A newborn baby's health can be a key determinant of their health and wellbeing throughout life. Factors such as physical health, social wellbeing and exposure to harmful behaviours can influence health outcomes for both mothers and babies.
The health of both mothers and babies can have important lifelong implications. Around 300,000 babies are born in Australia every year and Australia is one of the safest places in the world for a woman to give birth, and for a baby to be born.
Maternal demographics, such as maternal age and country of birth, can impact on maternal and perinatal health outcomes. The average age of mothers in Australia is increasing and about one third of mothers were born in a country other than Australia.
The time from conception to birth is known as the antenatal period. Maintaining a healthy lifestyle and attending routine antenatal care during pregnancy contributes to better outcomes for mothers and their babies. Antenatal care visits are designed to assess and improve the health of mothers and their babies during pregnancy. Most mothers access antenatal care in the first trimester (before 14 weeks’ gestational age), and have 5 or more antenatal care visits.
Tobacco smoking and alcohol consumption during pregnancy are associated with poorer perinatal outcomes such as pre-term birth, low birthweight or perinatal death. The rate of maternal death is also higher in women who reported smoking during the first 20 weeks of pregnancy than women who did not smoke. In Australia, less than 1 in 10 women report smoking at any time during their pregnancy and the vast majority do not consume alcohol.
Other important elements of maternal health covered in these reports are Body mass index and the presence of maternal health condition such as diabetes and hypertension.
Most women in Australia give birth in a public hospital. Over time, the rate of women who have a spontaneous onset of labour is decreasing and the rate of women who have a caesarean section birth is increasing, with more than one third of women giving birth by caesarean section.
Additional factors related to labour and birth detailed in these reports include the administration of analgesia and anaesthesia during labour and birth, and perineal status.
The health of a baby at birth is a key determinant of subsequent health and wellbeing. For example, the gestational age of a baby, and their birthweight, have important implications for their health, with poorer outcomes generally reported for those born early and with a birthweight below 2,500 grams.
In Australia, around 9% of babies are born pre-term and around 7% are of low birthweight, and there has been little change in recent years. Birthweight and gestational age are closely related – more than half of all babies who are pre-term are of low birthweight.
Other indicators of postnatal outcomes for the baby used in reporting include Apgar score at 5 minutes, whether an active resuscitation method was used, whether admission to the special care nursery or neonatal intensive care unit was required, and the baby’s length of stay in hospital.
Maternal death is rare and all maternal deaths are reviewed by health professionals to determine the likely cause and whether the pregnancy contributed to the death. The death of a baby occurring within the perinatal period (from 20 weeks of gestation to 28 days after birth) is not uncommon. Every day in Australia, 6 babies are stillborn and 2 die within 28 days of birth (neonatal death).
Data sources and reporting
Information and statistics about the health of mothers and their babies are important for monitoring and evaluating the provision and outcomes of maternity services and care in Australia. Data on almost every birth in Australia are collected by health professionals and included in the AIHW National Perinatal Data Collection (NPDC).
The Australian Insitute of Health and Welfare (AIHW) has developed nationally consistent and comprehensive maternal and perinatal mortality collections to enable better monitoring and targeting by health services, and to improve the safety and quality of maternity care. The National Maternal Mortality Data Collection (NMMDC) contains information on the deaths of women reported to have died while pregnant or within 42 days of the end of pregnancy from 2006 onwards.
The National Perinatal Mortality Data Collection (NPMDC) collates data regarding the deaths of babies in hospitals and in the community, and includes all neonatal deaths and stillbirths of a baby at least 20 weeks' gestation or at least 400 grams birthweight, during pregnancy, birth or within 28 days of birth. Work is currently underway to develop a Perinatal Mortality National Best Endeavours Data Set to standardise data items currently in the NPMDC to ensure nationally-consistent reporting of perinatal deaths, including comprehensive information on the demographic factors, contributory factors and the circumstances surrounding a perinatal death.
Data from the NPDC, NMMDC and NPMDC is used to inform annual updates of Australia’s mothers and babies and data from the NMMDC and NPMDC is reported in the biennial Stillbirths and neonatal deaths in Australia and triennial Maternal deaths in Australia publications.
The AIHW also collects data on maternity models of care in the Model of Care National Best Practice Data Set (MoC NBPDS). A model of care describes how a group of women are cared for during pregnancy, birth and the postnatal period and is collected at the service level, usually within each hospital. The latest information from the MoC NBPDS can be found in Maternity models of care in Australia. While this report looks at the characteristics of the models themselves, future reporting will link data from the NPDC and the MoC NBPDS. Two model of care data elements were added to the specifications for the NPDC from July 2020 and jurisdictions will implement these data elements into their perinatal collections. In the 2021 NPDC Queensland collected models of care information for all women giving birth in their jurisdiction. In Maternity models of care infocus, Queensland perinatal data and models of care information from the MoC NBPDS are linked, and Queensland data used as a case study to explore the number of women using different models of care in Queensland, whether these vary by maternal characteristics, and outcomes for mothers and babies by model of care. Similar information for women giving birth in other jurisdictions will be available once these model of care data elements are routinely collected in the NPDC.
The National Core Maternity Indicators (NCMIs) are a set of indicators developed to monitor the quality of maternity care in Australia. Annual reporting of the NCMIs cover the antenatal period, labour and birth and birth outcomes. The AIHW is currently reviewing the NCMIs in consultation with our expert advisory groups to ensure they maintain relevancy and continue to provide baseline data for monitoring and evaluating practice change in Australia.
The National Maternity Data Development Project (NMDDP) supports the continual development of a nationally consistent maternal and perinatal data collection in Australia. Stage 1 of the project commenced in 2011 in response to the National Maternity Services Plan’s recommendations around improved data collection and reporting. In the current stage of the NMDDP, the AIHW continues maternal and perinatal data development to support Woman-centred care: Strategic directions for Australian maternity services. The NMDDP is guided by the project advisory group (NMDDP AG) consisting of key experts in the fields of obstetrics, midwifery, research, statistics, consumer advocacy and health policy.
Congenital anomalies are a cause of child death and disability, and a major cause of perinatal death. The AIHW is re-establishing a National Congenital Anomalies Data Collection (NCADC) and has released its first report from this new collection, Congenital anomalies 2016. Based on data from 6 jurisdictions, this is the most recent national data available across jurisdictions’.
The AIHW has also commenced work to establish a Perinatal Mental Health pilot (PMHp) in response to the paucity of high quality and timely data about perinatal mental health in Australia. The PMHp will build the evidence on the mental health status and needs of parents during the antenatal and postnatal period.
Birth rate increased after a period of decline (from 56 per 1,000 women in 2020 to 61 per 1,000 in 2021)
Average maternal age is increasing (from 30.0 years in 2011 to 31.1 in 2021)
Over 8,400 (3%) babies born in 2017 had a congenital anomaly
Circulatory system anomalies were found in 33% of babies with an anomaly, and musculoskeletal system anomalies in 24%
In 2020, there were 14,605 babies born to 14,384 Aboriginal and Torres Strait Islander mothers
Aboriginal and Torres Strait Islander mothers aged under 20 years has halved (from 22% in 2005 to 11% in 2020)