Australia's mothers and babies

In 2020, almost 2 in 3 women (63%) in Australia had a vaginal birth. Non-instrumental vaginal births were more common for women whose babies were born at term (51%) or post-term (48%), who were teenage mothers (aged under 20) (64%) and who were underweight (56%) or normal weight (52%).

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% for forceps and 13% for vacuum extraction) compared with women with a parity of 4 or more (0.7% for forceps and 1.7% for vacuum extraction).

The proportion of instrumental vaginal births assisted by forceps decreased with increasing remoteness (from 5.7% for Major cities to 2.1% for Very remote areas) and were more common among mothers whose babies were born post-term (8.2%, compared to 5.3% for mothers whose babies were born at term) and mothers who lived in the least disadvantaged areas (5.9%, compared to 4.3% for mothers who lived in the most disadvantaged areas).

The proportion of instrumental vaginal births assisted by vacuum extraction was higher for women who gave birth in private hospitals (9.7%, compared with 6.9% for public hospitals) and mothers who lived in the least disadvantaged areas (8.7%, compared to 6.1% for mothers who lived in the most disadvantaged areas).

For related information see National Core Maternity Indicators:

Non-instrumental vaginal birth

Instrumental vaginal birth

For more information on vaginal births see National Perinatal Data Collection annual update data table 2.36.

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. This procedure is generally performed when vaginal birth is likely to pose a risk to the health of the mother or baby, or in scenarios such as stalled labour or unsuccessful vaginal birth.

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 2018). Risks to the mother include postoperative infection, haemorrhage, and complications during future pregnancies. Risks to the baby for planned caesarean section at less than 39 weeks’ gestation can include increased rates of neonatal respiratory issues, asthma, obesity and developmental issues (ACSQHC 2018).

In 2020, more than 1 in 3 mothers (37%) 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 as well as those who required a caesarean section after labour started.

Caesarean sections were more common among women whose babies were pre-term (51%), who were aged 40 and over (56%) and who were overweight (39%) and obese (46%).

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).

Over one in 4 (27%) 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 (39%) and lower for mothers who had previously given birth (13%).

For related information see National Core Maternity Indicator Caesarean section

For more information on caesarean section births see National Perinatal Data Collection annual update data tables 2.36 and 2.37.

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 (Chauhan et al. 2003; Jamshed et al. 2022). However, many women who choose to give birth vaginally after having had a previous caesarean section are successful (RANZCOG 2022).

Most mothers who 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.

The data visualisation below presents data on the history of caesarean section birth for women who have previously given birth, by selected maternal characteristics for 2020. Click the trend button to see how data has changed over a 9-year period.

Of mothers who have previously given birth and had a caesarean section, 24% had had one previous caesarean section, 5.7% had had two previous caesarean sections, and 1.5% had had three or more. The number of previous caesarean sections differed little by remoteness or socioeconomic status of the mother’s usual residence.

For related information see National Core Maternity Indicator Women having their second birth vaginally whose first birth was by caesarean section

For more information on previous caesarean sections see National Perinatal Data Collection annual update data table 2.43.

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 (89%, Robson group 7) and those with singleton pregnancies near term who had had one or more previous caesarean sections (86%, Robson group 5).

The data visualisation below presents data on the number and proportion of women who gave birth, by Robson group, in 2020.

For more information on the Robson classification of caesarean sections see National Perinatal Data Collection annual update data table 2.45.