Method of birth

The figure shows a bar chart of the proportion of women who gave birth by method of birth by a range of topics for 2019 and a line graph of topic trends from 2009 to 2019. In 2019, 107,543 women, or 36%, gave birth by caesarean section in 2019.

In 2019, almost two in 3 women (64%) in Australia had vaginal births, while the remainder (36%) had a caesarean section birth. Mothers who had caesarean sections include all those who had no labour onset as well as those who required a caesarean section after labour started. For multiple births, women are categorised by the method of birth of the first-born baby.

Non-instrumental vaginal births were more common for women whose babies were born at term (52%) or post-term (50%), who were teenage mothers (aged under 20) (67%) and who were underweight (57%) or normal weight (53%).

Caesarean sections were more common among women whose babies were pre-term (50%), who were aged 40 and over (55%) and who were overweight (38%) and obese (44%).

Instrumental vaginal birth (both forceps and vacuum extraction) decreased with increasing parity and was much more common among women who had not previously given birth (10.1% for forceps and 13.1% for vacuum extraction) compared with women with a parity of 4 or more (0.5% for forceps and 1.5% for vacuum extraction).

The proportion of instrumental vaginal births assisted by forceps decreased with increasing remoteness (from 5.6% for Major cities to 2.5% for Very remote areas), and were more common among mothers whose babies were born post-term (7.7%, compared to 5.3% for mothers whose babies were born at term) and mothers who lived in the highest socioeconomic areas (5.8%, compared to 4.1% for mothers who lived in the lowest socioeconomic areas).

The proportion of instrumental vaginal births assisted by vacuum extraction was higher for women who gave birth in private hospitals (10.3%, compared with 6.8% for public hospitals) and mothers who lived in the highest socioeconomic areas (8.7%, compared to 6.0% for mothers who lived in the lowest socioeconomic areas).

Internationally, the caesarean section rate has been increasing in most Organisation for Economic Cooperation and Development (OECD) countries, including Australia, and Australia’s rate of 34 per 100 live births is higher than the OECD average of 28 per 100 live births (OECD 2019).

While caesarean section is the most appropriate delivery method for many conditions and complications that can affect the mother and/or baby, the benefits need to be weighed against the risks (ACSQHC 2018). Risks to the mother include postoperative infection, haemorrhage and complications during future pregnancies. Risks to the baby include increased rates of asthma and obesity, and breathing difficulties and developmental issues in babies born by caesarean section at less than 39 weeks gestation (ACSQHC 2018).

One in 4 (25%) mothers had a primary caesarean section (that is, caesarean sections to mothers with no previous history of caesarean section). This rate was higher for first-time mothers (37%) and lower for mothers who had previously given birth (12%).

Having had a previous caesarean section was the most common main reason for having a caesarean section.

For related information see National Core Maternity Indicators:

Robson classification of caesarean sections

In 2015, the World Health Organization (WHO) recommended that, rather than using 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 2018; WHO RHR 2015).

The Robson classification allocates women into 10 mutually exclusive groups based on obstetric characteristics, such as the number of previous pregnancies, onset of labour, whether there has been a previous caesarean section, and the baby’s gestational age (WHO 2018; WHO RHR 2015). This can provide a more detailed understanding of the relatively high caesarean section rate in Australia and can be used to inform targeted intervention.

Hover over the graph to see the definition of each Robson group.

The figure contains three bar charts displaying the number of women in each Robson classification group who gave birth in 2019, the number of women in each Robson classification group who gave birth by caesarean section in 2019 and the per cent of women in each Robson classification group who gave birth by caesarean section in 2019.

First-time mothers with a breech pregnancy (baby is delivered buttocks or feet first) (Robson group 6) were most likely to have a caesarean section (93%), followed by mothers who have previously given birth with a breech pregnancy (88.5%, Robson group 7) and those with singleton pregnancies near term who had had one or more previous caesarean sections (86%, Robson group 5).