Thursday, December 19, 2013

Australia's mothers and babies 2011

The AIHW report, Australia's Mothers and Babies 2011, has been released today.  This and similar reports provide useful information about trends in maternity care across the nation.  The AIHW site has a large number of related publications.

From the report:

  • In 2011, there were 1,267 women who gave birth at home, representing 0.4 % of all women who gave birth. The highest proportions were in Victoria and Western Australia (0.8%) (Table 3.18). It is probable that not all homebirths are reported to the perinatal data collections.
  • The mean age of mothers who gave birth at home was 31.7 years (Table 3.49). The proportion of mothers younger than 20 was 1.3%, and the proportion aged 35 and over was 29.8%. 
  • The proportion of mothers who gave birth at home who identified as being of Aboriginal and Torres Strait Islander origin was 1.1%. 
  • Most women who gave birth at home were living in Major cities (70.8%) (Table 3.49).
  • Of mothers who gave birth at home, about one-quarter had their first baby (22.3%), and 77.4% were multiparous. 
  • The predominant method of birth for 99.3% of women who gave birth at home was non-instrumental vaginal (Table 3.49). The presentation was vertex for 97.6% of women who gave birth at home.
  • Of babies born at home in 2011, 99.2% were liveborn. The mean birthweight of these liveborn babies was 3,614 grams (Table 3.49). 
  • The proportion of liveborn babies of low birthweight born at home was 1.6%, and the proportion of preterm babies born at home was 1.3%.

Some of the highlights from the press release linked to this report are:

  • The report shows that in 2011, a total of 297,126 women gave birth to 301,810 babies. This was a small rise in the total number of births compared with 2010 (almost 1%) and a rise of over 18% since 2002.
  • The average age of women having their first baby has increased steadily from 27.6 years in 2002 to 28.3 years in 2011,
  • caesarean section rate has shown an upward trend in the 10 years to 2011, rising from 27% to a peak of just over 32% between 2002 and 2011.
  • 'Caesarean section rates increased with advancing maternal age,' Professor Sullivan said.
  • 'In 2011, caesarean section rates ranged from 18% for teenage mothers to 49% for mothers aged 40 and over.'
  • Repeat caesarean sections occurred for 84% of mothers with a history of caesarean section. About 1 in 8 mothers who had previously had a caesarean section had a subsequent non-instrumental vaginal birth.
  • For Indigenous mothers, the caesarean section rate was 27%, significantly lower than for non-Indigenous mothers (32%).
  • 'This may be partially explained by the younger age of Indigenous mothers of 25.3 years compared to 30.2 years for non-Indigenous mothers,' Professor Sullivan said.
  • In 2011, just over 6% of liveborn babies were of low birthweight (less than 2,500 grams), and among mothers who smoked during pregnancy the proportion of low birthweight babies was nearly double (11%).
The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia's health and welfare.
Canberra, 19 December 2013

MiPP Comment by Joy Johnston:

The Victorian perinatal data collection unit used to publish an annual Homebirths report, the same as they published a report for each hospital - but this has apparently now ceased. The last one I have is 2008.

In 2010 the publicly funded homebirth programs from Sunshine and Casey hospitals were commenced, and the pilot continued until Feb 2012, so most of the publicly funded births in the pilot would have been in 2011, and included in this AIHW report. The report of the pilot has been published, and it appears that 139 women were eligible for questionnaires. Not clear how many gave birth at home, but 88% of those who responded to the questionnaires gave birth spontaneously. It's always interesting when numbers are not published.  

Midwives who have been attending homebirths in Victoria for many years suspect that the number of privately attended planned homebirths has grown considerably since 2010, when the federal government's maternity reforms enabled Medicare rebate for certain midwifery services provided by participating midwives.  Homebirth was, in a curious twist of bureaucratic nonsense, excluded from rebatable services.  However, since home is the only place that a privately employed midwife is able to practise at present, and since the focus of midwifery logically includes the birth in the continuum, it is not surprising that an increasing number of midwives are providing homebirth services for an increasing number of mothers.  
Midwives please note the ACM Midwifery News (summer edition)  -  you will see an article that I wrote, reviewing private midwifery in Victoria.  Readers who are not midwives, who would like to see this article, please contact me via email joy[at] .

Your comments are welcome.

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