Method of birth
Method of birth refers to how the baby was born, which may be vaginally or by caesarean section. When compared with non-instrumental vaginal births, instrumental vaginal births (vacuum or forceps) and caesarean section births can carry additional risks for mothers and babies (see the sections Vaginal births and Caesarean section births).
Although each method carries risks, they are chosen by women and their health care providers to minimise complications and increase the likelihood of positive pregnancy outcomes (Department of Health and Aged Care 2024).
Over time, the proportion of women who had a vaginal non-instrumental birth has decreased, and the proportion of women who had a caesarean section birth has increased. Vaginal birth assisted by vacuum or forceps have remained relatively stable. In 2023:
- 48% of women had a non-instrumental vaginal birth (compared with 56% in 2010)
- 4.3% of women had a vaginal birth assisted by forceps (compared with 4.0% in 2010)
- 6.6% of women had a vaginal birth assisted by vacuum (compared with 8.1% in 2010)
- 41% of women had a caesarean section birth (compared with 32% in 2010).
Figure 1 presents trend data on the method of birth of women who gave birth, by selected maternal characteristics, between 2010 (or earliest available year of data) and 2023. Select the ‘Current data’ button to view 2023 data.
Figure 1: Proportion of women who gave birth, by method of birth and selected topic
Bar chart shows method of birth by selected topics and a line graph shows topic trends between 2010 (or earliest available year of data) and 2023.
For more information on vaginal births and caesarean section births, expand the sections below.
Having a vaginal birth has become less common in Australia since 2010 (68.4%). In 2023, 59% of women who gave birth in Australia had a vaginal birth. Non-instrumental vaginal births were more common for women whose babies were born at term (49%) or post-term (47%), who were aged under 20 (63%) and who were underweight (54%) or normal weight (51%).
Instrumental vaginal births may be indicated where the second stage of labour needs to progress due to a risk to the mother or baby (RANZCOG 2020). Instrumental vaginal births can result in increased risk of vaginal trauma, a perineal tear or neonatal injury (ACSQHC 2017; RANZCOG 2020).
Instrumental vaginal birth (which includes both forceps and vacuum extraction) decreased with increasing parity and was much more common among women who had not previously given birth (8.2% for forceps and 11% for vacuum extraction) compared with women with a parity of 4 or more (0.5% for forceps and 1.1% for vacuum extraction). It was also more common among women born in Nepal (8.3% for forceps and 10% for vacuum extraction), India (7.3% for forceps) and China (10.8% for vacuum extraction).
The proportion of instrumental vaginal births assisted by forceps decreased with increasing remoteness (from 4.6% for Major cities to 2.1% for Very remote areas) and were more common among mothers whose babies were born post-term (6.6%, compared to 4.4% for mothers whose babies were born at term) and mothers who lived in the highest socioeconomic areas (4.7%, compared to 3.7% 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 (8.2%, compared with 6.3% for public hospitals) and mothers who lived in the highest socioeconomic areas (7.7%, compared to 5.5% for mothers who lived in the lowest socioeconomic areas).
For more information on:
- vaginal births by state and territory, see National Perinatal Data Collection annual update data table 2.37
- vaginal births by selected maternal characteristics, see National Perinatal Data Collection annual update data visualisations table 4.3
- related National Core Maternity Indicators, see Non-instrumental vaginal birth and Instrumental vaginal birth.
Caesarean section describes a method of birth in which the baby is removed directly from the uterus through an incision in the mother’s abdomen. Caesarean births can occur as a result of a planned (elective) or unplanned (emergency caesarean) section (RANZCOG 2021).
An elective caesarean section is where a woman and their health care provider plan a caesarean birth prior to the onset of either labour or unexpected complications requiring urgent delivery (RANZCOG 2021). Factors in this decision include (but are not limited to) number of previous caesarean sections, position of the baby (or babies in the case of a multiple pregnancy), and position of the placenta (RANZCOG 2021).
An emergency caesarean section is when a decision to perform a caesarean is made, either during or before labour, if complications develop and delivery needs to be quick, due to concern for the mother or baby’s wellbeing (RANZCOG 2021).
The National Perinatal Data Collection (NPDC) does not differentiate between elective and emergency caesarean section births, however there is an NPDC data item for main reason for caesarean section.
While caesarean section is the safest and the most appropriate method of birth for many conditions and complications that can affect the mother and/or baby, the benefits need to be weighed against the risks (ACSQHC 2017). Risks to the mother include postoperative infection, blood loss, blood clots, and complications during future pregnancies (RANZCOG 2021). Risks to the baby include altered immune development, increased likelihood of allergy and asthma, reduced intestinal gut microbiome diversity and greater incidence of late childhood obesity (ACSQHC 2017; Sandall et al., 2018).
In 2023, around 2 in 5 mothers (41%) had a caesarean section birth. This is an increase from 32% in 2010. Mothers who had caesarean sections include all those who had no labour onset (66%) as well as those who required a caesarean section after labour started (34%).
Caesarean sections were more common among women whose babies were pre-term (53%), who were aged 40 and over (59%), who were overweight (42%) or obese (48%) and who were born in Nepal (50%), India, the Philippines or South Africa (all 49%).
Internationally, compared to the average for Organisation for Economic Co-operation and Development (OECD) countries in 2017 (or nearest year), Australia’s rate of caesarean sections was higher (34 per 100 live births, in Australia compared with 28 per 100 for the OECD average) (OECD 2019).
Almost 1 in 3 (30%) mothers had a primary caesarean section (that is, caesarean section births for mothers with no previous history of caesarean section). This rate was higher for first-time mothers (43%) and lower for mothers who had previously given birth (14%).
For more information on:
- caesarean section births by maternal age and state and territory, see National Perinatal Data Collection annual update data tables 2.38
- main reason for caesarean section birth by state and territory, see National Perinatal Data Collection annual update data tables 2.39
- caesarean section births by selected maternal characteristics, see National Perinatal Data Collection annual update data visualisations table 4.3
- related National Core Maternity Indicators see Caesarean section.
Having had a previous caesarean section can be associated with an increased risk of adverse outcomes for women and their babies during subsequent pregnancies, most often due to uterine scarring (Jamshed et al. 2022; RANZCOG 2019). However, many women who choose to give birth vaginally after having had a previous caesarean section are successful (RANZCOG 2019).
In 2023, most mothers who have previously given birth (multiparous) and had a previous caesarean section had a repeat caesarean section (76%). Having had a previous caesarean section was the most common main reason for having a caesarean section.
Given the increasing caesarean rate, the proportion of multiparous women who had never had a previous caesarean section has been decreasing, from 71% in 2012 to 64% in 2023.
Figure 2 presents trend data on the history of caesarean section birth for women who have previously given birth, by selected maternal characteristics, between 2012 and 2023. Select the ‘Current data’ button to view 2023 data.
Figure 2: Proportion of multiparous women who gave birth, by previous caesarean section and selected topic
Bar chart shows previous caesarean sections by selected topics and a line graph shows topic trends between 2012 and 2023.
Of mothers who have previously given birth and had a caesarean section, 26% had one previous caesarean section, 6.0% had two previous caesarean sections, and 1.6% had had three or more. The number of previous caesarean sections was similar by remoteness or socioeconomic area of the mother’s usual residence.
For more information on:
- multiparous mothers who had previously had a caesarean section by current method of birth and state and territory, see National Perinatal Data Collection annual update data table 2.44
- previous caesarean sections by selected maternal characteristics, see National Perinatal Data Collection annual update data visualisations table 4.4
- related National Core Maternity Indicators, see Women having their second birth vaginally whose first birth was by caesarean section.
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 SRH 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 SRH 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.
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 (92%), followed by mothers who have previously given birth with a breech pregnancy (88%, Robson group 7) and those with singleton pregnancies near term who had had one or more previous caesarean sections (87%, Robson group 5).
Figure 3 presents data on the number and proportion of women who gave birth, by Robson group, in 2023.
Figure 3: Number of women in each Robson classification group
3 bar charts showing number and proportion of women who gave birth by caesarean section and Robson classification group, in 2023.
For more information on:
Robson 10 group classification system of caesarean sections by state and territory, see National Perinatal Data Collection annual update data table 2.46.
ACSQHC (Australian Commission on Safety and Quality in Health Care) (2017) The second Australian atlas of healthcare variation, ACSQHC, accessed 3 January 2018.
Department of Health and Aged Care (2024) What is shared decision making?, Pregnancy, Birth and Baby website, accessed 11 July 2025.
Jamshed S, Chien SC, Tanweer A, Asdary RN, Hardhantyo M, Greenfield D, Chien CH, Weng SF, Jian WS and Iqbal U (2022) ‘Correlation between previous caesarean section and adverse maternal outcomes accordingly with Robson classification: systematic review and meta-analysis’, Frontiers in Medicine, 10(8):740000, doi:10.3389/fmed.2021.740000.
OECD (Organisation for Economic Co-operation and Development) (2019) Health at a glance 2019: OECD indicators, OECD, accessed 13 April 2021.
RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) (2019) Birth after previous caesarean section, RANZCOG, accessed 11 May 2022.
RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) (2020) Instrumental vaginal birth (C-Obs 16), RANZCOG Statements and guidelines, Obstetrics, Intrapartum care, labour and birth, RANZCOG, accessed 28 May 2025.
RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) (2021) Caesarean section, RANZCOG, accessed 25 May 2024.
Sandall J, Tribem RM, Avery L, Mola G, Visser GHA, Homer CSE, Gibbon D, Kelly NM, Kennedy HP, Kidanto H, Taylor P and Temmerman M (2018) ‘Short-term and long-term effects of caesarean section on the health of women and children’, The Lancet, 392(10155): 1349–1357.
WHO (World Health Organization) (2017) Robson classification: implementation manual, WHO, accessed 10 May 2018.
WHO SRH (World Health Organization Sexual and Reproductive Health and Research) (2015) WHO statement on caesarean section rates, reference number WHO/RHR/15.02, WHO SRH, accessed 21 November 2018.