 decreased from 19 to 14
bull The average age of first‑time mothers also increased from 282 in 2007 to 292 in 2017
Australiarsquos mothers and babies 2017mdashin brief 3
1 in 22 mothers were Aboriginal andor Torres Strait IslanderAround 45 of all mothers who gave birth in 2017 were Indigenousmdashslightly higher than the proportion of Indigenous women of reproductive age in the population (34)
Indigenous mothers were on average younger than non‑Indigenous mothers (260 years compared with 308)
Characteristics of mothers who gave birth in 2017
0 10 20 30 40 50 60 70 80 90 100
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia
Other main English-speaking countries
Other countries
Mat
erna
l age
Rem
oten
ess
Indi
geno
usst
atus
Coun
try
of b
irth
Per cent
Find out more in data visualisations Demographics of mothers and babies
Chapter X X4
Babies at a glanceMore babies are being bornbull There were 305667 babies born in 2017mdashan increase of 4 since 2007bull In all 303478 were live births and 2174 (less than 1) were stillbirths (a baby born without
signs of life see Glossary) Birth status was not recorded for a small number of births bull The stillbirth rate of 71 deaths per 1000 births has decreased slightly following a recent
peak of 78 per 1000 births in 2009
Number of babies born 2007ndash2017
Baby boys slightly outnumber girlsSlightly more babies were male (51) than female (49) This pattern is consistent with previous years The ratio was 1061 male liveborn babies per 100 female liveborn babies
1 in 18 babies were Aboriginal andor Torres Strait IslanderAround 1 in 18 babies (55 or 16934) were Indigenous in 2017 (based on Indigenous status of the baby) and 1 in 22 babies (45 or 13757) were born to Indigenous mothers (based on Indigenous status of the mother)
3 in 4 babies were born to mothers living in New South Wales Victoria or QueenslandThe proportion of babies born in each state and territory closely reflects the distribution of the total population in 2017
0
50000
100000
150000
200000
250000
300000
350000
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number
Year
Find out more in data visualisations Demographics of mothers and babies
51 49
Chapter 1 At a glance
Australiarsquos mothers and babies 2017mdashin brief 5
Mothers
Antenatal careAlmost all mothers attend antenatal care with 7 in 10 attending in the first trimester
Antenatal care is a planned visit between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout pregnancy It does not include visits where the sole purpose is to confirm the pregnancy
Antenatal care is associated with positive maternal and child health outcomesmdashthe likelihood of receiving effective health interventions is increased through attending antenatal care The Australian Pregnancy Care Guidelines (Department of Health 2018) recommend that the first antenatal visit occur within the first 10 weeks of pregnancy and that first‑time mothers with an uncomplicated pregnancy attend 10 visits (7 visits for subsequent uncomplicated pregnancies)
Regular antenatal care in the first trimester (before 14 weeks gestational age) is associated with better maternal health in pregnancy fewer interventions in late pregnancy and positive child health outcomes
Almost all mothers (999) who gave birth in 2017 had at least 1 antenatal visit
bull 94 had 5 or more visits
bull 86 had 7 or more visits
bull 58 had 10 or more visits
In 2017 in relation to the timing of the first antenatal visit
bull 56 of mothers had at least 1 antenatal visit in the first 10 weeks of pregnancy
bull 72 of mothers had at least 1 antenatal visit in the first trimester (less than 14 weeks)
bull 8 did not begin antenatal care until after 20 weeks gestation
2
Chapter X X6
Time to first antenatal visit by gestational age 2017
Trend information on antenatal care is limited due to the relatively recent standardised collection of data However the available data show little change over time
bull The proportion of mothers who had 5 or more antenatal visits throughout their pregnancy was 954 in 2012 and 957 in 2017 (based on mothers who gave birth at 32 weeks or more gestation excludes data from Victoria)
bull The proportion of mothers who received antenatal care in the first trimester of pregnancy was 627 in 2012 and 720 in 2017
See Chapter 5 for more data on trends
emsp
0
10
20
30
40
50
60
70
80
90
100
3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Cumulative percentage
Gestational age (weeks)
Find out more in data visualisations Antenatal care
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 7
The proportion of mothers who had 5 or more antenatal visits varied slightly by remoteness and socioeconomic disadvantage (data exclude very pre‑term births)bull 95 of mothers living in Major cities compared with 91 in Very remote areas bull 96 of mothers living in the highest SES areas compared with 93 in the lowest SES areas
Mothers who were born in main non‑English‑speaking countries (see Glossary) were less likely to attend antenatal care in the first trimester (66 compared with 74 of those born in Australia and other main English‑speaking countries) However the proportion attending 5 or more antenatal visits was similar (943 compared with 946)
Almost 2 in 3 Indigenous mothers had an antenatal visit in the first trimester (63) and almost 9 in 10 attended 5 or more visits throughout their pregnancy (87) compared with 71 and 94 of non‑Indigenous mothers respectively (age‑standardised) See Chapter 4 for more information on Indigenous mothers
Antenatal visits in the first trimester and 5 or more antenatal visits by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Data on 5 or more antenatal visits exclude very pre‑term births (less than 32 weeks gestation)
emsp
0 20 40 60 80 100
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Per cent
Antenatal visit in first trimester
0 20 40 60 80 100Per cent
5 or more visits
Indi
geno
usst
atus
(a)
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Indi
geno
usst
atus
(a)
Antenatal care visits vary by socioeconomic area and maternal characteristicsMothers living in the lowest socioeconomic status (SES) areas began antenatal care later in pregnancymdash67 of mothers living in the lowest SES areas attended antenatal care in the first trimester compared with 76 in the highest SES areas in 2017 This is an increase from 55 and 69 in 2012 respectively
Chapter X X8
Number of antenatal visits varies depending on where mothers liveIn 2017 the proportion of mothers attending 5 or more antenatal visits nationally was 94 (275410) (data exclude very pre‑term births) However the proportion varied across Primary Health Network (PHN) areas ranging from 84 in the Murray PHN area to 98 in the Central and Eastern Sydney PHN area
Map of percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes1 Data exclude very pre‑term births (less than 32 weeks gestation)2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general
practitioner is not reported3 See data table 51 for detailed data
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Australiarsquos mothers and babies
2017in brief
The Australian Institute of Health and Welfare is a major national agency whose purpose is to create authoritative and accessible information and statistics
that inform decisions and improve the health and welfare of all Australians
copy Australian Institute of Health and Welfare 2019
This product excluding the AIHW logo Commonwealth Coat of Arms and any material owned by a third party or protected by a trademark has been released under a Creative Commons BY 30 (CC‑BY 30) licence Excluded material owned by third parties may include for example design and layout images obtained under licence from third parties and signatures We have made all reasonable efforts to identify and label material owned by third parties
You may distribute remix and build upon this work However you must attribute the AIHW as the copyright holder of the work in compliance with our attribution policy available at ltwwwaihwgovaucopyrightgt The full terms and conditions of this licence are available at ltcreativecommonsorglicensesby30augt
ISBN 978‑1‑76054‑553‑6 (Online)ISBN 978‑1‑76054‑554‑3 (Print)
ISSN 1321‑8336 (Online)ISSN 2205‑5134 (Print)
Suggested citationAustralian Institute of Health and Welfare 2019 Australiarsquos mothers and babies 2017mdashin brief Perinatal statistics series no 35 Cat no PER 100 Canberra AIHW
Australian Institute of Health and WelfareBoard Chair Mrs Louise Markus
Director Mr Barry Sandison
Any enquiries relating to copyright or comments on this publication should be directed to Australian Institute of Health and Welfare GPO Box 570 Canberra ACT 2601 Tel (02) 6244 1000 Email infoaihwgovau
Published by the Australian Institute of Health and Welfare
Please note that there is the potential for minor revisions of data in this report Please check the online version at ltwwwaihwgovaugt for any amendments
Australiarsquos mothers and babies 2017mdashin brief iii
Contents1 At a glance 1
Mothers at a glance 1Babies at a glance 4
2 Mothers 5Antenatal care 5Smoking during pregnancy 10Maternal health 12Place of birth 14Onset of labour 15Method of birth 17
3 Babies 22Gestational age 22Birthweight 24Low birthweight 25Small for gestational age 27Baby presentation and method of birth 31Apgar scores 33Resuscitation 34Hospital births and length of stay 35Admission to special care nurseries and neonatal intensive care units 36Perinatal deaths 37
4 Aboriginal and Torres Strait Islander mothers and their babies 42Indigenous mothers 43Babies of Indigenous mothers 48Comparisons with non-Indigenous mothers and babies 51
5 Key statistics and trends 52
Appendixes 59Acknowledgments 59Abbreviations 60Glossary 61References 64Related publications 65
Chapter X Xiv
AIHW information on mothers and babiesAustraliarsquos mothers and babies 2017mdashin brief presents an overview of the key statistics from the Australian Institute of Health and Welfare (AIHW) National Perinatal Data Collection The corresponding online data visualisations complement this report and are available at lthttpswwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑data‑visualisationsgt
Detailed data tables including state and territory data are also available online at ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
This report and the online data visualisations are part of a comprehensive program of AIHW work in relation to maternal and perinatal care and outcomes Other major projects includebull National Core Maternity Indicators (NCMIs) data visualisations available at lthttpswww
aihwgovaureportsmothers-babiesncmi-data-visualisationsgt The NCMIs monitor the safety and quality of maternity care to ensure there is continual improvement following the introduction of the National Maternity Services Plan (AHMC 2011)
bull National Maternity Data Development Project (NMDDP) latest report available at lthttpswwwaihwgovaureportsmothers‑babiesenhancing‑maternity‑data‑collection‑reporting‑nmddgt The NMDDP aims to build a more comprehensive and consistent national data collection for maternal and perinatal health including development of clinical data items and maternity models of care and the establishment of ongoing national maternal and perinatal mortality data collection and reporting
bull geographic reporting of maternal and perinatal indicators from the Performance Accountability Framework latest report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt This publication presents detailed geographic data for indicators on antenatal care in the first trimester smoking during pregnancy and low birthweight
The National Perinatal Data CollectionThe National Perinatal Data Collection (NPDC) began in 1991 and is a collaborative effort by the AIHW and state and territory health departments
Perinatal data are collected for each birth in each state and territory usually by midwives and other birth attendants The data are collated by the relevant state or territory health department and a standard de‑identified extract is provided annually to the AIHW to form the NPDC
The NPDC covers both live births and stillbirths where gestational age is at least 20 weeks or birthweight is at least 400 grams except in Victoria and Western Australia where births are included if gestational age is at least 20 weeks or if gestation is unknown birthweight is at least 400 grams
See Appendix A for more information about the NPDC
Australiarsquos mothers and babies 2017mdashin brief 1
At a glance
Mothers at a glanceMore women are giving birth but the birth rate is falling bull In 2017 301095 women gave birth in Australiamdashan increase of 40 since 2007
(289499 women)
bull The rate of women giving birth has decreased between 2007 and 2017 with a rate of 60 per 1000 women of reproductive age (15ndash44 years) in 2017 down from 66 per 1000 women in 2007
Rate of women of reproductive age giving birth 2007 to 2017
Women are giving birth later in lifebull The average age of all women who gave birth continues to rise It was 306 in 2017
compared with 299 in 2007 The median age was slightly higher at 31 years in 2017
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Year
Number per 1000 women aged 15ndash44
1
299years
301years
306years
2007 2012 2017
Average age of all mothers 2007 to 2017
Chapter X X2
Trend in births to younger and older mothers in Australia 2007 to 2017
The rate of multiple pregnancies has fallenIn 2017 multiple pregnancies represented 15 of all pregnancies Almost all multiple pregnancies (988) were twins while a small proportion (12) were other multiples (triplets quadruplets or higher)
The proportion of multiple pregnancies was lowest among mothers aged under 20 (08) and highest among mothers aged 40 and over (27)
Between 2007 and 2017 the number of multiple pregnancies increased slightly from 4634 in 2007 to a peak of 4703 in 2008 and then declined to 4516 in 2017 The rate decreased slightly over this time from 16 per 1000 mothers to 15 per 1000
Most mothers live in Major cities and were born in AustraliaMost mothers lived in Major cities (72) and most were themselves born in Australia (64)mdashsimilar to the proportions of all women of reproductive age in the population
Over one‑quarter (27) of mothers who gave birth in 2017 were born in a main non‑English‑speaking country (see Glossary) compared with 25 of women of reproductive age in the population The proportion of mothers born in a main non‑English‑speaking country has increased from 18 in 2007
0
5
10
15
20
25
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Younger than 25 35 and older
Chapter 1 At a glance
bull The average age also increased for Aboriginal and Torres Strait Islander mothers from 252 in 2007 to 260 in 2017 with a median of 25 years
bull The proportion of mothers aged 35 and over increased from 22 in 2007 to 24 in 2017 while the proportion of mothers aged under 25 decreased from 19 to 14
bull The average age of first‑time mothers also increased from 282 in 2007 to 292 in 2017
Australiarsquos mothers and babies 2017mdashin brief 3
1 in 22 mothers were Aboriginal andor Torres Strait IslanderAround 45 of all mothers who gave birth in 2017 were Indigenousmdashslightly higher than the proportion of Indigenous women of reproductive age in the population (34)
Indigenous mothers were on average younger than non‑Indigenous mothers (260 years compared with 308)
Characteristics of mothers who gave birth in 2017
0 10 20 30 40 50 60 70 80 90 100
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia
Other main English-speaking countries
Other countries
Mat
erna
l age
Rem
oten
ess
Indi
geno
usst
atus
Coun
try
of b
irth
Per cent
Find out more in data visualisations Demographics of mothers and babies
Chapter X X4
Babies at a glanceMore babies are being bornbull There were 305667 babies born in 2017mdashan increase of 4 since 2007bull In all 303478 were live births and 2174 (less than 1) were stillbirths (a baby born without
signs of life see Glossary) Birth status was not recorded for a small number of births bull The stillbirth rate of 71 deaths per 1000 births has decreased slightly following a recent
peak of 78 per 1000 births in 2009
Number of babies born 2007ndash2017
Baby boys slightly outnumber girlsSlightly more babies were male (51) than female (49) This pattern is consistent with previous years The ratio was 1061 male liveborn babies per 100 female liveborn babies
1 in 18 babies were Aboriginal andor Torres Strait IslanderAround 1 in 18 babies (55 or 16934) were Indigenous in 2017 (based on Indigenous status of the baby) and 1 in 22 babies (45 or 13757) were born to Indigenous mothers (based on Indigenous status of the mother)
3 in 4 babies were born to mothers living in New South Wales Victoria or QueenslandThe proportion of babies born in each state and territory closely reflects the distribution of the total population in 2017
0
50000
100000
150000
200000
250000
300000
350000
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number
Year
Find out more in data visualisations Demographics of mothers and babies
51 49
Chapter 1 At a glance
Australiarsquos mothers and babies 2017mdashin brief 5
Mothers
Antenatal careAlmost all mothers attend antenatal care with 7 in 10 attending in the first trimester
Antenatal care is a planned visit between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout pregnancy It does not include visits where the sole purpose is to confirm the pregnancy
Antenatal care is associated with positive maternal and child health outcomesmdashthe likelihood of receiving effective health interventions is increased through attending antenatal care The Australian Pregnancy Care Guidelines (Department of Health 2018) recommend that the first antenatal visit occur within the first 10 weeks of pregnancy and that first‑time mothers with an uncomplicated pregnancy attend 10 visits (7 visits for subsequent uncomplicated pregnancies)
Regular antenatal care in the first trimester (before 14 weeks gestational age) is associated with better maternal health in pregnancy fewer interventions in late pregnancy and positive child health outcomes
Almost all mothers (999) who gave birth in 2017 had at least 1 antenatal visit
bull 94 had 5 or more visits
bull 86 had 7 or more visits
bull 58 had 10 or more visits
In 2017 in relation to the timing of the first antenatal visit
bull 56 of mothers had at least 1 antenatal visit in the first 10 weeks of pregnancy
bull 72 of mothers had at least 1 antenatal visit in the first trimester (less than 14 weeks)
bull 8 did not begin antenatal care until after 20 weeks gestation
2
Chapter X X6
Time to first antenatal visit by gestational age 2017
Trend information on antenatal care is limited due to the relatively recent standardised collection of data However the available data show little change over time
bull The proportion of mothers who had 5 or more antenatal visits throughout their pregnancy was 954 in 2012 and 957 in 2017 (based on mothers who gave birth at 32 weeks or more gestation excludes data from Victoria)
bull The proportion of mothers who received antenatal care in the first trimester of pregnancy was 627 in 2012 and 720 in 2017
See Chapter 5 for more data on trends
emsp
0
10
20
30
40
50
60
70
80
90
100
3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Cumulative percentage
Gestational age (weeks)
Find out more in data visualisations Antenatal care
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 7
The proportion of mothers who had 5 or more antenatal visits varied slightly by remoteness and socioeconomic disadvantage (data exclude very pre‑term births)bull 95 of mothers living in Major cities compared with 91 in Very remote areas bull 96 of mothers living in the highest SES areas compared with 93 in the lowest SES areas
Mothers who were born in main non‑English‑speaking countries (see Glossary) were less likely to attend antenatal care in the first trimester (66 compared with 74 of those born in Australia and other main English‑speaking countries) However the proportion attending 5 or more antenatal visits was similar (943 compared with 946)
Almost 2 in 3 Indigenous mothers had an antenatal visit in the first trimester (63) and almost 9 in 10 attended 5 or more visits throughout their pregnancy (87) compared with 71 and 94 of non‑Indigenous mothers respectively (age‑standardised) See Chapter 4 for more information on Indigenous mothers
Antenatal visits in the first trimester and 5 or more antenatal visits by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Data on 5 or more antenatal visits exclude very pre‑term births (less than 32 weeks gestation)
emsp
0 20 40 60 80 100
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Per cent
Antenatal visit in first trimester
0 20 40 60 80 100Per cent
5 or more visits
Indi
geno
usst
atus
(a)
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Indi
geno
usst
atus
(a)
Antenatal care visits vary by socioeconomic area and maternal characteristicsMothers living in the lowest socioeconomic status (SES) areas began antenatal care later in pregnancymdash67 of mothers living in the lowest SES areas attended antenatal care in the first trimester compared with 76 in the highest SES areas in 2017 This is an increase from 55 and 69 in 2012 respectively
Chapter X X8
Number of antenatal visits varies depending on where mothers liveIn 2017 the proportion of mothers attending 5 or more antenatal visits nationally was 94 (275410) (data exclude very pre‑term births) However the proportion varied across Primary Health Network (PHN) areas ranging from 84 in the Murray PHN area to 98 in the Central and Eastern Sydney PHN area
Map of percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes1 Data exclude very pre‑term births (less than 32 weeks gestation)2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general
practitioner is not reported3 See data table 51 for detailed data
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
The Australian Institute of Health and Welfare is a major national agency whose purpose is to create authoritative and accessible information and statistics
that inform decisions and improve the health and welfare of all Australians
copy Australian Institute of Health and Welfare 2019
This product excluding the AIHW logo Commonwealth Coat of Arms and any material owned by a third party or protected by a trademark has been released under a Creative Commons BY 30 (CC‑BY 30) licence Excluded material owned by third parties may include for example design and layout images obtained under licence from third parties and signatures We have made all reasonable efforts to identify and label material owned by third parties
You may distribute remix and build upon this work However you must attribute the AIHW as the copyright holder of the work in compliance with our attribution policy available at ltwwwaihwgovaucopyrightgt The full terms and conditions of this licence are available at ltcreativecommonsorglicensesby30augt
ISBN 978‑1‑76054‑553‑6 (Online)ISBN 978‑1‑76054‑554‑3 (Print)
ISSN 1321‑8336 (Online)ISSN 2205‑5134 (Print)
Suggested citationAustralian Institute of Health and Welfare 2019 Australiarsquos mothers and babies 2017mdashin brief Perinatal statistics series no 35 Cat no PER 100 Canberra AIHW
Australian Institute of Health and WelfareBoard Chair Mrs Louise Markus
Director Mr Barry Sandison
Any enquiries relating to copyright or comments on this publication should be directed to Australian Institute of Health and Welfare GPO Box 570 Canberra ACT 2601 Tel (02) 6244 1000 Email infoaihwgovau
Published by the Australian Institute of Health and Welfare
Please note that there is the potential for minor revisions of data in this report Please check the online version at ltwwwaihwgovaugt for any amendments
Australiarsquos mothers and babies 2017mdashin brief iii
Contents1 At a glance 1
Mothers at a glance 1Babies at a glance 4
2 Mothers 5Antenatal care 5Smoking during pregnancy 10Maternal health 12Place of birth 14Onset of labour 15Method of birth 17
3 Babies 22Gestational age 22Birthweight 24Low birthweight 25Small for gestational age 27Baby presentation and method of birth 31Apgar scores 33Resuscitation 34Hospital births and length of stay 35Admission to special care nurseries and neonatal intensive care units 36Perinatal deaths 37
4 Aboriginal and Torres Strait Islander mothers and their babies 42Indigenous mothers 43Babies of Indigenous mothers 48Comparisons with non-Indigenous mothers and babies 51
5 Key statistics and trends 52
Appendixes 59Acknowledgments 59Abbreviations 60Glossary 61References 64Related publications 65
Chapter X Xiv
AIHW information on mothers and babiesAustraliarsquos mothers and babies 2017mdashin brief presents an overview of the key statistics from the Australian Institute of Health and Welfare (AIHW) National Perinatal Data Collection The corresponding online data visualisations complement this report and are available at lthttpswwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑data‑visualisationsgt
Detailed data tables including state and territory data are also available online at ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
This report and the online data visualisations are part of a comprehensive program of AIHW work in relation to maternal and perinatal care and outcomes Other major projects includebull National Core Maternity Indicators (NCMIs) data visualisations available at lthttpswww
aihwgovaureportsmothers-babiesncmi-data-visualisationsgt The NCMIs monitor the safety and quality of maternity care to ensure there is continual improvement following the introduction of the National Maternity Services Plan (AHMC 2011)
bull National Maternity Data Development Project (NMDDP) latest report available at lthttpswwwaihwgovaureportsmothers‑babiesenhancing‑maternity‑data‑collection‑reporting‑nmddgt The NMDDP aims to build a more comprehensive and consistent national data collection for maternal and perinatal health including development of clinical data items and maternity models of care and the establishment of ongoing national maternal and perinatal mortality data collection and reporting
bull geographic reporting of maternal and perinatal indicators from the Performance Accountability Framework latest report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt This publication presents detailed geographic data for indicators on antenatal care in the first trimester smoking during pregnancy and low birthweight
The National Perinatal Data CollectionThe National Perinatal Data Collection (NPDC) began in 1991 and is a collaborative effort by the AIHW and state and territory health departments
Perinatal data are collected for each birth in each state and territory usually by midwives and other birth attendants The data are collated by the relevant state or territory health department and a standard de‑identified extract is provided annually to the AIHW to form the NPDC
The NPDC covers both live births and stillbirths where gestational age is at least 20 weeks or birthweight is at least 400 grams except in Victoria and Western Australia where births are included if gestational age is at least 20 weeks or if gestation is unknown birthweight is at least 400 grams
See Appendix A for more information about the NPDC
Australiarsquos mothers and babies 2017mdashin brief 1
At a glance
Mothers at a glanceMore women are giving birth but the birth rate is falling bull In 2017 301095 women gave birth in Australiamdashan increase of 40 since 2007
(289499 women)
bull The rate of women giving birth has decreased between 2007 and 2017 with a rate of 60 per 1000 women of reproductive age (15ndash44 years) in 2017 down from 66 per 1000 women in 2007
Rate of women of reproductive age giving birth 2007 to 2017
Women are giving birth later in lifebull The average age of all women who gave birth continues to rise It was 306 in 2017
compared with 299 in 2007 The median age was slightly higher at 31 years in 2017
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Year
Number per 1000 women aged 15ndash44
1
299years
301years
306years
2007 2012 2017
Average age of all mothers 2007 to 2017
Chapter X X2
Trend in births to younger and older mothers in Australia 2007 to 2017
The rate of multiple pregnancies has fallenIn 2017 multiple pregnancies represented 15 of all pregnancies Almost all multiple pregnancies (988) were twins while a small proportion (12) were other multiples (triplets quadruplets or higher)
The proportion of multiple pregnancies was lowest among mothers aged under 20 (08) and highest among mothers aged 40 and over (27)
Between 2007 and 2017 the number of multiple pregnancies increased slightly from 4634 in 2007 to a peak of 4703 in 2008 and then declined to 4516 in 2017 The rate decreased slightly over this time from 16 per 1000 mothers to 15 per 1000
Most mothers live in Major cities and were born in AustraliaMost mothers lived in Major cities (72) and most were themselves born in Australia (64)mdashsimilar to the proportions of all women of reproductive age in the population
Over one‑quarter (27) of mothers who gave birth in 2017 were born in a main non‑English‑speaking country (see Glossary) compared with 25 of women of reproductive age in the population The proportion of mothers born in a main non‑English‑speaking country has increased from 18 in 2007
0
5
10
15
20
25
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Younger than 25 35 and older
Chapter 1 At a glance
bull The average age also increased for Aboriginal and Torres Strait Islander mothers from 252 in 2007 to 260 in 2017 with a median of 25 years
bull The proportion of mothers aged 35 and over increased from 22 in 2007 to 24 in 2017 while the proportion of mothers aged under 25 decreased from 19 to 14
bull The average age of first‑time mothers also increased from 282 in 2007 to 292 in 2017
Australiarsquos mothers and babies 2017mdashin brief 3
1 in 22 mothers were Aboriginal andor Torres Strait IslanderAround 45 of all mothers who gave birth in 2017 were Indigenousmdashslightly higher than the proportion of Indigenous women of reproductive age in the population (34)
Indigenous mothers were on average younger than non‑Indigenous mothers (260 years compared with 308)
Characteristics of mothers who gave birth in 2017
0 10 20 30 40 50 60 70 80 90 100
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia
Other main English-speaking countries
Other countries
Mat
erna
l age
Rem
oten
ess
Indi
geno
usst
atus
Coun
try
of b
irth
Per cent
Find out more in data visualisations Demographics of mothers and babies
Chapter X X4
Babies at a glanceMore babies are being bornbull There were 305667 babies born in 2017mdashan increase of 4 since 2007bull In all 303478 were live births and 2174 (less than 1) were stillbirths (a baby born without
signs of life see Glossary) Birth status was not recorded for a small number of births bull The stillbirth rate of 71 deaths per 1000 births has decreased slightly following a recent
peak of 78 per 1000 births in 2009
Number of babies born 2007ndash2017
Baby boys slightly outnumber girlsSlightly more babies were male (51) than female (49) This pattern is consistent with previous years The ratio was 1061 male liveborn babies per 100 female liveborn babies
1 in 18 babies were Aboriginal andor Torres Strait IslanderAround 1 in 18 babies (55 or 16934) were Indigenous in 2017 (based on Indigenous status of the baby) and 1 in 22 babies (45 or 13757) were born to Indigenous mothers (based on Indigenous status of the mother)
3 in 4 babies were born to mothers living in New South Wales Victoria or QueenslandThe proportion of babies born in each state and territory closely reflects the distribution of the total population in 2017
0
50000
100000
150000
200000
250000
300000
350000
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number
Year
Find out more in data visualisations Demographics of mothers and babies
51 49
Chapter 1 At a glance
Australiarsquos mothers and babies 2017mdashin brief 5
Mothers
Antenatal careAlmost all mothers attend antenatal care with 7 in 10 attending in the first trimester
Antenatal care is a planned visit between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout pregnancy It does not include visits where the sole purpose is to confirm the pregnancy
Antenatal care is associated with positive maternal and child health outcomesmdashthe likelihood of receiving effective health interventions is increased through attending antenatal care The Australian Pregnancy Care Guidelines (Department of Health 2018) recommend that the first antenatal visit occur within the first 10 weeks of pregnancy and that first‑time mothers with an uncomplicated pregnancy attend 10 visits (7 visits for subsequent uncomplicated pregnancies)
Regular antenatal care in the first trimester (before 14 weeks gestational age) is associated with better maternal health in pregnancy fewer interventions in late pregnancy and positive child health outcomes
Almost all mothers (999) who gave birth in 2017 had at least 1 antenatal visit
bull 94 had 5 or more visits
bull 86 had 7 or more visits
bull 58 had 10 or more visits
In 2017 in relation to the timing of the first antenatal visit
bull 56 of mothers had at least 1 antenatal visit in the first 10 weeks of pregnancy
bull 72 of mothers had at least 1 antenatal visit in the first trimester (less than 14 weeks)
bull 8 did not begin antenatal care until after 20 weeks gestation
2
Chapter X X6
Time to first antenatal visit by gestational age 2017
Trend information on antenatal care is limited due to the relatively recent standardised collection of data However the available data show little change over time
bull The proportion of mothers who had 5 or more antenatal visits throughout their pregnancy was 954 in 2012 and 957 in 2017 (based on mothers who gave birth at 32 weeks or more gestation excludes data from Victoria)
bull The proportion of mothers who received antenatal care in the first trimester of pregnancy was 627 in 2012 and 720 in 2017
See Chapter 5 for more data on trends
emsp
0
10
20
30
40
50
60
70
80
90
100
3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Cumulative percentage
Gestational age (weeks)
Find out more in data visualisations Antenatal care
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 7
The proportion of mothers who had 5 or more antenatal visits varied slightly by remoteness and socioeconomic disadvantage (data exclude very pre‑term births)bull 95 of mothers living in Major cities compared with 91 in Very remote areas bull 96 of mothers living in the highest SES areas compared with 93 in the lowest SES areas
Mothers who were born in main non‑English‑speaking countries (see Glossary) were less likely to attend antenatal care in the first trimester (66 compared with 74 of those born in Australia and other main English‑speaking countries) However the proportion attending 5 or more antenatal visits was similar (943 compared with 946)
Almost 2 in 3 Indigenous mothers had an antenatal visit in the first trimester (63) and almost 9 in 10 attended 5 or more visits throughout their pregnancy (87) compared with 71 and 94 of non‑Indigenous mothers respectively (age‑standardised) See Chapter 4 for more information on Indigenous mothers
Antenatal visits in the first trimester and 5 or more antenatal visits by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Data on 5 or more antenatal visits exclude very pre‑term births (less than 32 weeks gestation)
emsp
0 20 40 60 80 100
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Per cent
Antenatal visit in first trimester
0 20 40 60 80 100Per cent
5 or more visits
Indi
geno
usst
atus
(a)
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Indi
geno
usst
atus
(a)
Antenatal care visits vary by socioeconomic area and maternal characteristicsMothers living in the lowest socioeconomic status (SES) areas began antenatal care later in pregnancymdash67 of mothers living in the lowest SES areas attended antenatal care in the first trimester compared with 76 in the highest SES areas in 2017 This is an increase from 55 and 69 in 2012 respectively
Chapter X X8
Number of antenatal visits varies depending on where mothers liveIn 2017 the proportion of mothers attending 5 or more antenatal visits nationally was 94 (275410) (data exclude very pre‑term births) However the proportion varied across Primary Health Network (PHN) areas ranging from 84 in the Murray PHN area to 98 in the Central and Eastern Sydney PHN area
Map of percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes1 Data exclude very pre‑term births (less than 32 weeks gestation)2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general
practitioner is not reported3 See data table 51 for detailed data
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
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clud
ing
stat
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site
at
ltww
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ihw
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repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Australiarsquos mothers and babies 2017mdashin brief iii
Contents1 At a glance 1
Mothers at a glance 1Babies at a glance 4
2 Mothers 5Antenatal care 5Smoking during pregnancy 10Maternal health 12Place of birth 14Onset of labour 15Method of birth 17
3 Babies 22Gestational age 22Birthweight 24Low birthweight 25Small for gestational age 27Baby presentation and method of birth 31Apgar scores 33Resuscitation 34Hospital births and length of stay 35Admission to special care nurseries and neonatal intensive care units 36Perinatal deaths 37
4 Aboriginal and Torres Strait Islander mothers and their babies 42Indigenous mothers 43Babies of Indigenous mothers 48Comparisons with non-Indigenous mothers and babies 51
5 Key statistics and trends 52
Appendixes 59Acknowledgments 59Abbreviations 60Glossary 61References 64Related publications 65
Chapter X Xiv
AIHW information on mothers and babiesAustraliarsquos mothers and babies 2017mdashin brief presents an overview of the key statistics from the Australian Institute of Health and Welfare (AIHW) National Perinatal Data Collection The corresponding online data visualisations complement this report and are available at lthttpswwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑data‑visualisationsgt
Detailed data tables including state and territory data are also available online at ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
This report and the online data visualisations are part of a comprehensive program of AIHW work in relation to maternal and perinatal care and outcomes Other major projects includebull National Core Maternity Indicators (NCMIs) data visualisations available at lthttpswww
aihwgovaureportsmothers-babiesncmi-data-visualisationsgt The NCMIs monitor the safety and quality of maternity care to ensure there is continual improvement following the introduction of the National Maternity Services Plan (AHMC 2011)
bull National Maternity Data Development Project (NMDDP) latest report available at lthttpswwwaihwgovaureportsmothers‑babiesenhancing‑maternity‑data‑collection‑reporting‑nmddgt The NMDDP aims to build a more comprehensive and consistent national data collection for maternal and perinatal health including development of clinical data items and maternity models of care and the establishment of ongoing national maternal and perinatal mortality data collection and reporting
bull geographic reporting of maternal and perinatal indicators from the Performance Accountability Framework latest report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt This publication presents detailed geographic data for indicators on antenatal care in the first trimester smoking during pregnancy and low birthweight
The National Perinatal Data CollectionThe National Perinatal Data Collection (NPDC) began in 1991 and is a collaborative effort by the AIHW and state and territory health departments
Perinatal data are collected for each birth in each state and territory usually by midwives and other birth attendants The data are collated by the relevant state or territory health department and a standard de‑identified extract is provided annually to the AIHW to form the NPDC
The NPDC covers both live births and stillbirths where gestational age is at least 20 weeks or birthweight is at least 400 grams except in Victoria and Western Australia where births are included if gestational age is at least 20 weeks or if gestation is unknown birthweight is at least 400 grams
See Appendix A for more information about the NPDC
Australiarsquos mothers and babies 2017mdashin brief 1
At a glance
Mothers at a glanceMore women are giving birth but the birth rate is falling bull In 2017 301095 women gave birth in Australiamdashan increase of 40 since 2007
(289499 women)
bull The rate of women giving birth has decreased between 2007 and 2017 with a rate of 60 per 1000 women of reproductive age (15ndash44 years) in 2017 down from 66 per 1000 women in 2007
Rate of women of reproductive age giving birth 2007 to 2017
Women are giving birth later in lifebull The average age of all women who gave birth continues to rise It was 306 in 2017
compared with 299 in 2007 The median age was slightly higher at 31 years in 2017
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Year
Number per 1000 women aged 15ndash44
1
299years
301years
306years
2007 2012 2017
Average age of all mothers 2007 to 2017
Chapter X X2
Trend in births to younger and older mothers in Australia 2007 to 2017
The rate of multiple pregnancies has fallenIn 2017 multiple pregnancies represented 15 of all pregnancies Almost all multiple pregnancies (988) were twins while a small proportion (12) were other multiples (triplets quadruplets or higher)
The proportion of multiple pregnancies was lowest among mothers aged under 20 (08) and highest among mothers aged 40 and over (27)
Between 2007 and 2017 the number of multiple pregnancies increased slightly from 4634 in 2007 to a peak of 4703 in 2008 and then declined to 4516 in 2017 The rate decreased slightly over this time from 16 per 1000 mothers to 15 per 1000
Most mothers live in Major cities and were born in AustraliaMost mothers lived in Major cities (72) and most were themselves born in Australia (64)mdashsimilar to the proportions of all women of reproductive age in the population
Over one‑quarter (27) of mothers who gave birth in 2017 were born in a main non‑English‑speaking country (see Glossary) compared with 25 of women of reproductive age in the population The proportion of mothers born in a main non‑English‑speaking country has increased from 18 in 2007
0
5
10
15
20
25
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Younger than 25 35 and older
Chapter 1 At a glance
bull The average age also increased for Aboriginal and Torres Strait Islander mothers from 252 in 2007 to 260 in 2017 with a median of 25 years
bull The proportion of mothers aged 35 and over increased from 22 in 2007 to 24 in 2017 while the proportion of mothers aged under 25 decreased from 19 to 14
bull The average age of first‑time mothers also increased from 282 in 2007 to 292 in 2017
Australiarsquos mothers and babies 2017mdashin brief 3
1 in 22 mothers were Aboriginal andor Torres Strait IslanderAround 45 of all mothers who gave birth in 2017 were Indigenousmdashslightly higher than the proportion of Indigenous women of reproductive age in the population (34)
Indigenous mothers were on average younger than non‑Indigenous mothers (260 years compared with 308)
Characteristics of mothers who gave birth in 2017
0 10 20 30 40 50 60 70 80 90 100
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia
Other main English-speaking countries
Other countries
Mat
erna
l age
Rem
oten
ess
Indi
geno
usst
atus
Coun
try
of b
irth
Per cent
Find out more in data visualisations Demographics of mothers and babies
Chapter X X4
Babies at a glanceMore babies are being bornbull There were 305667 babies born in 2017mdashan increase of 4 since 2007bull In all 303478 were live births and 2174 (less than 1) were stillbirths (a baby born without
signs of life see Glossary) Birth status was not recorded for a small number of births bull The stillbirth rate of 71 deaths per 1000 births has decreased slightly following a recent
peak of 78 per 1000 births in 2009
Number of babies born 2007ndash2017
Baby boys slightly outnumber girlsSlightly more babies were male (51) than female (49) This pattern is consistent with previous years The ratio was 1061 male liveborn babies per 100 female liveborn babies
1 in 18 babies were Aboriginal andor Torres Strait IslanderAround 1 in 18 babies (55 or 16934) were Indigenous in 2017 (based on Indigenous status of the baby) and 1 in 22 babies (45 or 13757) were born to Indigenous mothers (based on Indigenous status of the mother)
3 in 4 babies were born to mothers living in New South Wales Victoria or QueenslandThe proportion of babies born in each state and territory closely reflects the distribution of the total population in 2017
0
50000
100000
150000
200000
250000
300000
350000
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number
Year
Find out more in data visualisations Demographics of mothers and babies
51 49
Chapter 1 At a glance
Australiarsquos mothers and babies 2017mdashin brief 5
Mothers
Antenatal careAlmost all mothers attend antenatal care with 7 in 10 attending in the first trimester
Antenatal care is a planned visit between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout pregnancy It does not include visits where the sole purpose is to confirm the pregnancy
Antenatal care is associated with positive maternal and child health outcomesmdashthe likelihood of receiving effective health interventions is increased through attending antenatal care The Australian Pregnancy Care Guidelines (Department of Health 2018) recommend that the first antenatal visit occur within the first 10 weeks of pregnancy and that first‑time mothers with an uncomplicated pregnancy attend 10 visits (7 visits for subsequent uncomplicated pregnancies)
Regular antenatal care in the first trimester (before 14 weeks gestational age) is associated with better maternal health in pregnancy fewer interventions in late pregnancy and positive child health outcomes
Almost all mothers (999) who gave birth in 2017 had at least 1 antenatal visit
bull 94 had 5 or more visits
bull 86 had 7 or more visits
bull 58 had 10 or more visits
In 2017 in relation to the timing of the first antenatal visit
bull 56 of mothers had at least 1 antenatal visit in the first 10 weeks of pregnancy
bull 72 of mothers had at least 1 antenatal visit in the first trimester (less than 14 weeks)
bull 8 did not begin antenatal care until after 20 weeks gestation
2
Chapter X X6
Time to first antenatal visit by gestational age 2017
Trend information on antenatal care is limited due to the relatively recent standardised collection of data However the available data show little change over time
bull The proportion of mothers who had 5 or more antenatal visits throughout their pregnancy was 954 in 2012 and 957 in 2017 (based on mothers who gave birth at 32 weeks or more gestation excludes data from Victoria)
bull The proportion of mothers who received antenatal care in the first trimester of pregnancy was 627 in 2012 and 720 in 2017
See Chapter 5 for more data on trends
emsp
0
10
20
30
40
50
60
70
80
90
100
3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Cumulative percentage
Gestational age (weeks)
Find out more in data visualisations Antenatal care
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 7
The proportion of mothers who had 5 or more antenatal visits varied slightly by remoteness and socioeconomic disadvantage (data exclude very pre‑term births)bull 95 of mothers living in Major cities compared with 91 in Very remote areas bull 96 of mothers living in the highest SES areas compared with 93 in the lowest SES areas
Mothers who were born in main non‑English‑speaking countries (see Glossary) were less likely to attend antenatal care in the first trimester (66 compared with 74 of those born in Australia and other main English‑speaking countries) However the proportion attending 5 or more antenatal visits was similar (943 compared with 946)
Almost 2 in 3 Indigenous mothers had an antenatal visit in the first trimester (63) and almost 9 in 10 attended 5 or more visits throughout their pregnancy (87) compared with 71 and 94 of non‑Indigenous mothers respectively (age‑standardised) See Chapter 4 for more information on Indigenous mothers
Antenatal visits in the first trimester and 5 or more antenatal visits by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Data on 5 or more antenatal visits exclude very pre‑term births (less than 32 weeks gestation)
emsp
0 20 40 60 80 100
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Per cent
Antenatal visit in first trimester
0 20 40 60 80 100Per cent
5 or more visits
Indi
geno
usst
atus
(a)
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Indi
geno
usst
atus
(a)
Antenatal care visits vary by socioeconomic area and maternal characteristicsMothers living in the lowest socioeconomic status (SES) areas began antenatal care later in pregnancymdash67 of mothers living in the lowest SES areas attended antenatal care in the first trimester compared with 76 in the highest SES areas in 2017 This is an increase from 55 and 69 in 2012 respectively
Chapter X X8
Number of antenatal visits varies depending on where mothers liveIn 2017 the proportion of mothers attending 5 or more antenatal visits nationally was 94 (275410) (data exclude very pre‑term births) However the proportion varied across Primary Health Network (PHN) areas ranging from 84 in the Murray PHN area to 98 in the Central and Eastern Sydney PHN area
Map of percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes1 Data exclude very pre‑term births (less than 32 weeks gestation)2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general
practitioner is not reported3 See data table 51 for detailed data
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Chapter X Xiv
AIHW information on mothers and babiesAustraliarsquos mothers and babies 2017mdashin brief presents an overview of the key statistics from the Australian Institute of Health and Welfare (AIHW) National Perinatal Data Collection The corresponding online data visualisations complement this report and are available at lthttpswwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑data‑visualisationsgt
Detailed data tables including state and territory data are also available online at ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
This report and the online data visualisations are part of a comprehensive program of AIHW work in relation to maternal and perinatal care and outcomes Other major projects includebull National Core Maternity Indicators (NCMIs) data visualisations available at lthttpswww
aihwgovaureportsmothers-babiesncmi-data-visualisationsgt The NCMIs monitor the safety and quality of maternity care to ensure there is continual improvement following the introduction of the National Maternity Services Plan (AHMC 2011)
bull National Maternity Data Development Project (NMDDP) latest report available at lthttpswwwaihwgovaureportsmothers‑babiesenhancing‑maternity‑data‑collection‑reporting‑nmddgt The NMDDP aims to build a more comprehensive and consistent national data collection for maternal and perinatal health including development of clinical data items and maternity models of care and the establishment of ongoing national maternal and perinatal mortality data collection and reporting
bull geographic reporting of maternal and perinatal indicators from the Performance Accountability Framework latest report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt This publication presents detailed geographic data for indicators on antenatal care in the first trimester smoking during pregnancy and low birthweight
The National Perinatal Data CollectionThe National Perinatal Data Collection (NPDC) began in 1991 and is a collaborative effort by the AIHW and state and territory health departments
Perinatal data are collected for each birth in each state and territory usually by midwives and other birth attendants The data are collated by the relevant state or territory health department and a standard de‑identified extract is provided annually to the AIHW to form the NPDC
The NPDC covers both live births and stillbirths where gestational age is at least 20 weeks or birthweight is at least 400 grams except in Victoria and Western Australia where births are included if gestational age is at least 20 weeks or if gestation is unknown birthweight is at least 400 grams
See Appendix A for more information about the NPDC
Australiarsquos mothers and babies 2017mdashin brief 1
At a glance
Mothers at a glanceMore women are giving birth but the birth rate is falling bull In 2017 301095 women gave birth in Australiamdashan increase of 40 since 2007
(289499 women)
bull The rate of women giving birth has decreased between 2007 and 2017 with a rate of 60 per 1000 women of reproductive age (15ndash44 years) in 2017 down from 66 per 1000 women in 2007
Rate of women of reproductive age giving birth 2007 to 2017
Women are giving birth later in lifebull The average age of all women who gave birth continues to rise It was 306 in 2017
compared with 299 in 2007 The median age was slightly higher at 31 years in 2017
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Year
Number per 1000 women aged 15ndash44
1
299years
301years
306years
2007 2012 2017
Average age of all mothers 2007 to 2017
Chapter X X2
Trend in births to younger and older mothers in Australia 2007 to 2017
The rate of multiple pregnancies has fallenIn 2017 multiple pregnancies represented 15 of all pregnancies Almost all multiple pregnancies (988) were twins while a small proportion (12) were other multiples (triplets quadruplets or higher)
The proportion of multiple pregnancies was lowest among mothers aged under 20 (08) and highest among mothers aged 40 and over (27)
Between 2007 and 2017 the number of multiple pregnancies increased slightly from 4634 in 2007 to a peak of 4703 in 2008 and then declined to 4516 in 2017 The rate decreased slightly over this time from 16 per 1000 mothers to 15 per 1000
Most mothers live in Major cities and were born in AustraliaMost mothers lived in Major cities (72) and most were themselves born in Australia (64)mdashsimilar to the proportions of all women of reproductive age in the population
Over one‑quarter (27) of mothers who gave birth in 2017 were born in a main non‑English‑speaking country (see Glossary) compared with 25 of women of reproductive age in the population The proportion of mothers born in a main non‑English‑speaking country has increased from 18 in 2007
0
5
10
15
20
25
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Younger than 25 35 and older
Chapter 1 At a glance
bull The average age also increased for Aboriginal and Torres Strait Islander mothers from 252 in 2007 to 260 in 2017 with a median of 25 years
bull The proportion of mothers aged 35 and over increased from 22 in 2007 to 24 in 2017 while the proportion of mothers aged under 25 decreased from 19 to 14
bull The average age of first‑time mothers also increased from 282 in 2007 to 292 in 2017
Australiarsquos mothers and babies 2017mdashin brief 3
1 in 22 mothers were Aboriginal andor Torres Strait IslanderAround 45 of all mothers who gave birth in 2017 were Indigenousmdashslightly higher than the proportion of Indigenous women of reproductive age in the population (34)
Indigenous mothers were on average younger than non‑Indigenous mothers (260 years compared with 308)
Characteristics of mothers who gave birth in 2017
0 10 20 30 40 50 60 70 80 90 100
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia
Other main English-speaking countries
Other countries
Mat
erna
l age
Rem
oten
ess
Indi
geno
usst
atus
Coun
try
of b
irth
Per cent
Find out more in data visualisations Demographics of mothers and babies
Chapter X X4
Babies at a glanceMore babies are being bornbull There were 305667 babies born in 2017mdashan increase of 4 since 2007bull In all 303478 were live births and 2174 (less than 1) were stillbirths (a baby born without
signs of life see Glossary) Birth status was not recorded for a small number of births bull The stillbirth rate of 71 deaths per 1000 births has decreased slightly following a recent
peak of 78 per 1000 births in 2009
Number of babies born 2007ndash2017
Baby boys slightly outnumber girlsSlightly more babies were male (51) than female (49) This pattern is consistent with previous years The ratio was 1061 male liveborn babies per 100 female liveborn babies
1 in 18 babies were Aboriginal andor Torres Strait IslanderAround 1 in 18 babies (55 or 16934) were Indigenous in 2017 (based on Indigenous status of the baby) and 1 in 22 babies (45 or 13757) were born to Indigenous mothers (based on Indigenous status of the mother)
3 in 4 babies were born to mothers living in New South Wales Victoria or QueenslandThe proportion of babies born in each state and territory closely reflects the distribution of the total population in 2017
0
50000
100000
150000
200000
250000
300000
350000
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number
Year
Find out more in data visualisations Demographics of mothers and babies
51 49
Chapter 1 At a glance
Australiarsquos mothers and babies 2017mdashin brief 5
Mothers
Antenatal careAlmost all mothers attend antenatal care with 7 in 10 attending in the first trimester
Antenatal care is a planned visit between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout pregnancy It does not include visits where the sole purpose is to confirm the pregnancy
Antenatal care is associated with positive maternal and child health outcomesmdashthe likelihood of receiving effective health interventions is increased through attending antenatal care The Australian Pregnancy Care Guidelines (Department of Health 2018) recommend that the first antenatal visit occur within the first 10 weeks of pregnancy and that first‑time mothers with an uncomplicated pregnancy attend 10 visits (7 visits for subsequent uncomplicated pregnancies)
Regular antenatal care in the first trimester (before 14 weeks gestational age) is associated with better maternal health in pregnancy fewer interventions in late pregnancy and positive child health outcomes
Almost all mothers (999) who gave birth in 2017 had at least 1 antenatal visit
bull 94 had 5 or more visits
bull 86 had 7 or more visits
bull 58 had 10 or more visits
In 2017 in relation to the timing of the first antenatal visit
bull 56 of mothers had at least 1 antenatal visit in the first 10 weeks of pregnancy
bull 72 of mothers had at least 1 antenatal visit in the first trimester (less than 14 weeks)
bull 8 did not begin antenatal care until after 20 weeks gestation
2
Chapter X X6
Time to first antenatal visit by gestational age 2017
Trend information on antenatal care is limited due to the relatively recent standardised collection of data However the available data show little change over time
bull The proportion of mothers who had 5 or more antenatal visits throughout their pregnancy was 954 in 2012 and 957 in 2017 (based on mothers who gave birth at 32 weeks or more gestation excludes data from Victoria)
bull The proportion of mothers who received antenatal care in the first trimester of pregnancy was 627 in 2012 and 720 in 2017
See Chapter 5 for more data on trends
emsp
0
10
20
30
40
50
60
70
80
90
100
3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Cumulative percentage
Gestational age (weeks)
Find out more in data visualisations Antenatal care
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 7
The proportion of mothers who had 5 or more antenatal visits varied slightly by remoteness and socioeconomic disadvantage (data exclude very pre‑term births)bull 95 of mothers living in Major cities compared with 91 in Very remote areas bull 96 of mothers living in the highest SES areas compared with 93 in the lowest SES areas
Mothers who were born in main non‑English‑speaking countries (see Glossary) were less likely to attend antenatal care in the first trimester (66 compared with 74 of those born in Australia and other main English‑speaking countries) However the proportion attending 5 or more antenatal visits was similar (943 compared with 946)
Almost 2 in 3 Indigenous mothers had an antenatal visit in the first trimester (63) and almost 9 in 10 attended 5 or more visits throughout their pregnancy (87) compared with 71 and 94 of non‑Indigenous mothers respectively (age‑standardised) See Chapter 4 for more information on Indigenous mothers
Antenatal visits in the first trimester and 5 or more antenatal visits by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Data on 5 or more antenatal visits exclude very pre‑term births (less than 32 weeks gestation)
emsp
0 20 40 60 80 100
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Per cent
Antenatal visit in first trimester
0 20 40 60 80 100Per cent
5 or more visits
Indi
geno
usst
atus
(a)
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Indi
geno
usst
atus
(a)
Antenatal care visits vary by socioeconomic area and maternal characteristicsMothers living in the lowest socioeconomic status (SES) areas began antenatal care later in pregnancymdash67 of mothers living in the lowest SES areas attended antenatal care in the first trimester compared with 76 in the highest SES areas in 2017 This is an increase from 55 and 69 in 2012 respectively
Chapter X X8
Number of antenatal visits varies depending on where mothers liveIn 2017 the proportion of mothers attending 5 or more antenatal visits nationally was 94 (275410) (data exclude very pre‑term births) However the proportion varied across Primary Health Network (PHN) areas ranging from 84 in the Murray PHN area to 98 in the Central and Eastern Sydney PHN area
Map of percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes1 Data exclude very pre‑term births (less than 32 weeks gestation)2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general
practitioner is not reported3 See data table 51 for detailed data
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Australiarsquos mothers and babies 2017mdashin brief 1
At a glance
Mothers at a glanceMore women are giving birth but the birth rate is falling bull In 2017 301095 women gave birth in Australiamdashan increase of 40 since 2007
(289499 women)
bull The rate of women giving birth has decreased between 2007 and 2017 with a rate of 60 per 1000 women of reproductive age (15ndash44 years) in 2017 down from 66 per 1000 women in 2007
Rate of women of reproductive age giving birth 2007 to 2017
Women are giving birth later in lifebull The average age of all women who gave birth continues to rise It was 306 in 2017
compared with 299 in 2007 The median age was slightly higher at 31 years in 2017
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Year
Number per 1000 women aged 15ndash44
1
299years
301years
306years
2007 2012 2017
Average age of all mothers 2007 to 2017
Chapter X X2
Trend in births to younger and older mothers in Australia 2007 to 2017
The rate of multiple pregnancies has fallenIn 2017 multiple pregnancies represented 15 of all pregnancies Almost all multiple pregnancies (988) were twins while a small proportion (12) were other multiples (triplets quadruplets or higher)
The proportion of multiple pregnancies was lowest among mothers aged under 20 (08) and highest among mothers aged 40 and over (27)
Between 2007 and 2017 the number of multiple pregnancies increased slightly from 4634 in 2007 to a peak of 4703 in 2008 and then declined to 4516 in 2017 The rate decreased slightly over this time from 16 per 1000 mothers to 15 per 1000
Most mothers live in Major cities and were born in AustraliaMost mothers lived in Major cities (72) and most were themselves born in Australia (64)mdashsimilar to the proportions of all women of reproductive age in the population
Over one‑quarter (27) of mothers who gave birth in 2017 were born in a main non‑English‑speaking country (see Glossary) compared with 25 of women of reproductive age in the population The proportion of mothers born in a main non‑English‑speaking country has increased from 18 in 2007
0
5
10
15
20
25
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Younger than 25 35 and older
Chapter 1 At a glance
bull The average age also increased for Aboriginal and Torres Strait Islander mothers from 252 in 2007 to 260 in 2017 with a median of 25 years
bull The proportion of mothers aged 35 and over increased from 22 in 2007 to 24 in 2017 while the proportion of mothers aged under 25 decreased from 19 to 14
bull The average age of first‑time mothers also increased from 282 in 2007 to 292 in 2017
Australiarsquos mothers and babies 2017mdashin brief 3
1 in 22 mothers were Aboriginal andor Torres Strait IslanderAround 45 of all mothers who gave birth in 2017 were Indigenousmdashslightly higher than the proportion of Indigenous women of reproductive age in the population (34)
Indigenous mothers were on average younger than non‑Indigenous mothers (260 years compared with 308)
Characteristics of mothers who gave birth in 2017
0 10 20 30 40 50 60 70 80 90 100
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia
Other main English-speaking countries
Other countries
Mat
erna
l age
Rem
oten
ess
Indi
geno
usst
atus
Coun
try
of b
irth
Per cent
Find out more in data visualisations Demographics of mothers and babies
Chapter X X4
Babies at a glanceMore babies are being bornbull There were 305667 babies born in 2017mdashan increase of 4 since 2007bull In all 303478 were live births and 2174 (less than 1) were stillbirths (a baby born without
signs of life see Glossary) Birth status was not recorded for a small number of births bull The stillbirth rate of 71 deaths per 1000 births has decreased slightly following a recent
peak of 78 per 1000 births in 2009
Number of babies born 2007ndash2017
Baby boys slightly outnumber girlsSlightly more babies were male (51) than female (49) This pattern is consistent with previous years The ratio was 1061 male liveborn babies per 100 female liveborn babies
1 in 18 babies were Aboriginal andor Torres Strait IslanderAround 1 in 18 babies (55 or 16934) were Indigenous in 2017 (based on Indigenous status of the baby) and 1 in 22 babies (45 or 13757) were born to Indigenous mothers (based on Indigenous status of the mother)
3 in 4 babies were born to mothers living in New South Wales Victoria or QueenslandThe proportion of babies born in each state and territory closely reflects the distribution of the total population in 2017
0
50000
100000
150000
200000
250000
300000
350000
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number
Year
Find out more in data visualisations Demographics of mothers and babies
51 49
Chapter 1 At a glance
Australiarsquos mothers and babies 2017mdashin brief 5
Mothers
Antenatal careAlmost all mothers attend antenatal care with 7 in 10 attending in the first trimester
Antenatal care is a planned visit between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout pregnancy It does not include visits where the sole purpose is to confirm the pregnancy
Antenatal care is associated with positive maternal and child health outcomesmdashthe likelihood of receiving effective health interventions is increased through attending antenatal care The Australian Pregnancy Care Guidelines (Department of Health 2018) recommend that the first antenatal visit occur within the first 10 weeks of pregnancy and that first‑time mothers with an uncomplicated pregnancy attend 10 visits (7 visits for subsequent uncomplicated pregnancies)
Regular antenatal care in the first trimester (before 14 weeks gestational age) is associated with better maternal health in pregnancy fewer interventions in late pregnancy and positive child health outcomes
Almost all mothers (999) who gave birth in 2017 had at least 1 antenatal visit
bull 94 had 5 or more visits
bull 86 had 7 or more visits
bull 58 had 10 or more visits
In 2017 in relation to the timing of the first antenatal visit
bull 56 of mothers had at least 1 antenatal visit in the first 10 weeks of pregnancy
bull 72 of mothers had at least 1 antenatal visit in the first trimester (less than 14 weeks)
bull 8 did not begin antenatal care until after 20 weeks gestation
2
Chapter X X6
Time to first antenatal visit by gestational age 2017
Trend information on antenatal care is limited due to the relatively recent standardised collection of data However the available data show little change over time
bull The proportion of mothers who had 5 or more antenatal visits throughout their pregnancy was 954 in 2012 and 957 in 2017 (based on mothers who gave birth at 32 weeks or more gestation excludes data from Victoria)
bull The proportion of mothers who received antenatal care in the first trimester of pregnancy was 627 in 2012 and 720 in 2017
See Chapter 5 for more data on trends
emsp
0
10
20
30
40
50
60
70
80
90
100
3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Cumulative percentage
Gestational age (weeks)
Find out more in data visualisations Antenatal care
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 7
The proportion of mothers who had 5 or more antenatal visits varied slightly by remoteness and socioeconomic disadvantage (data exclude very pre‑term births)bull 95 of mothers living in Major cities compared with 91 in Very remote areas bull 96 of mothers living in the highest SES areas compared with 93 in the lowest SES areas
Mothers who were born in main non‑English‑speaking countries (see Glossary) were less likely to attend antenatal care in the first trimester (66 compared with 74 of those born in Australia and other main English‑speaking countries) However the proportion attending 5 or more antenatal visits was similar (943 compared with 946)
Almost 2 in 3 Indigenous mothers had an antenatal visit in the first trimester (63) and almost 9 in 10 attended 5 or more visits throughout their pregnancy (87) compared with 71 and 94 of non‑Indigenous mothers respectively (age‑standardised) See Chapter 4 for more information on Indigenous mothers
Antenatal visits in the first trimester and 5 or more antenatal visits by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Data on 5 or more antenatal visits exclude very pre‑term births (less than 32 weeks gestation)
emsp
0 20 40 60 80 100
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Per cent
Antenatal visit in first trimester
0 20 40 60 80 100Per cent
5 or more visits
Indi
geno
usst
atus
(a)
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Indi
geno
usst
atus
(a)
Antenatal care visits vary by socioeconomic area and maternal characteristicsMothers living in the lowest socioeconomic status (SES) areas began antenatal care later in pregnancymdash67 of mothers living in the lowest SES areas attended antenatal care in the first trimester compared with 76 in the highest SES areas in 2017 This is an increase from 55 and 69 in 2012 respectively
Chapter X X8
Number of antenatal visits varies depending on where mothers liveIn 2017 the proportion of mothers attending 5 or more antenatal visits nationally was 94 (275410) (data exclude very pre‑term births) However the proportion varied across Primary Health Network (PHN) areas ranging from 84 in the Murray PHN area to 98 in the Central and Eastern Sydney PHN area
Map of percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes1 Data exclude very pre‑term births (less than 32 weeks gestation)2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general
practitioner is not reported3 See data table 51 for detailed data
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Chapter X X2
Trend in births to younger and older mothers in Australia 2007 to 2017
The rate of multiple pregnancies has fallenIn 2017 multiple pregnancies represented 15 of all pregnancies Almost all multiple pregnancies (988) were twins while a small proportion (12) were other multiples (triplets quadruplets or higher)
The proportion of multiple pregnancies was lowest among mothers aged under 20 (08) and highest among mothers aged 40 and over (27)
Between 2007 and 2017 the number of multiple pregnancies increased slightly from 4634 in 2007 to a peak of 4703 in 2008 and then declined to 4516 in 2017 The rate decreased slightly over this time from 16 per 1000 mothers to 15 per 1000
Most mothers live in Major cities and were born in AustraliaMost mothers lived in Major cities (72) and most were themselves born in Australia (64)mdashsimilar to the proportions of all women of reproductive age in the population
Over one‑quarter (27) of mothers who gave birth in 2017 were born in a main non‑English‑speaking country (see Glossary) compared with 25 of women of reproductive age in the population The proportion of mothers born in a main non‑English‑speaking country has increased from 18 in 2007
0
5
10
15
20
25
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Younger than 25 35 and older
Chapter 1 At a glance
bull The average age also increased for Aboriginal and Torres Strait Islander mothers from 252 in 2007 to 260 in 2017 with a median of 25 years
bull The proportion of mothers aged 35 and over increased from 22 in 2007 to 24 in 2017 while the proportion of mothers aged under 25 decreased from 19 to 14
bull The average age of first‑time mothers also increased from 282 in 2007 to 292 in 2017
Australiarsquos mothers and babies 2017mdashin brief 3
1 in 22 mothers were Aboriginal andor Torres Strait IslanderAround 45 of all mothers who gave birth in 2017 were Indigenousmdashslightly higher than the proportion of Indigenous women of reproductive age in the population (34)
Indigenous mothers were on average younger than non‑Indigenous mothers (260 years compared with 308)
Characteristics of mothers who gave birth in 2017
0 10 20 30 40 50 60 70 80 90 100
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia
Other main English-speaking countries
Other countries
Mat
erna
l age
Rem
oten
ess
Indi
geno
usst
atus
Coun
try
of b
irth
Per cent
Find out more in data visualisations Demographics of mothers and babies
Chapter X X4
Babies at a glanceMore babies are being bornbull There were 305667 babies born in 2017mdashan increase of 4 since 2007bull In all 303478 were live births and 2174 (less than 1) were stillbirths (a baby born without
signs of life see Glossary) Birth status was not recorded for a small number of births bull The stillbirth rate of 71 deaths per 1000 births has decreased slightly following a recent
peak of 78 per 1000 births in 2009
Number of babies born 2007ndash2017
Baby boys slightly outnumber girlsSlightly more babies were male (51) than female (49) This pattern is consistent with previous years The ratio was 1061 male liveborn babies per 100 female liveborn babies
1 in 18 babies were Aboriginal andor Torres Strait IslanderAround 1 in 18 babies (55 or 16934) were Indigenous in 2017 (based on Indigenous status of the baby) and 1 in 22 babies (45 or 13757) were born to Indigenous mothers (based on Indigenous status of the mother)
3 in 4 babies were born to mothers living in New South Wales Victoria or QueenslandThe proportion of babies born in each state and territory closely reflects the distribution of the total population in 2017
0
50000
100000
150000
200000
250000
300000
350000
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number
Year
Find out more in data visualisations Demographics of mothers and babies
51 49
Chapter 1 At a glance
Australiarsquos mothers and babies 2017mdashin brief 5
Mothers
Antenatal careAlmost all mothers attend antenatal care with 7 in 10 attending in the first trimester
Antenatal care is a planned visit between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout pregnancy It does not include visits where the sole purpose is to confirm the pregnancy
Antenatal care is associated with positive maternal and child health outcomesmdashthe likelihood of receiving effective health interventions is increased through attending antenatal care The Australian Pregnancy Care Guidelines (Department of Health 2018) recommend that the first antenatal visit occur within the first 10 weeks of pregnancy and that first‑time mothers with an uncomplicated pregnancy attend 10 visits (7 visits for subsequent uncomplicated pregnancies)
Regular antenatal care in the first trimester (before 14 weeks gestational age) is associated with better maternal health in pregnancy fewer interventions in late pregnancy and positive child health outcomes
Almost all mothers (999) who gave birth in 2017 had at least 1 antenatal visit
bull 94 had 5 or more visits
bull 86 had 7 or more visits
bull 58 had 10 or more visits
In 2017 in relation to the timing of the first antenatal visit
bull 56 of mothers had at least 1 antenatal visit in the first 10 weeks of pregnancy
bull 72 of mothers had at least 1 antenatal visit in the first trimester (less than 14 weeks)
bull 8 did not begin antenatal care until after 20 weeks gestation
2
Chapter X X6
Time to first antenatal visit by gestational age 2017
Trend information on antenatal care is limited due to the relatively recent standardised collection of data However the available data show little change over time
bull The proportion of mothers who had 5 or more antenatal visits throughout their pregnancy was 954 in 2012 and 957 in 2017 (based on mothers who gave birth at 32 weeks or more gestation excludes data from Victoria)
bull The proportion of mothers who received antenatal care in the first trimester of pregnancy was 627 in 2012 and 720 in 2017
See Chapter 5 for more data on trends
emsp
0
10
20
30
40
50
60
70
80
90
100
3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Cumulative percentage
Gestational age (weeks)
Find out more in data visualisations Antenatal care
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 7
The proportion of mothers who had 5 or more antenatal visits varied slightly by remoteness and socioeconomic disadvantage (data exclude very pre‑term births)bull 95 of mothers living in Major cities compared with 91 in Very remote areas bull 96 of mothers living in the highest SES areas compared with 93 in the lowest SES areas
Mothers who were born in main non‑English‑speaking countries (see Glossary) were less likely to attend antenatal care in the first trimester (66 compared with 74 of those born in Australia and other main English‑speaking countries) However the proportion attending 5 or more antenatal visits was similar (943 compared with 946)
Almost 2 in 3 Indigenous mothers had an antenatal visit in the first trimester (63) and almost 9 in 10 attended 5 or more visits throughout their pregnancy (87) compared with 71 and 94 of non‑Indigenous mothers respectively (age‑standardised) See Chapter 4 for more information on Indigenous mothers
Antenatal visits in the first trimester and 5 or more antenatal visits by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Data on 5 or more antenatal visits exclude very pre‑term births (less than 32 weeks gestation)
emsp
0 20 40 60 80 100
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Per cent
Antenatal visit in first trimester
0 20 40 60 80 100Per cent
5 or more visits
Indi
geno
usst
atus
(a)
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Indi
geno
usst
atus
(a)
Antenatal care visits vary by socioeconomic area and maternal characteristicsMothers living in the lowest socioeconomic status (SES) areas began antenatal care later in pregnancymdash67 of mothers living in the lowest SES areas attended antenatal care in the first trimester compared with 76 in the highest SES areas in 2017 This is an increase from 55 and 69 in 2012 respectively
Chapter X X8
Number of antenatal visits varies depending on where mothers liveIn 2017 the proportion of mothers attending 5 or more antenatal visits nationally was 94 (275410) (data exclude very pre‑term births) However the proportion varied across Primary Health Network (PHN) areas ranging from 84 in the Murray PHN area to 98 in the Central and Eastern Sydney PHN area
Map of percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes1 Data exclude very pre‑term births (less than 32 weeks gestation)2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general
practitioner is not reported3 See data table 51 for detailed data
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Australiarsquos mothers and babies 2017mdashin brief 3
1 in 22 mothers were Aboriginal andor Torres Strait IslanderAround 45 of all mothers who gave birth in 2017 were Indigenousmdashslightly higher than the proportion of Indigenous women of reproductive age in the population (34)
Indigenous mothers were on average younger than non‑Indigenous mothers (260 years compared with 308)
Characteristics of mothers who gave birth in 2017
0 10 20 30 40 50 60 70 80 90 100
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia
Other main English-speaking countries
Other countries
Mat
erna
l age
Rem
oten
ess
Indi
geno
usst
atus
Coun
try
of b
irth
Per cent
Find out more in data visualisations Demographics of mothers and babies
Chapter X X4
Babies at a glanceMore babies are being bornbull There were 305667 babies born in 2017mdashan increase of 4 since 2007bull In all 303478 were live births and 2174 (less than 1) were stillbirths (a baby born without
signs of life see Glossary) Birth status was not recorded for a small number of births bull The stillbirth rate of 71 deaths per 1000 births has decreased slightly following a recent
peak of 78 per 1000 births in 2009
Number of babies born 2007ndash2017
Baby boys slightly outnumber girlsSlightly more babies were male (51) than female (49) This pattern is consistent with previous years The ratio was 1061 male liveborn babies per 100 female liveborn babies
1 in 18 babies were Aboriginal andor Torres Strait IslanderAround 1 in 18 babies (55 or 16934) were Indigenous in 2017 (based on Indigenous status of the baby) and 1 in 22 babies (45 or 13757) were born to Indigenous mothers (based on Indigenous status of the mother)
3 in 4 babies were born to mothers living in New South Wales Victoria or QueenslandThe proportion of babies born in each state and territory closely reflects the distribution of the total population in 2017
0
50000
100000
150000
200000
250000
300000
350000
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number
Year
Find out more in data visualisations Demographics of mothers and babies
51 49
Chapter 1 At a glance
Australiarsquos mothers and babies 2017mdashin brief 5
Mothers
Antenatal careAlmost all mothers attend antenatal care with 7 in 10 attending in the first trimester
Antenatal care is a planned visit between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout pregnancy It does not include visits where the sole purpose is to confirm the pregnancy
Antenatal care is associated with positive maternal and child health outcomesmdashthe likelihood of receiving effective health interventions is increased through attending antenatal care The Australian Pregnancy Care Guidelines (Department of Health 2018) recommend that the first antenatal visit occur within the first 10 weeks of pregnancy and that first‑time mothers with an uncomplicated pregnancy attend 10 visits (7 visits for subsequent uncomplicated pregnancies)
Regular antenatal care in the first trimester (before 14 weeks gestational age) is associated with better maternal health in pregnancy fewer interventions in late pregnancy and positive child health outcomes
Almost all mothers (999) who gave birth in 2017 had at least 1 antenatal visit
bull 94 had 5 or more visits
bull 86 had 7 or more visits
bull 58 had 10 or more visits
In 2017 in relation to the timing of the first antenatal visit
bull 56 of mothers had at least 1 antenatal visit in the first 10 weeks of pregnancy
bull 72 of mothers had at least 1 antenatal visit in the first trimester (less than 14 weeks)
bull 8 did not begin antenatal care until after 20 weeks gestation
2
Chapter X X6
Time to first antenatal visit by gestational age 2017
Trend information on antenatal care is limited due to the relatively recent standardised collection of data However the available data show little change over time
bull The proportion of mothers who had 5 or more antenatal visits throughout their pregnancy was 954 in 2012 and 957 in 2017 (based on mothers who gave birth at 32 weeks or more gestation excludes data from Victoria)
bull The proportion of mothers who received antenatal care in the first trimester of pregnancy was 627 in 2012 and 720 in 2017
See Chapter 5 for more data on trends
emsp
0
10
20
30
40
50
60
70
80
90
100
3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Cumulative percentage
Gestational age (weeks)
Find out more in data visualisations Antenatal care
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 7
The proportion of mothers who had 5 or more antenatal visits varied slightly by remoteness and socioeconomic disadvantage (data exclude very pre‑term births)bull 95 of mothers living in Major cities compared with 91 in Very remote areas bull 96 of mothers living in the highest SES areas compared with 93 in the lowest SES areas
Mothers who were born in main non‑English‑speaking countries (see Glossary) were less likely to attend antenatal care in the first trimester (66 compared with 74 of those born in Australia and other main English‑speaking countries) However the proportion attending 5 or more antenatal visits was similar (943 compared with 946)
Almost 2 in 3 Indigenous mothers had an antenatal visit in the first trimester (63) and almost 9 in 10 attended 5 or more visits throughout their pregnancy (87) compared with 71 and 94 of non‑Indigenous mothers respectively (age‑standardised) See Chapter 4 for more information on Indigenous mothers
Antenatal visits in the first trimester and 5 or more antenatal visits by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Data on 5 or more antenatal visits exclude very pre‑term births (less than 32 weeks gestation)
emsp
0 20 40 60 80 100
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Per cent
Antenatal visit in first trimester
0 20 40 60 80 100Per cent
5 or more visits
Indi
geno
usst
atus
(a)
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Indi
geno
usst
atus
(a)
Antenatal care visits vary by socioeconomic area and maternal characteristicsMothers living in the lowest socioeconomic status (SES) areas began antenatal care later in pregnancymdash67 of mothers living in the lowest SES areas attended antenatal care in the first trimester compared with 76 in the highest SES areas in 2017 This is an increase from 55 and 69 in 2012 respectively
Chapter X X8
Number of antenatal visits varies depending on where mothers liveIn 2017 the proportion of mothers attending 5 or more antenatal visits nationally was 94 (275410) (data exclude very pre‑term births) However the proportion varied across Primary Health Network (PHN) areas ranging from 84 in the Murray PHN area to 98 in the Central and Eastern Sydney PHN area
Map of percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes1 Data exclude very pre‑term births (less than 32 weeks gestation)2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general
practitioner is not reported3 See data table 51 for detailed data
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Chapter X X4
Babies at a glanceMore babies are being bornbull There were 305667 babies born in 2017mdashan increase of 4 since 2007bull In all 303478 were live births and 2174 (less than 1) were stillbirths (a baby born without
signs of life see Glossary) Birth status was not recorded for a small number of births bull The stillbirth rate of 71 deaths per 1000 births has decreased slightly following a recent
peak of 78 per 1000 births in 2009
Number of babies born 2007ndash2017
Baby boys slightly outnumber girlsSlightly more babies were male (51) than female (49) This pattern is consistent with previous years The ratio was 1061 male liveborn babies per 100 female liveborn babies
1 in 18 babies were Aboriginal andor Torres Strait IslanderAround 1 in 18 babies (55 or 16934) were Indigenous in 2017 (based on Indigenous status of the baby) and 1 in 22 babies (45 or 13757) were born to Indigenous mothers (based on Indigenous status of the mother)
3 in 4 babies were born to mothers living in New South Wales Victoria or QueenslandThe proportion of babies born in each state and territory closely reflects the distribution of the total population in 2017
0
50000
100000
150000
200000
250000
300000
350000
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number
Year
Find out more in data visualisations Demographics of mothers and babies
51 49
Chapter 1 At a glance
Australiarsquos mothers and babies 2017mdashin brief 5
Mothers
Antenatal careAlmost all mothers attend antenatal care with 7 in 10 attending in the first trimester
Antenatal care is a planned visit between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout pregnancy It does not include visits where the sole purpose is to confirm the pregnancy
Antenatal care is associated with positive maternal and child health outcomesmdashthe likelihood of receiving effective health interventions is increased through attending antenatal care The Australian Pregnancy Care Guidelines (Department of Health 2018) recommend that the first antenatal visit occur within the first 10 weeks of pregnancy and that first‑time mothers with an uncomplicated pregnancy attend 10 visits (7 visits for subsequent uncomplicated pregnancies)
Regular antenatal care in the first trimester (before 14 weeks gestational age) is associated with better maternal health in pregnancy fewer interventions in late pregnancy and positive child health outcomes
Almost all mothers (999) who gave birth in 2017 had at least 1 antenatal visit
bull 94 had 5 or more visits
bull 86 had 7 or more visits
bull 58 had 10 or more visits
In 2017 in relation to the timing of the first antenatal visit
bull 56 of mothers had at least 1 antenatal visit in the first 10 weeks of pregnancy
bull 72 of mothers had at least 1 antenatal visit in the first trimester (less than 14 weeks)
bull 8 did not begin antenatal care until after 20 weeks gestation
2
Chapter X X6
Time to first antenatal visit by gestational age 2017
Trend information on antenatal care is limited due to the relatively recent standardised collection of data However the available data show little change over time
bull The proportion of mothers who had 5 or more antenatal visits throughout their pregnancy was 954 in 2012 and 957 in 2017 (based on mothers who gave birth at 32 weeks or more gestation excludes data from Victoria)
bull The proportion of mothers who received antenatal care in the first trimester of pregnancy was 627 in 2012 and 720 in 2017
See Chapter 5 for more data on trends
emsp
0
10
20
30
40
50
60
70
80
90
100
3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Cumulative percentage
Gestational age (weeks)
Find out more in data visualisations Antenatal care
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 7
The proportion of mothers who had 5 or more antenatal visits varied slightly by remoteness and socioeconomic disadvantage (data exclude very pre‑term births)bull 95 of mothers living in Major cities compared with 91 in Very remote areas bull 96 of mothers living in the highest SES areas compared with 93 in the lowest SES areas
Mothers who were born in main non‑English‑speaking countries (see Glossary) were less likely to attend antenatal care in the first trimester (66 compared with 74 of those born in Australia and other main English‑speaking countries) However the proportion attending 5 or more antenatal visits was similar (943 compared with 946)
Almost 2 in 3 Indigenous mothers had an antenatal visit in the first trimester (63) and almost 9 in 10 attended 5 or more visits throughout their pregnancy (87) compared with 71 and 94 of non‑Indigenous mothers respectively (age‑standardised) See Chapter 4 for more information on Indigenous mothers
Antenatal visits in the first trimester and 5 or more antenatal visits by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Data on 5 or more antenatal visits exclude very pre‑term births (less than 32 weeks gestation)
emsp
0 20 40 60 80 100
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Per cent
Antenatal visit in first trimester
0 20 40 60 80 100Per cent
5 or more visits
Indi
geno
usst
atus
(a)
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Indi
geno
usst
atus
(a)
Antenatal care visits vary by socioeconomic area and maternal characteristicsMothers living in the lowest socioeconomic status (SES) areas began antenatal care later in pregnancymdash67 of mothers living in the lowest SES areas attended antenatal care in the first trimester compared with 76 in the highest SES areas in 2017 This is an increase from 55 and 69 in 2012 respectively
Chapter X X8
Number of antenatal visits varies depending on where mothers liveIn 2017 the proportion of mothers attending 5 or more antenatal visits nationally was 94 (275410) (data exclude very pre‑term births) However the proportion varied across Primary Health Network (PHN) areas ranging from 84 in the Murray PHN area to 98 in the Central and Eastern Sydney PHN area
Map of percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes1 Data exclude very pre‑term births (less than 32 weeks gestation)2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general
practitioner is not reported3 See data table 51 for detailed data
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Australiarsquos mothers and babies 2017mdashin brief 5
Mothers
Antenatal careAlmost all mothers attend antenatal care with 7 in 10 attending in the first trimester
Antenatal care is a planned visit between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout pregnancy It does not include visits where the sole purpose is to confirm the pregnancy
Antenatal care is associated with positive maternal and child health outcomesmdashthe likelihood of receiving effective health interventions is increased through attending antenatal care The Australian Pregnancy Care Guidelines (Department of Health 2018) recommend that the first antenatal visit occur within the first 10 weeks of pregnancy and that first‑time mothers with an uncomplicated pregnancy attend 10 visits (7 visits for subsequent uncomplicated pregnancies)
Regular antenatal care in the first trimester (before 14 weeks gestational age) is associated with better maternal health in pregnancy fewer interventions in late pregnancy and positive child health outcomes
Almost all mothers (999) who gave birth in 2017 had at least 1 antenatal visit
bull 94 had 5 or more visits
bull 86 had 7 or more visits
bull 58 had 10 or more visits
In 2017 in relation to the timing of the first antenatal visit
bull 56 of mothers had at least 1 antenatal visit in the first 10 weeks of pregnancy
bull 72 of mothers had at least 1 antenatal visit in the first trimester (less than 14 weeks)
bull 8 did not begin antenatal care until after 20 weeks gestation
2
Chapter X X6
Time to first antenatal visit by gestational age 2017
Trend information on antenatal care is limited due to the relatively recent standardised collection of data However the available data show little change over time
bull The proportion of mothers who had 5 or more antenatal visits throughout their pregnancy was 954 in 2012 and 957 in 2017 (based on mothers who gave birth at 32 weeks or more gestation excludes data from Victoria)
bull The proportion of mothers who received antenatal care in the first trimester of pregnancy was 627 in 2012 and 720 in 2017
See Chapter 5 for more data on trends
emsp
0
10
20
30
40
50
60
70
80
90
100
3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Cumulative percentage
Gestational age (weeks)
Find out more in data visualisations Antenatal care
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 7
The proportion of mothers who had 5 or more antenatal visits varied slightly by remoteness and socioeconomic disadvantage (data exclude very pre‑term births)bull 95 of mothers living in Major cities compared with 91 in Very remote areas bull 96 of mothers living in the highest SES areas compared with 93 in the lowest SES areas
Mothers who were born in main non‑English‑speaking countries (see Glossary) were less likely to attend antenatal care in the first trimester (66 compared with 74 of those born in Australia and other main English‑speaking countries) However the proportion attending 5 or more antenatal visits was similar (943 compared with 946)
Almost 2 in 3 Indigenous mothers had an antenatal visit in the first trimester (63) and almost 9 in 10 attended 5 or more visits throughout their pregnancy (87) compared with 71 and 94 of non‑Indigenous mothers respectively (age‑standardised) See Chapter 4 for more information on Indigenous mothers
Antenatal visits in the first trimester and 5 or more antenatal visits by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Data on 5 or more antenatal visits exclude very pre‑term births (less than 32 weeks gestation)
emsp
0 20 40 60 80 100
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Per cent
Antenatal visit in first trimester
0 20 40 60 80 100Per cent
5 or more visits
Indi
geno
usst
atus
(a)
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Indi
geno
usst
atus
(a)
Antenatal care visits vary by socioeconomic area and maternal characteristicsMothers living in the lowest socioeconomic status (SES) areas began antenatal care later in pregnancymdash67 of mothers living in the lowest SES areas attended antenatal care in the first trimester compared with 76 in the highest SES areas in 2017 This is an increase from 55 and 69 in 2012 respectively
Chapter X X8
Number of antenatal visits varies depending on where mothers liveIn 2017 the proportion of mothers attending 5 or more antenatal visits nationally was 94 (275410) (data exclude very pre‑term births) However the proportion varied across Primary Health Network (PHN) areas ranging from 84 in the Murray PHN area to 98 in the Central and Eastern Sydney PHN area
Map of percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes1 Data exclude very pre‑term births (less than 32 weeks gestation)2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general
practitioner is not reported3 See data table 51 for detailed data
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Chapter X X6
Time to first antenatal visit by gestational age 2017
Trend information on antenatal care is limited due to the relatively recent standardised collection of data However the available data show little change over time
bull The proportion of mothers who had 5 or more antenatal visits throughout their pregnancy was 954 in 2012 and 957 in 2017 (based on mothers who gave birth at 32 weeks or more gestation excludes data from Victoria)
bull The proportion of mothers who received antenatal care in the first trimester of pregnancy was 627 in 2012 and 720 in 2017
See Chapter 5 for more data on trends
emsp
0
10
20
30
40
50
60
70
80
90
100
3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41
Cumulative percentage
Gestational age (weeks)
Find out more in data visualisations Antenatal care
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 7
The proportion of mothers who had 5 or more antenatal visits varied slightly by remoteness and socioeconomic disadvantage (data exclude very pre‑term births)bull 95 of mothers living in Major cities compared with 91 in Very remote areas bull 96 of mothers living in the highest SES areas compared with 93 in the lowest SES areas
Mothers who were born in main non‑English‑speaking countries (see Glossary) were less likely to attend antenatal care in the first trimester (66 compared with 74 of those born in Australia and other main English‑speaking countries) However the proportion attending 5 or more antenatal visits was similar (943 compared with 946)
Almost 2 in 3 Indigenous mothers had an antenatal visit in the first trimester (63) and almost 9 in 10 attended 5 or more visits throughout their pregnancy (87) compared with 71 and 94 of non‑Indigenous mothers respectively (age‑standardised) See Chapter 4 for more information on Indigenous mothers
Antenatal visits in the first trimester and 5 or more antenatal visits by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Data on 5 or more antenatal visits exclude very pre‑term births (less than 32 weeks gestation)
emsp
0 20 40 60 80 100
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Per cent
Antenatal visit in first trimester
0 20 40 60 80 100Per cent
5 or more visits
Indi
geno
usst
atus
(a)
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Indi
geno
usst
atus
(a)
Antenatal care visits vary by socioeconomic area and maternal characteristicsMothers living in the lowest socioeconomic status (SES) areas began antenatal care later in pregnancymdash67 of mothers living in the lowest SES areas attended antenatal care in the first trimester compared with 76 in the highest SES areas in 2017 This is an increase from 55 and 69 in 2012 respectively
Chapter X X8
Number of antenatal visits varies depending on where mothers liveIn 2017 the proportion of mothers attending 5 or more antenatal visits nationally was 94 (275410) (data exclude very pre‑term births) However the proportion varied across Primary Health Network (PHN) areas ranging from 84 in the Murray PHN area to 98 in the Central and Eastern Sydney PHN area
Map of percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes1 Data exclude very pre‑term births (less than 32 weeks gestation)2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general
practitioner is not reported3 See data table 51 for detailed data
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Australiarsquos mothers and babies 2017mdashin brief 7
The proportion of mothers who had 5 or more antenatal visits varied slightly by remoteness and socioeconomic disadvantage (data exclude very pre‑term births)bull 95 of mothers living in Major cities compared with 91 in Very remote areas bull 96 of mothers living in the highest SES areas compared with 93 in the lowest SES areas
Mothers who were born in main non‑English‑speaking countries (see Glossary) were less likely to attend antenatal care in the first trimester (66 compared with 74 of those born in Australia and other main English‑speaking countries) However the proportion attending 5 or more antenatal visits was similar (943 compared with 946)
Almost 2 in 3 Indigenous mothers had an antenatal visit in the first trimester (63) and almost 9 in 10 attended 5 or more visits throughout their pregnancy (87) compared with 71 and 94 of non‑Indigenous mothers respectively (age‑standardised) See Chapter 4 for more information on Indigenous mothers
Antenatal visits in the first trimester and 5 or more antenatal visits by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Data on 5 or more antenatal visits exclude very pre‑term births (less than 32 weeks gestation)
emsp
0 20 40 60 80 100
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Per cent
Antenatal visit in first trimester
0 20 40 60 80 100Per cent
5 or more visits
Indi
geno
usst
atus
(a)
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Rem
oten
ess
SES
Indi
geno
usst
atus
(a)
Antenatal care visits vary by socioeconomic area and maternal characteristicsMothers living in the lowest socioeconomic status (SES) areas began antenatal care later in pregnancymdash67 of mothers living in the lowest SES areas attended antenatal care in the first trimester compared with 76 in the highest SES areas in 2017 This is an increase from 55 and 69 in 2012 respectively
Chapter X X8
Number of antenatal visits varies depending on where mothers liveIn 2017 the proportion of mothers attending 5 or more antenatal visits nationally was 94 (275410) (data exclude very pre‑term births) However the proportion varied across Primary Health Network (PHN) areas ranging from 84 in the Murray PHN area to 98 in the Central and Eastern Sydney PHN area
Map of percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes1 Data exclude very pre‑term births (less than 32 weeks gestation)2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general
practitioner is not reported3 See data table 51 for detailed data
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Chapter X X8
Number of antenatal visits varies depending on where mothers liveIn 2017 the proportion of mothers attending 5 or more antenatal visits nationally was 94 (275410) (data exclude very pre‑term births) However the proportion varied across Primary Health Network (PHN) areas ranging from 84 in the Murray PHN area to 98 in the Central and Eastern Sydney PHN area
Map of percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes1 Data exclude very pre‑term births (less than 32 weeks gestation)2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general
practitioner is not reported3 See data table 51 for detailed data
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Australiarsquos mothers and babies 2017mdashin brief 9
Percentage of mothers attending 5 or more antenatal visits by Primary Health Network area of usual residence 2017
Notes
1 Data exclude very pre‑term births (less than 32 weeks gestation)
2 For the Australian Capital Territory in many cases early antenatal care provided by the womanrsquos general practitioner is not reported
3 See data table 51 for detailed data
977
976
974
973
972
966
966
965
962
961
961
960
960
956
951
950
949
948
944
943
941
939
938
937
936
930
922
921
889
886
849
841
0 20 40 60 80 100
Central and Eastern Sydney (PHN101)
Brisbane North (PHN301)
Northern Sydney (PHN102)
Country SA (PHN402)
Adelaide (PHN401)
Perth South (PHN502)
South Eastern NSW (PHN106)
Nepean Blue Mountains (PHN104)
Central Queensland Wide BaySunshine Coast (PHN306)
Western NSW (PHN107)
Northern Queensland (PHN307)
Western Sydney (PHN103)
Hunter New England and Central Coast (PHN108)
Darling Downs and West Moreton (PHN304)
Perth North (PHN501)
Western Queensland (PHN305)
Brisbane South (PHN302)
Western Victoria (PHN206)
Total
Gold Coast (PHN303)
South Western Sydney (PHN105)
Murrumbidgee (PHN110)
Country WA (PHN503)
North Coast (PHN109)
Northern Territory (PHN701)
Tasmania (PHN601)
North Western Melbourne (PHN201)
Eastern Melbourne (PHN202)
Gippsland (PHN204)
South Eastern Melbourne (PHN203)
Australian Capital Territory (PHN801)
Murray (PHN205)
Per cent
Primary Health Network area
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Chapter X X10
Smoking during pregnancyRates of smoking during pregnancy continue to fall
Tobacco smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes including low birthweight being small for gestational age pre-term birth and perinatal death
One in 10 mothers (29267 or 99) who gave birth in 2017 smoked at some time during their pregnancy a decrease from 146 in 2009 More data on trends are available in Chapter 5
Rates of smoking were higher in the first 20 weeks of pregnancy (28573 or 95) than after 20 weeks of pregnancy (21484 or 73)
On average mothers who smoked during pregnancybull had their first antenatal visit later in pregnancy
(13 weeks) than those who did not smoke (11 weeks)bull had 1 fewer antenatal care visits (9 visits) than those who did not smoke (10 visits)
These patterns were present across all socioeconomic groups
Some mothers were more likely than others to smoke in the first 20 weeks of pregnancy In 2017 proportions were highest among the following mothers noting that some may fall into more than 1 of these categoriesbull younger mothers (aged under 20)mdashalmost one‑third (324) smoked in the first 20 weeks
of pregnancy compared with 59 of mothers aged 35ndash39 and 67 aged 40 and over bull mothers living in Remote and Very remote areasmdasharound one‑third (337) of mothers in
Very remote and less than one‑fifth (176) in Remote areas compared with 72 of those living in Major cities
bull mothers living in the lowest SES areasmdashalmost one‑fifth (178) smoked in the first 20 weeks of pregnancy compared with 29 in the highest SES areas The difference was still notable after adjusting for maternal agemdash191 compared with 78 (age‑standardised percentages)
bull mothers born in Australia or other main English‑speaking countriesmdash125 compared with 17 of mothers from main non‑English‑speaking countries (see Glossary)
bull Indigenous mothersmdash434 smoked in the first 20 weeks of pregnancy compared with 114 of non‑Indigenous mothers (age‑standardised percentages)
1 in 10 mothers smoked during pregnancy
Find out more in data visualisations Smoking
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Australiarsquos mothers and babies 2017mdashin brief 11
Mothers who smoked in the first 20 weeks of pregnancy by selected maternal characteristics 2017
(a) Age‑standardised percentagesNote Per cents calculated after excluding records with not stated values
Almost 1 in 4 quit smoking during pregnancyWomen who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies Support to stop smoking is widely available through antenatal clinics
Almost 1 in 4 (6421 or 22) of the 28573 mothers who gave birth in 2017 and who reported smoking during the first 20 weeks of pregnancy did not continue to smoke after 20 weeks of pregnancy
Some women may smoke before knowing they are pregnant and stop once they find out they are pregnant According to the 2016 National Drug Strategy Household Survey around 1 in 6 (16) women smoked before they knew they were pregnant and 1 in 10 (11) smoked after they found out they were pregnant (AIHW 2017)
0 5 10 15 20 25 30 35 40 45 50
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Mat
erna
l age
Rem
oten
ess
SES
Mat
erna
lCO
B
Per cent
Indi
geno
usst
atus
(a)
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-
Chapter X X12
Maternal healthAlmost half of mothers are overweight or obese at their first antenatal visitObesity in pregnancy contributes to increased risks of illness and death for both mother and baby Pregnant women who are obese have an increased risk of thromboembolism gestational diabetes pre‑eclampsia post‑partum haemorrhage (bleeding) and wound infections They are also more likely to deliver via caesarean section Babies of mothers who are obese have higher rates of congenital anomaly stillbirth and neonatal death than babies of mothers who are not obese (CMACE amp RCOG 2010)
Body mass index (BMI) is a ratio of weight and height (kgm2) The normal range of BMI for non‑pregnant women is 185 to 249 While increases in BMI are expected during pregnancy a BMI of 30 or more at the first antenatal visit is defined as obesity in pregnancy
Data on maternal BMI were available for mothers in all states and territories for the first time in 2017 However data collection methods vary between jurisdictions
Among mothers who gave birth in 2017
bull one‑fifth (200) were classified as obese (with a BMI of 300 or more)
bull one‑quarter (256) were overweight but not obese (BMI of 250ndash299)
bull half (504) were in the normal weight range (BMI of 185ndash249)
bull one in 25 (39) were underweight (BMI of less than 185)
The proportion of mothers who were overweight or obese increased with age from 37 of mothers aged under 20 to 51 of those aged 40 and over Mothers who had a caesarean section were more likely to be overweight or obese (53) than mothers who had a non‑instrumental (43) or instrumental vaginal birth (37) (age‑standardised)
Almost 1 in 2 mothers were overweight or obese at their first antenatal visit
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 13
Mothers by body mass index group maternal age and method of birth 2017
(a) Age‑standardised percentages For multiple births the method of birth of the first‑born baby was used
Note Per cents calculated after excluding records with not stated values
emsp
0
20
40
60
80
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40and over
Non-instrumental
vaginal
Instrumentalvaginal
Caesareansection
Maternal age Method of birth
Per cent Underweight Normal Overweight Obese
(a)
Find out more in data visualisations Body mass index and Maternal medical conditions
Diabetes and hypertensionInformation is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes Gestational diabetes affected 127 per 1000 mothers who gave birth in 2017 while a small proportion of mothers had other conditionsbull 71 per 1000 mothers had pre‑existing (chronic) hypertension bull 360 per 1000 had gestational hypertensionbull 78 per 1000 had pre‑existing diabetes
Note that data collection methods for hypertension and diabetes vary across jurisdictions and data exclude Victoria (see Appendix Table D2)
Chapter X X14
Place of birthHospitals are the most common place to give birthAlmost all births in Australia occur in hospitals in conventional labour wards In 2017 97 (291052) of mothers gave birth in hospitals while much smaller proportions gave birth in birth centres (24 or 7247) at home (03 or 806) or in other settings including births occurring before arrival at hospital (07 or 1974 mothers)
Three-quarters of hospital births are in public hospitals The majority (74) of mothers who gave birth in hospital did so in a public hospital and the remaining 26 gave birth in a private hospital Almost two‑thirds (63) of mothers gave birth within 1 day of admission and a further 29 gave birth within 2 days of admission
After birth the median length of stay in hospital was 3 days The median was equal for mothers who delivered by caesarean section (3 days) and lower for those who had a vaginal birth (2 days) There was a trend toward shorter postnatal stays between 2007 and 2017 with 21 of mothers discharged less than 2 days after giving birth in 2017 (14 in 2007) and 14 of mothers staying 5 or more days (21 in 2007) The proportion of mothers discharged between 2 and 4 days after giving birth was unchanged at 65 (based on mothers who were discharged to home and excludes data from Western Australia see Appendix Table D2)
The average age of mothers who gave birth in hospitals was 306 years and 41 were under the age of 30 Mothers who gave birth in public hospitals were younger on average (299) than those who gave birth in private hospitals (327) Mothers who gave birth in hospitals were more likely to be first‑time mothers (43) than in other settings
Babies born in hospitals had a lower average birthweight (3340 grams) and lower average gestational age (387 weeks) than in birth centres or home settings This may be due to the fact that babies requiring a higher level of care including those who are pre-term or low birthweight are more likely to be delivered in a hospital setting
Mothers who give birth in birth centres are slightly youngerThe average age of mothers who gave birth in birth centres was 300 years slightly younger than in other birth settings and 44 were under the age of 30 Around one‑third (36) of those who delivered in birth centres were first‑time mothers The average birthweight of babies born in birth centres was 3476 grams and the average gestational age was 394 weeks
Mothers giving birth at home are older and less likely to be first-time mothersThe average age of the relatively small number of mothers who gave birth at home was higher than in other settings (317 years) and these mothers were less likely to be aged under 30 (31) or to be first‑time mothers (25) Babies born at home had a higher average birthweight (3672 grams) and higher average gestational age (397 weeks) than in other places of birth These data should be interpreted with caution due to the small numbers of mothers giving birth at home
Find out more in data visualisations Place of birth
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 15
Onset of labourYounger mothers are more likely to have spontaneous labourLabour can occur spontaneously or may be induced through medical or surgical intervention If there is no labour then a caesarean section is performed
Overall almost half of mothers who gave birth in 2017 (46 or 137293) had a spontaneous labour around 1 in 3 had an induced labour (33 or 97914) and 1 in 5 had no labour onset (22 or 65799)
Labour onset varied considerably by maternal age group Younger mothers (under 20) were the most likely to have spontaneous labour onset (574) and the least likely to have no labour onset (69) Conversely mothers aged 40 and over were least likely to have spontaneous labour onset (261) and most likely to have no labour onset (423) There was little difference in the proportion of mothers with induced labour between the age groups (30ndash36)
There were changes between 2007 and 2017 in the type of labour onsetmdasha decrease in spontaneous labour (from 57 to 46) and corresponding increases for the induction of labour (from 25 to 33) and no labour onset (from 18 to 22) See Chapter 5 for more data on trends
Mothers by onset of labour and maternal age 2017
Note lsquoInducedrsquo may include cases where induction of labour was attempted but labour did not result
0
10
20
30
40
50
60
70
80
90
100
Under 20 20ndash24 25ndash29 30ndash34 35ndash39 40 and over
Per cent
Maternal age
Spontaneous Induced No labour
Chapter X X16
Induction type and reasonFor mothers whose labour was induced a combination of medical andor surgical types of induction were most commonly used (excludes data from Western Australia see Appendix Table D2)
Based on data from 5 jurisdictions diabetes (14) and prolonged pregnancy (13) were the main reasons for inducing labour (excludes data from New South Wales Victoria and South Australia see Appendix Table D2)
Augmentation of labourOnce labour starts it may be necessary to intervene to speed up or augment the labour Labour was augmented for 14 of mothers in 2017mdashequivalent to 30 of mothers with spontaneous onset of labour The augmentation rate was higher among first‑time mothers at 42 of those with spontaneous labour onset compared with 22 of mothers who had given birth previously (excludes data from Western Australia see Appendix Table D2)
emsp
Find out more in data visualisations Onset of labour
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 17
Method of birthTwo-thirds of mothers have vaginal births one-third have caesareansIn 2017 65 of mothers (196832) had a vaginal birth and 35 (104237) had a caesarean section Mothers who had a caesarean section include all mothers who had no labour onset as well as some mothers who required a caesarean section after labour started
Most vaginal births (81) were non‑instrumental When instrumental births were required vacuum extraction were more commonly used than forceps (11 and 8 respectively)
Non-instrumental vaginal birth decreased with age and increased slightly with each category of remotenessbull Non‑instrumental vaginal birth decreased as maternal age increased (from 68 for
teenage mothers to 38 for mothers 40 and over)bull Fewer mothers living in Major cities had a non‑instrumental vaginal birth (53) compared
with mothers in Very remote areas (56) (age‑standardised)bull Mothers living in the highest SES areas were less likely to have a non‑instrumental vaginal
birth (50) than those in the lowest SES areas (57) (age‑standardised)
Instrumental vaginal birth decreased as age increased (from 126 for teenage mothers to 78 for mothers 40 and over) and with increasing remoteness (from 125 in Major cities to 85 in Very remote areas age‑standardised) Instrumental vaginal birth was more common among mothers living in the highest SES areas (141) than in the lowest SES areas (96) (age‑standardised)
Mothers by method of birth and selected maternal characteristics 2017
(a) Age‑standardised percentages Note For multiple births the method of birth of the first‑born baby was used
0
20
40
60
80
100
Under20
20ndash24 25ndash29 30ndash34 35ndash39 40 andover
Majorcities
Innerregional
Outerregional
Remote Veryremote
LowestSES
HighestSES
Maternal age Remoteness SES
Per centNon-instrumental vaginal Instrumental vaginal Caesarean section
(a) (a)
Chapter X X18
Perineal status after vaginal birthOne‑quarter of mothers had an intact perineum after vaginal birth (24) while around half had either a first degree laceration or vaginal graze (23) or a second degree laceration (30) A small proportion of mothers had a third or fourth degree laceration (3) or other types of laceration (8) Around 1 in 5 mothers had an episiotomy (23) and of these 42 also had a laceration of some degree Therefore these figures do not sum to 100
Internationally Australiarsquos rate of third and fourth degree lacerations was higher than the average for Organisation for Economic Co‑operation and Development (OECD) countries in 2014 for both non‑instrumental and instrumental vaginal birthsbull 25 per 100 non‑instrumental vaginal births compared with the OECD average of 15 bull 72 per 100 instrumental vaginal births compared with the OECD average of 57 (OECD 2017)
Variation between countries is likely to be affected by differences in clinical practice and reporting (ACSQHC 2017)
Caesarean sections are more common among older mothersCaesarean section rates increased with age but differed little by remoteness and SES Mothers aged 40 and over were almost 3 times as likely to deliver by caesarean section as teenage mothers (54 and 20)
The overall rate of primary caesarean section (that is caesarean sections to mothers with no previous history of caesarean sections) was 24 this rate was higher for first‑time mothers (36) and lower for mothers who had previously given birth (11)
The great majority (86) of mothers who had had a previous caesarean section had a repeat caesarean section while the remainder had a vaginal birth (110 had a non‑instrumental vaginal birth and 34 had an instrumental vaginal birth)
Having had a previous caesarean section was the most common main reason for having a caesarean section (excludes data from Victoria and South Australia see Appendix Table D2)
Caesarean sections have increased over timeSince 2007 vaginal non‑instrumental births have fallen 5 percentage points (decreasing from 58 in 2007 to 53 in 2017) whereas the caesarean section rate has increased by 4 percentage points (from 31 in 2007 to 35 in 2017) Vaginal birth with instruments has remained relatively stable between 11 and 13 throughout this period These trends remain when changes in maternal age over time are taken into account See Chapter 5 for more data on trends
Internationally the caesarean section rate has been increasing in most OECD countries The OECD average increased from a rate of 20 per 100 live births in 2000 to 28 per 100 in 2015 or nearest year Australiarsquos rate remained higher than the OECD average over this time and ranked 26th out of 34 OECD countries in 2015 or nearest year with a rate of 34 per 100 live births (rates ranked from lowest to highest) The rate was lowest in Finland (16 per 100 live births) and highest in Turkey (53 per 100) (OECD 2017)
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 19
Mothers by method of birth 2007 to 2017
Note For multiple births the method of birth of the first‑born baby was used
Robson classification of caesarean sectionsIn 2015 the World Health Organization (WHO) recommended that rather than a population‑based estimate of caesarean section rate the Robson 10 group classification system (Robson classification) be used to evaluate and compare caesarean section rates between groups of women (ACSQHC 2017 WHO RHR 2015) The Robson classification allocates women to 10 mutually exclusive groups based on obstetric characteristics such as parity (number of previous pregnancies) onset of labour whether there has been a previous caesarean section and the babyrsquos gestational age (WHO RHR 2015) (for more detail see Appendix D)
In 2017 using the Robson classification women with a breech pregnancy were most likely to have a caesarean section (92 for first births 87 for subsequent births) followed by those with singleton pregnancies near term who had 1 or more previous caesarean sections (85) Focusing on key groups within the Robson classification can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention
0
10
20
30
40
50
60
70
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Non-instrumental vaginal Instrumental vaginal Caesarean section
Chapter X X20
Women who gave birth in 2017 by the 10 Robson classification groups
First time mother singleton pregnancy baby in breech (feet first) presentation5994 women gave birth in this group5538 had a caesarean section
92 caesarean rate
Mother has previously given birth with current singleton baby in breech (feet first) presentation4912 women gave birth in this group4291 had a caesarean section
87 caesarean rate
Mother has previously given birth with a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation44880 women gave birth in this group38297 had a caesarean section
85 caesarean rate
Multiple pregnancy including women with previous caesarean scars4516 women gave birth in this group3147 had a caesarean section
70 caesarean rate
All women with a singleton pregnancy baby in transverse (side on) or oblique lie including women with previous caesarean scars3220 women gave birth in this group1517 had a caesarean section
47 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour58404 women gave birth in this group26305 had a caesarean section
45 caesarean rate
All women with a singleton pregnancy baby in vertex (head first) presentation le36 weeks gestation including women with previous caesarean scars17387 women gave birth in this group7249 had a caesarean section
42 caesarean rate
First time mother singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)51743 women gave birth in this group8508 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation induced labour or caesarean section before labour 44292 women gave birth in this group7007 had a caesarean section
16 caesarean rate
Mother has previously given birth without a previous caesarean scar singleton pregnancy baby in vertex (head first) presentation ge37 weeks gestation spontaneous labour (not induced)61188 women gave birth in this group1571 had a caesarean section
26 caesarean rate
Chapter 2 Mothers
Australiarsquos mothers and babies 2017mdashin brief 21
Pain relief during labour and operative deliveryAnalgesia is used to relieve pain during labour (spontaneous or induced) while anaesthesia is used for operative delivery (caesarean section or instrumental vaginal birth) More than 1 type of analgesic or anaesthetic can be administered
Of the 235207 mothers who had labour in 2017 nearly 4 in 5 (78) had pain relief The most common types were nitrous oxide (inhaled) (54) followed by regional analgesic (38) and systemic opioids (16) Mothers who did not have pain relief were more likely to be older to have given birth before to be Indigenous and to live in the lowest SES areas or more remote areas than those who had pain relief
All mothers who have a caesarean section receive a type of anaesthetic except in the rare case of post‑mortem delivery In 2017 the vast majority (941) of mothers who had a caesarean section had a regional anaesthetic and 61 had a general anaesthetic (note that some mothers had both)
Most mothers who had an instrumental vaginal birth also had an anaesthetic (88) A regional anaesthetic was most common (65 of mothers who had an instrumental vaginal birth) followed by a local anaesthetic to the perineum (24)
4 in 5 mothers with labour onset received pain relief
Find out more in data visualisations Method of birth Perineal status Analgesia and Anaesthesia
Chapter X X22
Babies
Gestational age1 in 11 babies are born pre-termGestational age is the duration of pregnancy in completed weeks
In 2017 the median gestational age for all babies was 39 weeks with the vast majority (91) born at term (37ndash41 weeks)
Overall 87 of babies were born pre‑term (before 37 completed weeks gestation) in 2017 Most of these births (81) occurred between 32 and 36 completed weeks The median gestational age for all pre‑term births was 35 weeks
Pre‑term birth is associated with a higher risk of adverse neonatal outcomes This is reflected in the median gestational age for liveborn babies (39 weeks) which was considerably higher than for stillborn babies (24 weeks) It is also reflected in the fact that most stillbirths were for pre‑term babies (85) and only 15 of stillbirths occurred at term
Less than 1 per cent (05) of all babies were born post‑term (42 weeks and over)
From 2007 to 2017 the proportion of babies born between 37 and 39 weeks increased while the proportion born from 40 weeks onwards decreased
3
Gestational age of babies in 2017
8 7 pre-term 91 born at term lt1 post-term
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 23
Babies by gestational age 2007 and 2017
Note Pre‑term births may include a small number of births of less than 20 weeks gestation
Pre-term birth much more likely for multiple birthsBabies born in multiple births were much more likely to be born pre‑termmdash660 of twins and 982 of all other multiples (triplets and higher) were born pre‑term in 2017 This compared with 70 of singleton babies
Other characteristics were also associated with increased likelihood of pre‑term birth noting that some babies might have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash142 born pre‑term compared with 85 of babies of non-Indigenous mothers
bull babies whose mothers smoked during pregnancymdash136 born pre‑term compared with 81 of babies whose mothers did not smoke
bull babies born to mothers usually residing in more remote areasmdash135 in Very remote areas compared with 84 in Major cities
bull babies of younger (under 20) and older (40 and over) mothersmdash113 and 131 were pre‑term compared with 85 of babies with mothers aged 20ndash39
emsp
0
5
10
15
20
25
30
35
20ndash36 37 38 39 40 41 42 and over
Pre-term Term Post-term
Per cent
Gestational age (weeks)
2007 2017
Find out more in data visualisations Gestational age
Chapter X X24
BirthweightThe vast majority of liveborn babies are in the normal birthweight rangeA babyrsquos birthweight is a key indicator of infant health and a determinant of a babyrsquos chances of survival and health later in life This section provides an overview of birthweight the following sections focus on low birthweight and small for gestational age babies
In 2017 the average birthweight of all babies was 3313 grams The average was slightly higher for liveborn babies (3328 grams) with the vast majority of these born in the normal birthweight range (92 or 279485) 67 (20271) were low birthweight and a small proportion were high birthweight (12 or 3641)
The average birthweight of stillborn babies (1097 grams) was far lower than for liveborn babies (3328 grams) Four in 5 (83) stillborn babies were low birthweight and two‑thirds (66) weighed less than 1000 grams
Babies by birthweight and birth status 2017
emsp
0
10
20
30
40
50
60
70
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500ndash2999
3000ndash3499
3500ndash3999
4000ndash4499
4500and over
Low Normal High
Per cent
Birthweight (grams)
Liveborn Stillborn
Birthweight rangesHigh 4500 grams and overNormal 2500 to 4499 grams Low less than 2500 grams
(WHO 1992)
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 25
Low birthweight1 in 15 liveborn babies are low birthweight Babies are considered to be of low birthweight when their weight at birth is less than 2500 grams Low birthweight is closely associated with pre‑term birthmdashalmost 3 in 4 low birthweight babies were pre-term and more than half of pre-term babies were of low birthweight in 2017
This section looks at low birthweight in more detail and relates to live births only
In 2017 67 (20271) of liveborn babies were of low birthweight Of these babies
bull 15 or 2996 weighed less than 1500 grams
bull 7 or 1341 weighed less than 1000 grams
Between 2007 and 2017 there was little change in the proportion of low birthweight babiesmdashit remained between 61 and 67 over this time
The proportion of low birthweight babies was higher among
bull female babies (73) compared with male babies (61)
bull twins (55) and other multiples (99) compared with singletons (52)
bull babies born in public hospitals (73) compared with babies born in private hospitals (49)
bull babies of mothers who smoked during pregnancy (129) compared with babies whose mothers did not (60)
bull babies of Indigenous mothers (125) compared with those of non‑Indigenous mothers (64) (see Chapter 4 for more information)
Internationally the proportion of low birthweight babies in Australia in 2016 or nearest year (65) was equal to the OECD average (65) with Australia ranked 17th out of 36 OECD countries The rate of low birthweight was lowest in Estonia and Finland (41) and highest in Japan (94) (OECD 2017)
lt2500 grams
6 7
Proportion of low birthweight babies in 2017
Chapter X X26
Low birthweight liveborn babies by selected maternal characteristics 2017
0 2 4 6 8 10 12 14
Smoked
Did not smoke
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Indigenous
Non-Indigenous
Smok
ing
stat
usRe
mot
enes
sSE
SIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Birthweight
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 27
Small for gestational ageBabies of mothers who smoked during pregnancy were more likely to be small for gestational age A baby may be small due to being born early (pre‑term) or be small for gestational age which indicates a possible growth restriction within the uterus Poor fetal growth is associated with increased risk of stillbirth and with fetal distress during labour and may predispose babies to long-term conditions in later life
Babies are defined as small for gestational age if their birthweight is below the 10th percentile for their gestational age and sex according to national birthweight percentiles The latest birthweight percentiles were developed for Australia using information about liveborn singleton babies born between 2004 and 2013 (Johnson et al 2016 for more detail see Appendix D) Data in this section relate to singleton live births only
Certain characteristics were associated with increased likelihood of being small for gestational age in 2017 noting that some babies may have had more than 1 of these characteristics These included
bull babies of Indigenous mothersmdash14 were small for gestational age compared with 9 of babies of non-Indigenous mothers
bull babies of mothers born in main non‑English‑speaking countries (see Glossary)mdash13 compared with 8 of babies whose mothers were born in Australia or other main English‑speaking countries
bull babies born to mothers usually residing in more remote areasmdash12 in Very remote areas compared with 10 in Major cities
bull babies of mothers living in the lowest SES areasmdash11 compared with 9 in the highest SES areas
bull babies of younger mothers (under 20)mdash14 were small for gestational age compared with 9 of babies with mothers aged 20ndash39
bull babies whose mothers were underweightmdash18 compared with 10 of babies whose mothers were in the normal weight range according to BMI
bull babies whose mothers smoked during pregnancymdash16 compared with 9 of babies whose mothers did not smoke
Chapter X X28
Babies who were small for gestational age by selected maternal characteristics 2017
Note Includes liveborn singleton babies only
emsp
0 2 4 6 8 10 12 14 16 18 20
Smoked
Did not smoke
Underweight
Normal weight
Overweight
Obese
Major cities
Inner regional
Outer regional
Remote
Very remote
Indigenous
Non-Indigenous
Australia and mainEnglish-speaking countries
Main non-English-speaking countries
Smok
ing
stat
usM
ater
nal B
MI
Rem
oten
ess
Indi
geno
usst
atus
COB
Per cent
Mat
erna
l
Find out more in data visualisations Birthweight adjusted for gestational age
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 29
Rates of small for gestational age babies vary depending on where mothers liveThe proportion of liveborn singleton babies who were small for gestational age varied across the 31 PHN areas in Australia in 2017 The proportions ranged from 69 in the Western Victoria PHN area to 133 in the Western Sydney PHN area
Map of percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
Chapter X X30
Percentage of small for gestational age babies by Primary Health Network area of motherrsquos usual residence 2017
Notes1 See data table 56 for detailed data2 Includes liveborn singleton babies only
133
117
113
107
106
101
101
101
99
98
94
92
91
90
90
89
89
88
88
88
88
86
84
83
81
80
79
79
77
77
77
69
0 2 4 6 8 10 12 14
Western Sydney (PHN103)
Northern Territory (PHN701)
Central and Eastern Sydney (PHN101)
Australian Capital Territory (PHN801)
South Western Sydney (PHN105)
Northern Sydney (PHN102)
Western NSW (PHN107)
North Western Melbourne (PHN201)
Nepean Blue Mountains (PHN104)
North Coast (PHN109)
Total
Brisbane South (PHN302)
Northern Queensland (PHN307)
South Eastern Melbourne (PHN203)
Perth South (PHN502)Hunter New England and
Central Coast (PHN108)Murrumbidgee (PHN110)
Adelaide (PHN401)
Western Queensland (PHN305)
Country WA (PHN503)
Eastern Melbourne (PHN202)
South Eastern NSW (PHN106)
Brisbane North (PHN301)
Country SA (PHN402)Darling Downs and
West Moreton (PHN304)Murray (PHN205)
Central Queensland Wide BaySunshine Coast (PHN306)
Gippsland (PHN204)
Perth North (PHN501)
Tasmania (PHN601)
Gold Coast (PHN303)
Western Victoria (PHN206)
Per cent
Primary Health Network area
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 31
Baby presentation and method of birthMultiple births are less likely to present head firstThe presentation of the baby at birth refers to the anatomical part of the baby that is facing down the birth canal
In 2017 the vast majority of babies (94 or 287463) were in a vertex presentation at birth in which the top of the head is facing down the birthing canal Small proportions of babies had different (non‑vertex) presentations
bull around 1 in 22 babies (45 or 13621) were in a breech presentation (where the baby exits buttocks or feet first)
bull around 1 in 100 babies (13 or 4121) were in other presentations including face brow shouldertransverse and compound presentations
In 2017 multiple births were around 7 times as likely to be in non‑vertex presentation as singletons (33 compared with 5 respectively) The proportion was greater for higher‑order multiples (triplets and higher) (39) than for twins (33) Non‑vertex presentation increased with birth order for multiple births from 24 among babies who were born first to 41 among subsequent babies
Babies by presentation at birth and plurality 2017
Note lsquoOtherrsquo includes face brow shouldertransverse and compound presentations
0
10
20
30
40
50
60
70
80
90
100
Singleton Twins Other multiples
Per cent
Plurality
Vertex Breech Other
Chapter X X32
A babyrsquos presentation at birth can influence the method of birth Most babies in a vertex presentation were delivered by vaginal birth (68) and 32 were delivered via caesarean section Conversely almost 9 in 10 babies (88) presenting in breech position were delivered via caesarean section and only 12 delivered by vaginal birth
A babyrsquos method of birth can also be influenced by plurality (the number of births resulting from a pregnancy) The likelihood of vaginal birth decreased as plurality increased from two‑thirds (66) of singleton babies to around one‑third (30) of twins and 10 of other multiples This pattern was reversed for caesarean sections which were least common among singletons (34) and most common among multiple births (70 of twins and 90 of other multiples)
See Chapter 2 for more information on method of birth for mothers where the method of birth of the first‑born baby is used when reporting multiple births
Babies by method of birth and selected baby characteristics 2017
Note lsquoOtherrsquo presentation includes face brow shouldertransverse and compound presentations
emsp
0 10 20 30 40 50 60 70 80 90 100
Vertex
Breech
Other
Singleton
Twins
Other multiples
Pres
enta
tion
Plur
alit
y
Per cent
Vaginal Caesarean section
Find out more in data visualisations Method of birth and Presentation
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 33
Apgar scores Apgar scores are highest among babies born at termApgar scores are clinical indicators of a babyrsquos condition shortly after birth The score is based on 5 characteristics of the baby skin colour pulse breathing muscle tone and reflex irritability Each characteristic is given between 0 and 2 points with a total score between 0 and 10 points
An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment while a score of less than 7 indicates complications for the baby
In 2017 almost all liveborn babies (98) had an Apgar score of 7 or more Apgar scores of 4ndash6 were recorded for 15 of all liveborn babies while just 03 had scores of 0ndash3
Apgar scores differed by gestational age and birthweight
bull 92 of babies born pre‑term had an Apgar score of 7 or more compared with 98 of babies born at term
bull 91 of low birthweight babies (less than 2500 grams) had an Apgar score of 7 or more compared with 98 of babies weighing 2500 grams or more
Liveborn babies Apgar score of 7 or more at 5 minutes by gestational age and birthweight 2017
75 80 85 90 95 100
Pre-term (20ndash 36)
Term (37ndash 41)
Post-term (42 and over)
Less than 2500 grams(low birthweight)
2500 grams and over
Ges
tati
onal
age
(wee
ks)
Birt
hwei
ght
Per cent
Find out more in data visualisations Apgar score at 5 minutes
Chapter X X34
Resuscitation1 in 5 liveborn babies require active resuscitationResuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effect and to correct metabolic disturbances Resuscitation types range in severity from suction to external cardiac massage and ventilation If more than 1 type of resuscitation is performed the most severe type is recorded
Almost one‑fifth (19) of liveborn babies required some form of active resuscitation immediately after birth in 2017 (excludes data from Western Australia see Appendix Table D2) Around one‑third of those requiring resuscitation received suction or oxygen therapy (33) and the same proportion (33) received breathing assistance by intermittent positive pressure ventilation (IPPV) through a bag and mask or by endotracheal intubation Less than 2 of babies who required resuscitation had external cardiac massage and ventilation
Liveborn babies who received active resuscitation by resuscitation measure 2017
Note Excludes data from Western Australia (see Appendix Table D2)
emspFind out more in data visualisations Resuscitation
0 5 10 15 20 25 30 35
IPPV through bag and mask
Suction
Oxygen therapy
Endotracheal IPPV
External cardiac massageand ventilation
Other (not further defined)
Per cent
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 35
Hospital births and length of stayPre-term babies low birthweight babies and babies in multiple births stayed in hospital longerThe vast majority of babies were born in hospital (97 or 295593 babies in 2017) and of these most were discharged home (95 or 249647) A small proportion of babies (3) were transferred to another hospital and 1 were perinatal deaths (stillbirths or neonatal deaths occurring in the hospital of birth) Note that all data presented for this topic exclude data from Western Australia (see Appendix Table D2)
Among babies who were discharged home the median length of stay in hospital was 3 days with around 9 in 10 (92) staying 5 days or less
A number of factors influence a babyrsquos length of stay in hospital including birthweight and gestational age low birthweight babies had a median stay of 8 days (compared with 3 days for normal birthweight babies) and pre‑term babies had a median stay of 7 days (compared with 3 days for babies delivered at term)
As noted in earlier sections babies who are part of a multiple birth are more likely to be of low birthweight and to be born pre‑term This is reflected in the median length of stay in hospital which was higher for twins (5 days) and for other multiples (32 days) than for singletons (3 days)
emsp
Find out more in data visualisations Hospital length of stay (baby)
Median length of hospital stay
All babies Pre-term babies
Low birthweight babies
3 days
7 days
8 days
Chapter X X36
Admission to special care nurseries and neonatal intensive care unitsPre-term babies and multiple births are more likely to need specialised careSome liveborn babies require more specialised treatment and care than is available on the postnatal ward Of all liveborn babies 18 (31723) were admitted to a special care nursery (SCN) or neonatal intensive care unit (NICU) in 2017 Note that babies who were transferred between hospitals (around 4 of all babies) and who were then admitted to an SCN or NICU may not be included in these data and data also exclude New South Wales and Western Australia (see Appendix Table D2)
Pre‑term babies were more likely to be admitted to an SCN or NICU (80) than babies delivered at term (12) or post‑term (14) Most pre‑term babies are of low birthweight and 79 of low birthweight babies were admitted compared with 14 of normal birthweight babies and 26 of those with a high birthweight
The majority of multiple births are pre-term and therefore twins and other multiples were much more likely to be admitted than singletons (69 and 94 compared with 17 respectively)
Babies born to Indigenous mothers were 15 times as likely to be admitted to an SCN or NICU as babies of non‑Indigenous mothers
Liveborn babies by admission to a special care nursery or neonatal intensive care unit by selected baby characteristics 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
emsp
0 20 40 60 80 100
Pre-term (20ndash36)
Term (37ndash 41)
Post-term (42 and over)
Singletons
Twins
Other multiples
Indigenous mother
Non-Indigenous mother
Ges
tati
onal
age
(wee
ks)
Plur
alit
yIn
dige
nous
stat
us
Per cent
Find out more in data visualisations Admission to a SCN or NICU
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 37
Perinatal deathsGestational age and birthweight are the biggest predictors of perinatal death
Counting perinatal deaths
Various definitions are used for reporting and registering perinatal deaths in Australia The National Perinatal Data Collection defines perinatal deaths as all fetal deaths (stillbirths) and neonatal deaths (deaths of liveborn babies aged less than 28 days) of at least 400 grams birthweight or at least 20 weeks gestation
Fetal and neonatal deaths may include late termination of pregnancy (20 weeks or more gestation)
Perinatal and fetal death rates are calculated using all live births and stillbirths in the denominator Neonatal death rates are calculated using live births only
Neonatal deaths may not be included for babies transferred to another hospital re-admitted to hospital after discharge or who died at home after discharge The AIHW has established a separate National Perinatal Mortality Data Collection to capture complete information on these deaths The latest report from this collection is for deaths occurring in 2015 and 2016 and is available from the AIHW website ltwwwaihwgovaugt (AIHW 2019)
Perinatal and infant death periods used by the National Perinatal Data Collection
20 weeks gestation Labour Birth 28 days
Prior to labour andor birth During labour andor birth
First 24 hours 1ndash7 days 8ndash27 days
Antepartum Intrapartum Very early neonatal
Early neonatal
Late neonatal
Stillbirths Neonatal deaths
Perinatal deaths
At least 20 weeks gestation or 400 grams birthweight
Chapter X X38
In 2017 there were 10 perinatal deaths for every 1000 births a total of 2911 perinatal deaths This included
bull 2174 fetal deaths (stillbirths) a rate of 7 deaths per 1000 births
bull 737 neonatal deaths a rate of 2 deaths per 1000 live births
Perinatal mortality rates decreased as gestational age and birthweight increased
bull For gestational age rates were highest among babies born at 20ndash27 weeks gestation (694 per 1000 births) and lowest among babies born at term (37ndash41 weeks) (2 per 1000 births)
bull For birthweight rates were highest among extremely low birthweight babies (less than 1000 grams) (692 per 1000 births) and lowest among babies with a birthweight of 2500 grams or higher (2 per 1000 births)
Other factors were also associated with higher rates of perinatal mortality (although to a lesser extent than gestational age and birthweight) including
bull maternal agemdashbabies born to mothers under 20 20ndash24 and 40 and over had the highest rates of perinatal mortality (16 12 and 13 deaths per 1000 births respectively) Babies of mothers aged 30ndash34 had the lowest rate (8 per 1000)
bull maternal Indigenous statusmdashperinatal mortality rates among babies of Indigenous mothers (16 per 1000 births) were 17 times those of non‑Indigenous mothers (9 per 1000) (see Chapter 4 for more information)
bull multiple birthsmdashtwins and other multiples had perinatal mortality rates around 4 and 11 times that of singletons (35 and 95 deaths per 1000 births compared with 9 respectively)
Patterns by these characteristics were similar for both fetal and neonatal deaths noting that fetal mortality (stillbirth) rates were consistently higher than neonatal mortality rates
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 39
Perinatal deaths by gestational age and birthweight 2017
emsp
0
25
50
75
100
125
150
20ndash27 28ndash31 32ndash36 37ndash41 42 andover
Less than1000
1000ndash1499
1500ndash1999
2000ndash2499
2500andoverGestational age (weeks) Birthweight (grams)
Deaths per 1000 births
650
675
Find out more in data visualisations Stillbirths and neonatal deaths
Chapter X X40
Congenital anomalies are the leading cause of perinatal deaths
Classifying perinatal deaths
Causes of death for perinatal deaths are classified according to the Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification (PSANZ‑PDC)
Information about cause of death is based on data for 6 states and territories (Victoria Queensland South Australia Tasmania the Australian Capital Territory and the Northern Territory) Perinatal deaths in these 6 jurisdictions (1829 deaths) represented almost two‑thirds of all perinatal deaths in 2017
The most common cause of all perinatal deaths was congenital anomalies accounting for 3 in 10 (31) perinatal deaths This was followed by spontaneous pre‑term birth and unexplained antepartum death (15 and 14 respectively) The leading causes of death vary between fetal and neonatal deaths
Fetal and neonatal deaths by cause of death (PSANZ-PDC) 2017
Note Excludes data from New South Wales and Western Australia (see Appendix Table D2)
0 5 10 15 20 25 30 35
Congenital anomalies
Unexplained antepartum death
Maternal conditions
Specific perinatal conditions
Spontaneous pre-term
Fetal growth restriction
Antepartum haemorrhage
Perinatal infection
Hypertension
Hypoxic peripartum death
No obstetric antecedent
Not stated
Per cent
Fetal deaths
Neonatal deaths
Chapter 3 Babies
Australiarsquos mothers and babies 2017mdashin brief 41
These patterns were influenced by gestational age maternal age and plurality For example
bull perinatal deaths due to congenital anomalies increased with increasing maternal age
bull spontaneous pre-term birth decreased with increasing gestational age
bull the most common cause of death among singleton babies was congenital anomaly while spontaneous pre‑term birth and specific perinatal conditions were the most common causes of death among twins and other multiples
bull most perinatal deaths of babies born to mothers aged under 20 were due to maternal conditions while congenital anomalies were the most common cause of perinatal death for babies whose mothers were 40 and over
Chapter X X42
4 Aboriginal and Torres Strait Islander mothers and their babies
Most Indigenous mothers and their babies are doing well with improvements in outcomes for mothers and babies observed in recent years There has been a notable increase in the proportion of Indigenous mothers attending an antenatal visit in the first trimester and a slight increase in the proportion attending 5 or more antenatal visits The rate of Indigenous mothers smoking during pregnancy has decreased and there is also a small decrease in perinatal mortality rates and the proportion of babies of Indigenous mothers who are small for gestational age
Although a range of data by Indigenous status has been presented in earlier chapters this chapter provides more in-depth information on Indigenous mothers and their babies This is followed by some comparisons with non-Indigenous mothers and babies which show the scope for further improvements
All data in this chapter is based on crude rates rather than age-standardised rates unless otherwise stated
In 2017 45 of all women who gave birth identified as being Aboriginal andor Torres Strait Islander These 13551 women gave birth to 13757 babies Around 1 in 18 (55 or 16934) of all babies born were Aboriginal andor Torres Strait Islander (based on the Indigenous status of the baby)
emsp
Proportion of Indigenous mothers and babies in 2017
4 5 5 5
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 43
Indigenous mothers3 in 4 Indigenous mothers who gave birth are aged under 30In 2017 Indigenous mothers were most likely
bull to be aged 20ndash24 years (32) followed by 25ndash29 years (24) and less than 20 years (20)
bull to live in Major cities (34) however a substantial proportion lived in Remote (8) or Very remote areas (12)
bull to live in the lowest socioeconomic status (SES) areas (46) compared with the highest SES areas (36)
Characteristics of Indigenous mothers who gave birth in 2017
0 10 20 30 40 50 60
Under 20
20ndash24
25ndash29
30ndash34
35ndash39
40 and over
Major cities
Inner regional
Outer regional
Remote
Very remote
Lowest SES
Highest SES
Mat
erna
l age
Rem
oten
ess
SES
Per cent
Chapter X X44
More Indigenous mothers are accessing antenatal care in the first trimesterOn average Indigenous mothers attended their first antenatal visit at 13 weeks gestation and attended a total of 9 antenatal visits in 2017 (data on number of visits exclude very pre‑term births)
Most Indigenous mothers (63) had their first antenatal visit in the first trimester of pregnancy (less than 14 completed weeks gestation) in 2017 and this has increased over time from 50 in 2012
The proportion of Indigenous mothers receiving antenatal care in the first trimester was highest in Inner regional areas (65) compared with 62ndash63 in other areas These proportions have all increased since 2012
The majority of Indigenous mothers who gave birth at 32 weeks or more attended at least 5 antenatal visits (88) a small increase from 86 in 2012 (excludes data from Victoria see Appendix Table D2)
Indigenous mothers who attended an antenatal visit in the first trimester by remoteness 2012 and 2017
0
10
20
30
40
50
60
70
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
2012 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 45
Fewer Indigenous mothers are smoking during pregnancyAbout 2 in 5 Indigenous mothers (44) reported smoking during pregnancy a decrease from 52 in 2009
For Indigenous mothers rates of smoking were highest among Remote (48) and Very remote (55) areas and lowest in Major cities (38) Since 2012 smoking rates have decreased across all remoteness areas with the exception of Very remote areas which has increased slightly from 53
Of those who smoked the rate of smoking cessation during pregnancy was 12 This is based on Indigenous mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy
Indigenous mothers who smoked at any time during pregnancy 2009 to 2017
Note Motherrsquos tobacco smoking status during pregnancy is self‑reported
0
5
10
15
20
25
30
35
40
45
50
2009 2010 2011 2012 2013 2014 2015 2016 2017
Per cent
Year
Chapter X X46
Around 2 in 5 Indigenous mothers are in the healthy weight rangeAmong Indigenous mothers who gave birth in 2017
bull around 2 in 5 (39) were in the normal weight range according to body mass index
bull one‑quarter (25) were overweight
bull almost one‑third (30) were obese
bull a small proportion were underweight (7)
Information is also available on other maternal health conditions including pre-existing or gestational hypertension and diabetes In 2017 among Indigenous mothers who gave birth
bull 12 had gestational diabetes and 20 had pre‑existing diabetes
bull 34 had gestational hypertension and 09 had pre‑existing (chronic) hypertension (excludes data from Victoria see Appendix Table D2)
Around half of Indigenous mothers have spontaneous onset of labourIndigenous mothers were more likely to have spontaneous onset of labour (52) than induced labour (31) or no labour (17) in 2017
Since 2007 the rate of spontaneous onset of labour has decreased from 67 while the rates of induced labour and no labour have increased correspondingly (from 21 and 12 respectively)
Of Indigenous mothers who had labour in 2017 around 3 in 4 (76) received pain relief during labour
Non-instrumental vaginal births are most common for Indigenous mothersMost (64) Indigenous mothers had a non‑instrumental vaginal birth in 2017 followed by a caesarean section (29) and an instrumental vaginal birth (7)
Rates of caesarean section and instrumental vaginal birth have both increased since 2007 (from 24 and 5 of mothers respectively) and the rate of non‑instrumental vaginal birth has decreased (from 71)
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 47
Indigenous mothers by method of birth 2007 and 2017
Note For multiple births the method of birth of the first‑born baby was used
emsp
0
10
20
30
40
50
60
70
80
Non-instrumental vaginal Instrumental vaginal Caesarean section
Per cent
Method of birth
2007 2017
Find out more in the data visualisations Indigenous mothers
Chapter X X48
Babies of Indigenous mothersMost babies of Indigenous mothers are born at termIn 2017 the median gestational age of babies of Indigenous mothers was 39 weeks
The majority of babies of Indigenous mothers were born at term (85) however around 1 in 7 (14) were born pre‑term Less than 1 were born post‑term These proportions have remained steady since 2007
Steady rates of low birthweight among babies of Indigenous mothersIn 2017 the average liveborn baby of an Indigenous mother weighed 3202 grams
Of all liveborn babies of Indigenous mothers 125 (1695) were of low birthweight This proportion included
bull 104 of babies of Indigenous mothers in the low birthweight range of 1500ndash2499 grams
bull 20 of babies of Indigenous mothers with very low birthweight (less than 1500 grams) Most babies in this group were extremely low birthweight (less than 1000 grams)
There was no change in the proportion of low birthweight babies born to Indigenous mothers between 2007 and 2017 with the rate remaining steady at 125 However the proportion of babies born small for gestational age has decreased slightly between 2013 and 2017 from 144 to 137 See Chapter 5 for more data on trends
Low birthweight babies of Indigenous mothers were similar across remoteness areas ranging from 12 in Major cities to 14 in Very remote areas
lt2500 grams
11 6
lt2500 grams
12 5
Proportion of low birthweight babies of Indigenous mothers in 2017
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 49
Low birthweight of liveborn babies of Indigenous mothers by remoteness 2012 and 2017
Almost all babies of Indigenous mothers have high Apgar scores at 5 minutes after birthApgar scores use of resuscitation and admission to special care nurseries (SCN) or neonatal intensive care units (NICU) can give an indication of the health of newborn babies
In 2017 among liveborn babies of Indigenous mothers
bull around one‑quarter (27) were admitted to an SCN or NICU (excludes data from New South Wales and Western Australia see Appendix Table D2)
bull the vast majority had an Apgar score of 7 or more at 5 minutes (97)
bull around one‑fifth (21) required some form of active resuscitation (excludes data from Western Australia see Appendix Table D2)
Babies of Indigenous mothers born in hospital and discharged home had a median length of stay in hospital of 2 days Almost 1 in 3 (30) stayed 1 day or less and a further 45 stayed 2ndash3 days followed by smaller proportions staying 4ndash5 days (14) or 6 days or more (11) (excludes data from Western Australia see Appendix Table D2)
2012 2017
0
2
4
6
8
10
12
14
16
18
Major cities Inner regional Outer regional Remote Very remote
Per cent
Remoteness area
Chapter X X50
Perinatal mortality rates decreasing slightly for babies of Indigenous mothersIn 2017 there were 16 perinatal deaths for every 1000 births among babies of Indigenous mothers This included
bull 11 fetal deaths (stillbirths) per 1000 births for babies of Indigenous mothersmdasha decrease from 13 per 1000 in 2007
bull 5 neonatal deaths per 1000 live births for babies of Indigenous mothersmdasha decrease from 7 per 1000 in 2007
Perinatal mortality rates have decreased from 20 deaths per 1000 births in 2007 to 16 in 2017
The leading causes of death for babies of Indigenous mothers were spontaneous pre-term birth (23 of perinatal deaths in 2017) and congenital anomalies (21) (data excludes New South Wales and Western Australia)
emsp
Chapter 4 Aboriginal and Torres Strait Islander mothers and their babies
Australiarsquos mothers and babies 2017mdashin brief 51
Comparisons with non-Indigenous mothers and babiesThere were disparities between Indigenous and non-Indigenous mothers and their babies across a range of maternal and perinatal measures in 2017
Compared with non-Indigenous mothers Indigenous mothers were
8 x as likely to be teenage mothers
0 9 x as likely to attend an antenatal visit in the first trimester of pregnancy
0 9 x as likely to attend 5 or more antenatal visits (data excludes very pre‑term births)
4 x as likely to smoke at any time during pregnancy
1 6 x as likely to be obese
1 2 x as likely to have gestational diabetes (data excludes Victoria)
4 x as likely to have pre‑existing diabetes (data excludes Victoria)
1 4 x as likely to have pre‑existing (chronic) hypertension (data excludes Victoria)
1 3 x as likely to have gestational hypertension (data excludes Victoria)
Note Data are based on age-standardised percentages with the exception of teenage mothers
Compared with babies of non-Indigenous mothers babies of Indigenous mothers were
1 7 x as likely to be born pre-term
1 9 x as likely to be low birthweight
1 5 x as likely to be small for gestational age
1 5 x as likely to be admitted to a special care nursery or neonatal intensive care unit
1 6 x as likely to be stillborn
2 x as likely to die within the first 28 days of life (neonatal death)
Find out more in the data visualisations Indigenous mothers
Chapter X X52
5 Ke
y st
atis
tics
and
tre
nds
This
cha
pter
pre
sent
s th
e da
ta b
ehin
d th
e ke
y st
atis
tics
and
tren
ds re
port
ed in
cha
pter
s 2
to 4
Det
aile
d da
ta ta
bles
in
clud
ing
stat
e an
d te
rrito
ry d
ata
are
als
o av
aila
ble
onlin
e fr
om th
e AI
HW
web
site
at
ltww
wa
ihw
gov
au
repo
rts
mot
hers
‑bab
ies
aust
ralia
s‑m
othe
rs‑b
abie
s‑20
17‑in
‑brie
fgt
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Mot
hers
Wom
en w
ho g
ave
birt
h N
umbe
r 28
949
929
215
929
454
729
545
629
734
330
757
030
477
730
784
430
426
831
024
730
109
51
743
60
Wom
en w
ho g
ave
birt
h pe
r 10
00 w
omen
of
repr
oduc
tive
age
(15ndash
44 y
ears
)
Rate
65
865
364
663
963
764
863
363
261
762
359
6ndash0
5ndash
74
Aver
age
mat
erna
l age
(yea
rs)
A
ll m
othe
rs
Aver
age
299
299
300
300
300
301
301
302
303
305
306
01
22
I
ndig
enou
s m
othe
rs
Aver
age
252
251
252
252
253
252
253
255
256
259
260
01
33
F
irst-t
ime
mot
hers
Av
erag
e 28
228
227
928
329
028
428
628
728
929
029
20
13
9M
ater
nal a
ge (y
ears
)
Und
er 2
5 Pe
r cen
t 18
718
718
318
017
517
216
916
015
314
413
8ndash0
5ndash
258
2
5ndash34
Pe
r cen
t 59
058
458
959
059
860
460
961
962
362
762
50
58
1
35
and
over
Pe
r cen
t 22
322
922
923
022
722
422
322
122
322
823
70
01
3An
tena
tal v
isits
5 o
r mor
e an
tena
tal v
isits
(b)
A
ll m
othe
rsPe
r cen
t n
an
an
an
an
a95
495
495
295
595
795
70
10
4
Ind
igen
ous
mot
hers
AS
per
cen
tn
an
an
an
an
a86
185
185
586
986
687
60
42
2
Non
-Indi
geno
us
m
othe
rs
AS p
er c
ent
na
na
na
na
na
953
954
953
955
956
956
01
03
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 53
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
A
nten
atal
visi
t in
the
first
trim
este
r
All
mot
hers
Pe
r cen
t n
an
an
an
an
a62
761
861
664
668
672
02
01
65
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
na
505
518
527
569
619
629
28
28
0
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
an
an
an
a61
460
260
163
167
170
72
01
71
Toba
cco
smok
ing
durin
g pr
egna
ncy
S
mok
ed a
t any
tim
e du
ring
preg
nanc
y
All
mot
hers
Pe
r cen
t n
an
a14
613
713
212
511
711
010
49
99
9ndash0
6ndash
348
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
499
494
481
471
477
452
447
428
443
ndash08
ndash13
5
Non
-Indi
geno
us
mot
hers
AS
per
cen
tn
an
a16
315
414
814
213
212
612
211
611
8ndash0
6ndash
301
S
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
A
ll m
othe
rsPe
r cen
t n
an
an
an
a12
912
111
310
610
19
59
5ndash0
6ndash
279
I
ndig
enou
s m
othe
rs
AS p
er c
ent
na
na
na
na
472
465
466
444
436
419
434
ndash09
ndash10
8
N
on-In
dige
nous
mot
hers
AS
per
cen
tn
an
an
an
a14
513
812
812
211
811
211
4ndash0
5ndash
231
Post
nata
l sta
y
L
ess
than
2 d
ays
Per c
ent
138
144
170
163
172
180
196
205
207
214
211
08
55
2
2
ndash4 d
ays
Per c
ent
649
653
637
663
659
654
650
649
649
647
651
ndash00
ndash02
5
or m
ore
days
Pe
r cen
t 20
719
318
217
416
916
515
414
514
313
813
7ndash0
7ndash
349
Ons
et o
f lab
our
S
pont
aneo
us la
bour
Pe
r cen
t 56
657
056
256
054
854
252
751
350
148
445
6ndash1
1ndash
185
I
nduc
ed la
bour
Pe
r cen
t 25
324
825
325
226
026
327
628
429
330
532
50
73
01
N
o la
bour
Pe
r cen
t 18
118
218
418
819
119
419
720
320
521
021
90
42
05
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X54
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Met
hod
of b
irth
N
on-in
stru
men
tal
v
agin
al b
irth
Per c
ent
579
575
568
563
556
552
548
544
542
534
528
ndash05
ndash8
5
I
nstr
umen
tal v
agin
al
b
irth
Per c
ent
112
114
117
120
121
124
124
125
125
128
126
01
12
7
C
aesa
rean
sec
tion
Per c
ent
309
311
315
302
323
324
328
331
333
338
346
04
12
4M
ultip
le p
regn
anci
es
M
ultip
le p
regn
anci
es
p
er 1
000
mot
hers
Ra
te
160
161
156
159
155
150
152
150
149
145
150
ndash01
ndash8
9
Babi
esBa
bies
bor
n N
umbe
r 29
420
829
692
829
922
730
021
530
202
531
225
130
948
931
254
830
888
731
481
430
566
71
727
58
Ges
tatio
nal a
ge
P
re‑te
rm (2
0ndash36
wee
ks)
Per c
ent
81
82
82
83
83
85
86
86
87
85
87
01
72
T
erm
(37ndash
41 w
eeks
) Pe
r cen
t 90
990
990
890
991
090
990
990
990
990
890
7ndash0
0ndash0
1
P
ost‑t
erm
(42
wee
ks
a
nd o
ver)
Pe
r cen
t 0
90
90
90
80
70
60
50
50
40
60
5ndash0
1ndash
567
Birt
hwei
ght(c
)
L
ow b
irthw
eigh
tPe
r cen
t 6
26
16
26
26
36
26
46
46
56
56
70
08
2
L
ow b
irthw
eigh
t
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
125
124
120
120
126
118
122
118
119
116
125
ndash00
ndash33
L
ow b
irthw
eigh
t
bab
ies
with
non
-Indi
geno
us m
othe
rs
Per c
ent
59
59
59
60
60
60
61
62
62
63
64
01
86
L
ow b
irthw
eigh
t
Ind
igen
ous
babi
es
Per c
ent
na
na
na
na
na
na
111
108
111
108
115
01
30
L
ow b
irthw
eigh
t
non
-Indi
geno
us b
abie
s Pe
r cen
t n
an
an
an
an
an
a6
16
16
26
26
30
13
4
(con
tinue
d)
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 55
Year
Topi
cU
nit
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Annu
al
chan
ge(a
)Pe
r ce
nt
chan
ge(a
)
Birt
hwei
ght(c
) (con
tinue
d)
L
ow b
irthw
eigh
t sin
glet
onPe
r cen
t 4
74
74
74
84
84
84
84
95
05
15
20
09
9
L
ow b
irthw
eigh
t
s
ingl
eton
bab
ies
with
Ind
igen
ous
mot
hers
Per c
ent
112
112
109
107
112
105
109
105
104
102
107
ndash01
ndash6
9
L
ow b
irthw
eigh
t
sin
glet
on b
abie
s w
ith
n
on-In
dige
nous
mot
hers
Per c
ent
45
44
45
45
45
45
46
47
48
48
49
00
10
9
L
ow b
irthw
eigh
t sin
glet
on
I
ndig
enou
s ba
bies
Pe
r cen
t n
an
an
an
an
an
a9
89
69
69
69
90
00
9
L
ow b
irthw
eigh
t sin
glet
on
n
on-In
dige
nous
bab
ies
Per c
ent
na
na
na
na
na
na
45
46
47
48
49
01
66
Perin
atal
dea
ths
P
erin
atal
dea
ths
per
10
00 b
irths
Ra
te
103
102
74
102
102
96
97
96
92
91
95
ndash00
ndash43
S
tillb
irths
per
10
00 b
irths
Ra
te
74
74
78
73
74
72
71
70
70
67
71
ndash01
ndash9
2
N
eona
tal d
eath
s
p
er 1
000
live
birt
hs
Rate
2
92
82
22
92
82
42
62
52
22
42
4ndash0
0ndash1
61
na
N
ot a
vaila
ble
In
dica
tes
resu
lts w
ith s
tatis
tical
ly s
igni
fican
t inc
reas
es o
r dec
reas
es a
t the
p lt
00
5 le
vel o
ver t
he p
erio
d 20
07 to
201
7 S
ee A
ppen
dix
D fo
r fur
ther
in
form
atio
n on
met
hods
(a)
Det
erm
ined
by
linea
r reg
ress
ion
(see
App
endi
x D
for f
urth
er in
form
atio
n on
met
hods
) Th
e an
nual
cha
nge
is th
e es
timat
ed a
vera
ge a
nnua
l cha
nge
betw
een
2007
and
201
7 T
he p
erce
ntag
e ch
ange
is th
e pe
rcen
tage
cha
nge
betw
een
2007
and
201
7(b
) Ba
sed
on w
omen
who
gav
e bi
rth
at 3
2 w
eeks
or m
ore
gest
atio
n (e
xclu
ding
unk
now
n ge
stat
ion)
Tre
nd d
ata
excl
udes
Vic
toria
(see
App
endi
x Ta
ble
D2)
(c
) In
clud
es li
vebo
rn b
abie
s on
ly
Not
es1
Re
sults
sho
uld
be in
terp
rete
d w
ith c
autio
n du
e to
cha
nges
in d
ata
colle
ctio
n m
etho
ds o
ver t
ime
2
Age‑
stan
dard
ised
(AS)
per
cen
ts h
ave
been
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Key
tren
ds fo
r Au
stra
liarsquos
mot
hers
and
bab
ies
200
7 to
201
7 (c
onti
nued
)
Chapter X X56
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Mat
erna
l cha
ract
eris
tics
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Mot
herrsquos
Indi
geno
us
stat
us(e
)
In
dige
nous
62
90
987
30
943
43
832
30
914
21
710
72
23
01
7
N
on-In
dige
nous
70
7
941
11
4
347
8
5
49
1
8
Mat
erna
l age
U
nder
20
614
90
5
324
19
7
113
9
1
29
20ndash
24
653
11
924
10
207
06
238
12
89
08
63
07
22
08
2
5ndash29
70
01
194
11
010
30
329
61
58
20
74
90
51
90
7
30ndash
34
744
12
950
10
63
02
360
18
82
07
46
05
17
06
3
5ndash39
75
01
295
11
15
90
242
82
29
20
85
10
61
70
6
40
and
over
74
31
294
61
06
70
254
02
713
11
27
00
82
10
7
Rem
oten
ess
M
ajor
citi
es
715
94
6
72
10
347
8
41
05
0
17
In
ner r
egio
nal
735
10
936
10
149
21
344
10
94
11
54
11
21
12
O
uter
regi
onal
73
51
094
11
016
82
334
61
09
41
15
71
12
11
2
R
emot
e 73
01
094
01
017
62
534
51
09
71
15
81
12
81
7
V
ery
rem
ote
685
10
912
10
337
47
350
10
135
16
93
19
32
19
Soci
oeco
nom
ic s
tatu
s (S
ES)
L
owes
t SES
67
20
992
91
017
86
133
00
99
71
26
51
62
31
5
H
ighe
st S
ES
758
95
6
29
35
5
78
4
1
15
(con
tinue
d)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 57
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
than
7 a
t 5
min
s(d)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Dur
atio
n of
pre
gnan
cy a
t firs
t ant
enat
al v
isit
(wee
ks)
L
ess t
han
14 (fi
rst t
rimes
ter)
962
8
2
361
8
8
49
1
8
1
4ndash19
93
71
010
21
231
70
97
50
95
11
01
81
0
2
0 an
d ov
er
834
09
174
21
319
09
92
11
66
13
20
11
Num
ber o
f ant
enat
al v
isits
N
one
547
62
219
06
393
51
258
56
57
35
1
38
30
5
16
01
831
20
919
02
511
92
63
92
4
2ndash4
54
70
7
20
92
431
20
923
53
114
63
24
82
9
5 o
r mor
e 73
4
88
35
1
77
4
6
17
Smok
ed in
the
first
20
wee
ks o
f pre
gnan
cy
S
mok
ed
621
08
880
09
318
09
136
17
112
25
28
16
D
id n
ot s
mok
e 73
0
951
35
1
82
4
5
17
Baby
out
com
es
Ges
tatio
nal a
ge
P
re‑te
rm
725
10
892
09
155
17
484
14
522
266
77
58
T
erm
72
0
947
9
0
336
2
0
13
P
ost‑t
erm
65
80
995
21
07
30
834
31
0
0
20
11
20
9
(con
tinue
d)
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter X X58
Mot
hers
Babi
es
Ante
nata
l vi
sit i
n fir
st
trim
este
r
5 or
mor
e an
tena
tal
visi
ts(a
)
Smok
ed in
the
first
20
wee
ks
of p
regn
ancy
Caes
area
n se
ctio
n(b)
Pre-
term
Low
bi
rthw
eigh
t(c)
Apga
r sc
ore
less
th
an 7
at
5 m
ins(d
)
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Per
cent
Rate
ra
tio
Birt
hwei
ght
L
ow (l
ess
than
25
00
g
ram
s)70
31
089
50
919
22
147
01
472
519
1
8
15
8
N
orm
al (2
500
to 4
499
gra
ms)
721
94
6
89
33
8
38
1
4
H
igh
(45
00 g
ram
s
a
nd o
ver)
707
10
951
10
62
07
448
13
11
03
17
13
Plur
ality
S
ingl
eton
s
34
4
70
5
2
18
Tw
ins
666
19
660
95
553
107
45
26
O
ther
mul
tiple
s
62
61
898
214
198
719
07
64
3
Tota
l 72
0
93 8
9
5
34 6
8
7
5 2
1
8
Not
app
licab
le
(a)
Base
d on
wom
en w
ho g
ave
birt
h at
32
wee
ks o
r mor
e ge
stat
ion
(exc
ludi
ng u
nkno
wn
gest
atio
n)
(b)
Per c
ents
for c
aesa
rean
sec
tion
deliv
ery
have
bee
n di
rect
ly a
ge‑s
tand
ardi
sed
to th
e Au
stra
lian
fem
ale
popu
latio
n ag
ed 1
5ndash44
as
at 3
0 Ju
ne 2
001
w
ith th
e ex
cept
ion
of th
e m
ater
nal a
ge c
ateg
ory
(c)
Incl
udes
live
born
sin
glet
on b
abie
s on
ly w
ith th
e ex
cept
ion
of th
e pl
ural
ity c
ateg
ory
(d)
Incl
udes
live
born
bab
ies
only
(e
) Pe
r cen
ts b
y m
othe
rrsquos In
dige
nous
sta
tus
for a
nten
atal
vis
it in
the
first
trim
este
r 5
or m
ore
ante
nata
l vis
its s
mok
ed in
the
first
20
wee
ks o
f pre
gnan
cy a
nd
caes
area
n se
ctio
n ha
ve b
een
dire
ctly
age
‑sta
ndar
dise
d to
the
Aust
ralia
n fe
mal
e po
pula
tion
aged
15ndash
44 a
s at
30
June
200
1
Not
e R
efer
ence
cat
egor
ies
for r
ate
ratio
s ar
e in
dica
ted
in it
alic
s S
ee A
ppen
dix
D fo
r fur
ther
info
rmat
ion
on m
etho
ds
Key
stat
isti
cs b
y m
ater
nal c
hara
cter
isti
cs a
nd b
aby
outc
omes
201
7 (c
onti
nued
)
Chapter 5 Key statistics and trends
Australiarsquos mothers and babies 2017mdashin brief 59
AppendixesAppendixes are available for download from the AIHW website on the Australiarsquos mothers and babies 2017mdashin brief web page ltwwwaihwgovaureportsmothers-babies australias‑mothers‑babies‑2017‑in‑briefgtbull Appendix A About the National Perinatal Data Collectionbull Appendix B Perinatal national minimum data set itemsbull Appendix C State and territory perinatal data collectionsbull Appendix D Data quality methods and interpretation
AcknowledgmentsThis report was written by Deanna Eldridge Kathryn Sedgwick Denae Cotter and Joshua Alexander of the Australian Institute of Health and Welfare (AIHW) The authors gratefully acknowledge the contributions of Fadwa Al-Yaman and Natalie Cooper also of the AIHW
A large number of stakeholders provided valuable advice and input to the National Perinatal Data Collection and to this report including the National Perinatal Data Development Committee and in particular the following staff from the state and territory health departments who provided data and reviewed this reportbull Tim Harrold and Martin Drummond Centre for Epidemiology and Evidence
New South Wales Ministry of Healthbull Shirin Anil Diana Stubbs and Mary‑Ann Davey from the Consultative Councils Unit
Stewardship and Support Branch Safer Care Victoria and Kirsty Anderson from the Health Information and Reporting Branch Department of Health and Human Services Victoria
bull Sue Cornes Joanne Ellerington Vesna Dunne and Ben Wilkinson Statistical Services Branch Department of Health Queensland
bull Maureen Hutchinson and Alan Joyce Maternal and Child Health Unit Information Data and Standards Department of Health Western Australia
bull Katina DrsquoOnise Helen Thomas and Brooke Drechsler Prevention and Population Health Branch Department of Health South Australia
bull Peter Mansfield Peggy Tsang and Cynthia Rogers Health Information Unit Department of Health and Human Services Tasmania
bull Rosalind Sexton and Wayne Anderson Epidemiology Section ACT Healthbull Leanne OrsquoNeil and Shu Qin Li Health Gains Planning Department of Health
Northern Territory
The AIHW also acknowledges the time effort and expertise of all maternity staff in collecting and providing the data for the National Perinatal Data Collection
Chapter X X60
AbbreviationsACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
BMI body mass index
COB country of birth
IPPV intermittent positive pressure ventilation
NBEDS national best endeavours data set
NCMI National Core Maternity Indicators
NICU neonatal intensive care unit
NMDDP National Maternity Data Development Project
NMDS national minimum data set
NPDC National Perinatal Data Collection
NSW New South Wales
NT Northern Territory
OECD Organisation for Economic Co‑operation and Development
PHN Primary Health Network
PSANZ‑PDC Perinatal Society of Australia and New Zealand Clinical Practice Guideline for Perinatal Mortality Perinatal Death Classification
Qld Queensland
SA South Australia
SCN special care nursery
SES socioeconomic status
Tas Tasmania
Vic Victoria
WA Western Australia
WHO World Health Organization
Australiarsquos mothers and babies 2017mdashin brief 61
Glossaryage-specific rate A rate for a specific age group The numerator and denominator relate to the same age group
age standardisation A method of removing the influence of age when comparing populations with different age structures This is usually necessary because the rates of many diseases vary strongly (usually increasing) with age The age structures of the different populations are converted to the same lsquostandardrsquo structure and then the disease rates that would have occurred with that structure are calculated and compared
age structure The relative number of people in each age group in a population
antenatal The period covering conception up to the time of birth Synonymous with prenatal
Apgar score Numerical score used to indicate the babyrsquos condition at 1 minute and at 5 minutes after birth Between 0 and 2 points are given for each of 5 characteristics heart rate breathing colour muscle tone and reflex irritability The total score is between 0 and 10
augmentation of labour Intervention after the spontaneous onset of labour to assist the progress of labour
babyrsquos length of stay Number of days between date of birth and date of separation from the hospital of birth (calculated by subtracting the date of birth from the date of separation)
birth status Status of the baby immediately after birth (stillborn or liveborn)
birthweight The first weight of the baby (stillborn or liveborn) obtained after birth (usually measured to the nearest 5 grams and obtained within 1 hour of birth)
breech presentation A fetal presentation in which the buttocks are at the opening of the uterus In a frank breech the legs are straight up in front of the body In a complete breech the legs are folded but the feet are above the buttocks In an incomplete breech the feet are below the buttocks
caesarean section A method of birth in which a surgical incision is made into the motherrsquos uterus via the abdomen to directly remove the baby
diabetes (diabetes mellitus) A chronic condition in which the body cannot properly use its main energy source the sugar glucose This is due to a relative or absolute deficiency in insulin Insulin a hormone produced by the pancreas helps glucose enter the bodyrsquos cells from the bloodstream and then be processed by them Diabetes is marked by an abnormal build‑up of glucose in the blood and can have serious short‑ and long‑term effects
episiotomy An incision of the perineum and vagina to enlarge the vulval orifice
fetal death (stillbirth) Death before the complete expulsion or extraction from its mother of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight Death is indicated by the fact that after such separation the fetus does not breathe or show any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles
Chapter X X62
fetal death rate Number of fetal deaths per 1000 total births (fetal deaths plus live births)
first degree laceration Graze laceration rupture or tear of the perineal skin during delivery that may be considered to be slight or that involves fourchette labia vagina or vulva
forceps Handheld hinged obstetric instrument applied to the fetal head to assist birth
fourth degree laceration Perineal laceration rupture or tear as in third degree laceration occurring during delivery and also involving anal mucosa or rectal mucosa
gestational age Duration of pregnancy in completed weeks calculated from the date of the first day of a womanrsquos last menstrual period and her babyrsquos date of birth or via ultrasound or derived from clinical assessment during pregnancy or from examination of the baby after birth
high blood pressurehypertension Definitions vary but a well‑accepted one is from the World Health Organization (WHO) a systolic blood pressure of 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more or [the person is] receiving medication for high blood pressure
Indigenous A person of Aboriginal andor Torres Strait Islander descent who identifies as an Aboriginal andor Torres Strait Islander
induction of labour Intervention to stimulate the onset of labour
instrumental birth Vaginal birth using forceps or vacuum extraction
intrauterine growth restriction A fetus whose estimated weight is below the 10th percentile for its gestational age
live birth The complete expulsion or extraction from its mother of a product of conception irrespective of the duration of the pregnancy which after such separation breathes or shows any other evidence of life such as beating of the heart pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached each product of such a birth is considered liveborn (WHO definition)
low birthweight Weight of a baby at birth that is less than 2500 grams
main non-English-speaking country Countries where a language other than English is likely to be spoken Includes all countries other than Australia Canada Republic of Ireland New Zealand South Africa United Kingdom and the United States of America
maternal age Motherrsquos age in completed years at the birth of her baby
mode of separation Status at separation of patient (dischargetransferdeath) and place to which patient is released (where applicable)
motherrsquos length of stay Number of days between admission date (during the admission resulting in a birth) and separation date (from the hospital where birth occurred) The interval is calculated by subtracting the date of admission from the date of separation
Australiarsquos mothers and babies 2017mdashin brief 63
neonatal death Death of a liveborn baby within 28 days of birth
neonatal mortality rate Number of neonatal deaths per 1000 live births
non-Indigenous People who have indicated that they are not of Aboriginal or Torres Strait Islander descent
parity Number of previous pregnancies resulting in live births or stillbirths excluding the current pregnancy
perinatal death A fetal or neonatal death of at least 20 weeks gestation or at least 400 grams birthweight
perinatal mortality rate Number of perinatal deaths per 1000 total births (fetal deaths plus live births)
perineal status State of the perineum following birth Perineal status is categorised as intact first second third or fourth degree laceration episiotomy or as another type of perineal laceration rupture or tear
plurality Number of births resulting from a pregnancy
postneonatal death Death of a liveborn baby after 28 days and within 1 year of birth
post-term birth Birth at 42 or more completed weeks of gestation
presentation at birth The part of the fetus that presents first at birth
pre-term birth Birth before 37 completed weeks of gestation
primary caesarean section Caesarean section to a mother with no previous history of caesarean section
resuscitation of baby Active measures taken shortly after birth to assist the babyrsquos ventilation and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances
second degree laceration Perineal laceration rupture or tear as in first degree laceration occurring during delivery and also involving pelvic floor perineal muscles or vaginal muscles
spontaneous labour Onset of labour without intervention
stillbirth See fetal death (stillbirth)
teenage mother Mother aged younger than 20 at the birth of her baby
third degree laceration Perineal laceration rupture or tear as in second degree laceration occurring during delivery and also involving the anal floor rectovaginal septum or sphincter not otherwise specified
vacuum extraction Assisted birth using traction or rotation on a suction cap applied to the babyrsquos head
Chapter X X64
ReferencesACSQHC (Australian Commission on Safety and Quality in Health Care) 2017 The Second Australian Atlas of Healthcare Variation Sydney ACSQHC Viewed 1 May 2019 lthttpswwwsafetyandqualitygovauatlasatlas‑2017gt
AHMC (Australian Health Ministersrsquo Conference) 2011 National Maternity Services Plan Canberra Australian Government Department of Health and Ageing
AIHW (Australian Institute of Health and Welfare) 2017 National Drug Strategy Household Survey 2016 detailed findings Drug statistics series no 31 Cat no PHE 214 Canberra AIHW
AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
CMACE amp RCOG (Centre for Maternal and Child Enquiries amp Royal College of Obstetricians and Gynaecologists) 2010 Management of women with obesity in pregnancy CMACERCOG Joint Guideline Viewed 1 May 2019 lthttpswwwrcogorgukglobalassetsdocumentsguidelinescmacercogjointguidelinemanagementwomenobesitypregnancyapdfgt
Department of Health 2018 Clinical Practice Guidelines Pregnancy Care Canberra Australian Government Department of Health
Johnson D Prendergast L Ramage C Eldridge D Liu C amp Al‑Yaman F 2016 lsquoDeveloping national birthweight for gestational age percentile charts for Australiarsquo Presentation at the Perinatal Society of Australia and New Zealand (PSANZ) 20th Annual Congress Townsville 22ndash25 May
OECD (Organisation for Economic Co‑operation and Development) 2017 Health at a glance 2017 OECD indicators Paris OECD Publishing Viewed 1 May 2019 lthttpsdoiorg101787health_glance‑2017‑engt
WHO RHR (World Health Organization Department of Reproductive Health and Research) 2015 WHO statement on caesarean section rates WHORHR1502 Geneva WHO Viewed 1 May 2019 lthttpwwwwhointreproductivehealthpublicationsmaternal_perinatal_healthcs‑statementengt
WHO 1992 International Statistical Classification of Diseases and Related Health Problems 10th Revision Geneva WHO
Australiarsquos mothers and babies 2017mdashin brief 65
Related publicationsThis report Australiarsquos mothers and babies 2017mdashin brief is part of an annual series Earlier and subsequent editions can be downloaded free from the AIHW website ltwwwaihwgovaureports-statisticspopulation-groupsmothers-babiesreportsgt
Detailed data tables and appendixes relating to this report were published separately online See ltwwwaihwgovaureportsmothers‑babiesaustralias‑mothers‑babies‑2017‑in‑briefgt
The following AIHW publications and data visualisations relating to mothers and babies may also be of interest
bull Australiarsquos mothers and babies data visualisations available at lthttpswwwaihwgovaureportsmothers-babiesaustralias-mothers-babies-data-visualisationsgt
bull AIHW 2019 forthcoming Stillbirths and neonatal deaths in Australia 2015 and 2016 Cat no PER 102 Canberra AIHW
bull AIHW 2018 Teenage mothers in Australia 2015 Cat no PER 93 Canberra AIHW
bull AIHW 2018 MyHealthyCommunities Child and maternal health in 2014ndash2016 Web report available at lthttpswwwaihwgovaureportsmothers‑babieschild‑maternal‑health‑2014‑2016gt Canberra AIHW
bull AIHW 2018 Maternal deaths in Australia 2016 Cat no PER 99 Canberra AIHW
bull National Core Maternity Indicators data visualisations available at lthttpswwwaihwgovaureportsmothers‑babiesncmi‑data‑visualisationsgt
Australiarsquos mothers and babies 2017mdash
in brief
aihwgovau
Stronger evidence better decisions improved health and welfare
Australiarsquos mothers and babies 2017mdashin brief presents key statistics and trends on pregnancy and childbirth of mothers and the characteristics and outcomes of their babies This report is designed to accompany complementary online data visualisations available at ltwwwaihwgovaureportsmothers-babies australias-mothers-babies-data-visualisationsgt
Australiarsquos mothers and babies
2017in brief
- Contents
- 1 At a glance
-
- Mothers at a glance
- Babies at a glance
-
- 2 Mothers
-
- Antenatal care
- Smoking during pregnancy
- Maternal health
- Place of birth
- Onset of labour
- Method of birth
-
- 3 Babies
-
- Gestational age
- Birthweight
- Low birthweight
- Small for gestational age
- Baby presentation and method of birth
- Apgar scores
- Resuscitation
- Hospital births and length of stay
- Admission to special care nurseries and neonatal intensive care units
- Perinatal deaths
-
- 4 Aboriginal and Torres Strait Islander mothers and their babies
-
- Indigenous mothers
- Babies of Indigenous mothers
-
- 5 Key statistics and trends
- Appendixes
- Acknowledgments
- Abbreviations
- Glossary
- References
- Related publications
- Blank Page
- Blank Page
-