This report provides a baseline for monitoring changes in the quality of maternity services across Australia using 10 national core maternity indicators. The indicators are the outcome of work by the Department of Health, Western Australia (DoHWA) and Women’s Healthcare (formerly Hospitals) Australasia (WHA) after extensive consultation and refinement. They have been endorsed by the heads of Australian Government and state and territory health departments.
Summary information for the indicators is in Table S1. Not all the data to derive these indicators are collected in a standardised way, or are available for all years across all jurisdictions; therefore, results should be interpreted with caution.
|1||Smoking in pregnancy for all women giving birth||16.7||16.6||14.5|
|2||Antenatal care in the first trimester for all women giving birth||n.a.||76.3||79.0|
|3a||Episiotomy for women having their first baby and giving birth vaginally without instruments||16.2||16.2||15.1|
|3b||Episiotomy for women having their first baby and giving birth vaginally with instruments||59.9||61.9||58.5|
|4||Apgar score of less than 7 at 5 minutes for births at or after term||0.9||1.0||1.1|
|5||Induction of labour for selected women giving birth for the first time||31.0||32.3||32.7|
|6||Caesarean section for selected women giving birth for the first time||25.3||26.3||27.1|
|7||Normal (non-instrumental) vaginal birth for selected women giving birth for the first time||51.9||50.2||49.6|
|8||Instrumental vaginal birth for selected women giving birth for the first time||22.8||23.5||23.3|
|9||General anaesthetic for women giving birth by caesarean section||n.a.||8.2||8.4|
|10||Small babies among births at or after 40 weeks gestation||2.1||1.8||1.8|
National rates have decreased for indicators 1, 3a and 10:
- Although smoking rates have decreased overall, marked differences among sociodemographic groups persist, with 13% of women in Major cities reporting smoking in pregnancy compared with 36% living in Very remote areas.
- The small reduction in the proportion of babies born weighing less than 2,750 grams at or after 40 weeks from 2.1% in 2004 to 1.8% in 2009 was seen in most settings.
- Decreased rates of episiotomy among women having their first baby and giving birth vaginally are most evident in hospitals with 500 or fewer annual births.
A longer time series is necessary to confirm the increased rates for indicators 2 and 9. Indicators 4, 5, 6, 7 and 8 point to areas for possible further attention:
- Induction, caesarean section and instrumental vaginal birth rates increased over the reference period among selected women while the rate of normal birth decreased proportionately.
- Apgar score is a measure of the baby’s adaptation to the environment. Higher rates of Apgar scores below 7 need to be explained.
Detailed trends by jurisdictional, health service and sociodemographic factors presented in this report may help to pinpoint areas where further gains could be made in the safety and quality of maternity care in Australia.