On 26th October 2017, the Australian Institute of Health & Welfare (AIHW) released the National Statistics on Mothers and Babies.

This data provides an overview of mothers and babies, maternal demographics, the antenatal period, labour and birth, and baby outcomes for the years 2010 to 2015.

The statistics are really interesting, and the national caesarean rate although still way too high and outside the World Health Organisation recommended levels of between 10%-15%, is not as high as I had thought they would be.

I have picked out the main statistics that were of interest to me, but have also included the full report at the end of this page for anyone who is interested in seeing each demographic broken down more specifically.

In 2015, 304,268 women gave birth in Australiaan increase of 13% since 2005 (267,795 women).

The rate of women giving birth has fluctuated between 2005 and 2015, with a rate of 62 per 1,000 women of reproductive age (15 – 44 years) in 2015.

The rate has declined from a peak of 66 per 1,000 women in 2007.

The average age of all women who gave birth continues to rise and was 30.3 in 2015, compared with 29.7 in 2005.

The median age was slightly higher, at 31 years in 2015.

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More babies are being born – there were 308,887 babies born in 2015 – an increase of 12% since 2005.

In all, 306,725 were live births and 2,160 (less than 1%) were stillbirths.

The stillbirth rate of 7 deaths per 1,000 births has not changed substantially since 2005, remaining between 7.0 and 7.8 per 1,000 births over this time.

Baby boys slightly outnumber baby girls with 51% of males versus 49% of females.

One in 10 mothers (31,268 or 10%) who gave birth in 2015 smoked at some time during their pregnancy, a decrease from 15% in 2009.

Almost all births in Australia occur in hospitals, in conventional labour wards.

In 2015, 97% (296,602) of mothers gave birth in hospitals, while much smaller proportions gave birth in birth centres (1.8% or 5,491), at home (0.3% or 910) or in other settings including births occurring before arrival at hospital (0.4% or 1,265 mothers).

Regardless of place of birth, almost all babies were live born (98% or more).

Overall, half of mothers who gave birth in 2015 (50% or 152,496) had a spontaneous labour, around 1 in 3 had an induced labour (29% or 89,298) and 1 in 5 had no labour onset (21% or 62,447).

There were changes between 2005 and 2015 in the type of labour onset – a decrease in spontaneous labour (from 57% to 50%) and corresponding increases for the induction of labour (from 26% to 29%) and no labour onset (from 18% to 21%).

Most vaginal births (81%) were non-instrumental.

When instrumental delivery was required, vacuum extraction was more commonly used than forceps (11% and 8%, respectively).

Vaginal delivery with instruments has remained relatively stable between 11% and 12% throughout this period.

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Image: Wikispaces

Caesareans versus Vaginal Births

Caesarean sections have increased over time since 2005, vaginal non-instrumental delivery has fallen 5 percentage points (decreasing from 59% in 2005 to 54% in 2015) whereas the caesarean section rate has increased by 3 percentage points (from 30% in 2005 to 33% in 2015).

In 2015, 67% of mothers (202,890) had a vaginal birth and 33% (101,370) 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.

These trends remain when changes in maternal age over time are taken into account.

Caesarean 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 (52% and 18%).

The overall rate of primary caesarean section was 23% (that is, caesarean sections to mothers with no previous history of caesarean sections) this rate was higher for first time mothers (34%) and lower for mothers who had previously given birth (11%).

The vast majority (85%) of mothers who had had a previous caesarean section had a repeat caesarean section, while the remainder had a vaginal birth (12% had a non-instrumental vaginal birth and almost 4% had an instrumental vaginal birth).

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 2013.

Australia’s rate remained higher than the OECD average over this time and ranked 22nd out of 32 OECD countries in 2013 with a rate of 32 per 100 live births (caesarean section rates are ranked from lowest to highest).

The rate was lowest in Iceland (15 per 100 live births) and highest in Turkey (50 per 100 live births) (OECD 2015).

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Among mothers who gave birth in 2015 (excluding those in New South Wales):

  • one fifth (20%) were classified as obese (with a BMI of 30.0 or more)
  • one quarter (26%) were overweight (BMI of 25.0 – 29.9)
  • half (50%) were in the normal weight range (BMI of 18.5 – 24.9)
  • one in 25 were underweight.

Of the 241,794 mothers who had labour in 2015, around 3 in 4 received pain relief (77%).

The most common types were nitrous oxide (inhaled) (54%), followed by regional analgesic (35%) and systemic opioids (18%).

Mothers who did not receive 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, compared with those who received pain relief.

In 2015, the average gestational age for all babies was 38.6 weeks, with the vast majority (91%) born at term (37 – 41 weeks).

Average gestational age varied by birth status – 38.7 weeks for liveborn babies, and considerably lower for stillborn babies (26.8 weeks).

In 2015, the mean birth weight of all babies was 3,327 grams.

The mean was slightly higher for liveborn babies (3,342 grams), with the vast majority of these born in the normal birthweight range (92% or 282,530); 6.5% (19,852) were low birthweight, and a small proportion were high birthweight (1.4% or 4,263)

Birthweight ranges (as per World Health Organisation – WHO 1992): 

  • High – 4,500 grams and over
  • Normal – 2,500 to 4, 4,499 grams
  • Low – less than 2,500 grams

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In 2015, the vast majority of babies (94% or 291,361) 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:

  • around 1 in 25 babies (4.3% or 13,424) were in a breech presentation (where the baby exits buttocks or feet first);
  • around 1 in 100 babies (1.3% or 3,880) were in other presentations including face, brow, shoulder / transverse and compound presentations.

In 2015, multiple births were almost 7 times as likely to be in non-vertex presentation as singletons (32% compared with 5%, respectively).

The proportion was greater for higher-order multiples (triplets and higher) (39%) than for twins (32%).

Non-vertex presentation increased with birth order for multiple births, from 24% among babies who were born first to 41% among subsequent babies.

In 2015, there were 9 perinatal deaths for every 1,000 births, a total of 2,849 perinatal deaths.

This included:

  • 2,160 foetal deaths (stillbirths) or 7 foetal deaths per 1,000 births
  • 689 neonatal deaths, a rate of 2 neonatal deaths per 1,000 live births.

 

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You can read the comprehensive report by clicking here:

CLICK HERE FOR AIHW MOTHERS & BABIES REPORT 2015