Health of mothers and babies

The health of both mothers and babies can have important lifelong implications.  Maternal demographics, such as maternal age and country of birth, can impact on maternal and perinatal health. Maintaining a healthy lifestyle during pregnancy and attending routine antenatal care contributes to better outcomes for both mother and baby. The health of a baby at birth is a key determinant of their health and wellbeing throughout life, 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.

This page uses data from the National Perinatal Data Collection (AIHW 2021) and other related perinatal collections to explore aspects of pregnancy and childbirth as well as key outcomes for babies at birth. For more information on data sources used in this page, and to see a full list of AIHW products that focus on mothers and babies, see Data sources and Reports.

Profile of mothers and babies

About 298,600 women gave birth to around 303,100 babies in 2019. While the number of babies born and women giving birth has been increasing, the rate of women giving birth has fallen from 65 per 1,000 women of reproductive age (15–44) in 2009 to 58 per 1,000 women in 2019.

In 2019:

• 74% of mothers lived in Major cities compared with the proportion of women of reproductive age in the population (76%).
• 36% of mothers were born overseas compared with the proportion of women of reproductive age in the population (34%).
• 20% of mothers were from the lowest socioeconomic areas compared with the proportion of women of reproductive age in the population (17%).
• 4.8% of mothers were of Aboriginal and Torres Strait Islander origin compared with 3.6% of Indigenous women of reproductive age in the population.
• 51% of babies born were male, with a ratio of 106 live-born boys to 100 live-born girls.
• 6% of babies born were Indigenous babies.

Detailed information on mothers and babies from population groups, such as Indigenous mothers and babies or those from remote areas, is available from Australia’s mothers and babies.

COVID-19 impacts

During 2020, shutdowns and service disruptions may have affected the ability of pregnant women to attend face-to-face antenatal care. Additionally, because of personal safety concerns, women may have opted not to attend face-to-face appointments, as health advice encouraged avoiding public spaces except for essential purposes (RANZCOG 2021; RCOG 2022). On 13 March 2020, the Australian Government added services to the Medicare Benefits Schedule to cover antenatal services delivered via telehealth (Department of Health 2021b).

During 2020, over 1.6 million services for antenatal care were processed nationally. Of these, there were around 136,000 fewer face-to-face antenatal services in 2020 compared with 2019. This decrease was mostly offset by telehealth services (added in March 2020) that contributed 126,000 antenatal services from March to December 2020. The overall reduction of antenatal services in 2020 compared with 2019 was less than 10,000 services (a 0.6% reduction).

For more information see Antenatal care during COVID–19, 2020.

Mothers

Maternal age

Maternal age is an important risk factor for both obstetric and perinatal outcomes. Adverse outcomes are more common in younger and older mothers. Women in Australia are continuing to give birth later in life:

• The average age of women who gave birth was 30.8 in 2019 compared with 30.0 in 2009.
• The proportion of women giving birth aged 35 and over remained relatively stable from 23% in 2009 to 25% in 2019, while the proportion aged under 25 decreased from 18% to 13% (Figure 1).

Smoking status

Smoking during pregnancy is the most common preventable risk factor for pregnancy complications and is associated with poorer perinatal outcomes, including low birthweight, being small for gestational age, pre-term birth and perinatal death. Women who stop smoking during pregnancy can reduce the risk of adverse outcomes for themselves and their babies. Support to stop smoking is widely available through antenatal clinics.

Almost 1 in 10 (9.3%) mothers who gave birth in 2019 smoked at some time during their pregnancy, a decrease from 15% in 2009 (Figure 1). Of mothers who were smoking at the start of their pregnancy, 1 in 5 (20%) quit smoking during the pregnancy.

Antenatal care

Antenatal care is a planned visit between a pregnant woman and a midwife or doctor to assess and improve the wellbeing of the mother and baby throughout the pregnancy. Routine antenatal care, beginning in the first trimester (before 14 weeks gestational age), is known to contribute to better maternal health in pregnancy, fewer interventions in late pregnancy, and positive child health outcomes (AHMAC 2011; WHO RHR 2015).

Looking at the number of antenatal visits by mothers who gave birth at 32 weeks or more gestation in 2019:

• Almost all mothers (99.8%) received antenatal care during pregnancy.
• 77% of mothers received antenatal care within the first 10 weeks of pregnancy.
• 57% of first-time mothers had at least 10 antenatal visits during pregnancy and 85% of mothers who had given birth previously had at least 7 visits the rates have remained steady since 2013 (excludes data from Victoria) (Figure 1).

Method of birth

In 2019, 64% of mothers (190,853) had a vaginal birth and 36% (107,543) had a caesarean section (Figure 2).

Around half (51%) of all births were non-instrumental vaginal births. When instrumental births were required, vacuum extraction was more common than forceps (8% and 5% of all births, respectively) (Figure 2).

Since 2009, the rate of non-instrumental vaginal births decreased (from 57% in 2009 to 51% in 2019) whereas the caesarean section rate increased (from 32% in 2009 to 36% in 2019) (Figure 1). The rate of vaginal birth with instruments was relatively stable over this time, between 12% and 13%. These trends remain when changes in maternal age over time are considered.

Babies

Gestational age

Gestational age is the duration of pregnancy in completed weeks. Gestational age is reported in 3 categories: pre‑term (less than 37 weeks gestation), term (37 to 41 weeks) and post-term (42 weeks and over). The gestational age of a baby has important implications for their health, with poorer outcomes generally reported for those born early. Pre‑term birth is associated with a higher risk of adverse neonatal outcomes.

In 2019:

• The median gestational age for all babies was 39 weeks.
• 91% of all babies born were born at term (Figure 2).

Birthweight

Birthweight is a key indicator of infant health and a principal determinant of a baby’s chance of survival and good health. A birthweight below 2,500 grams is considered low and is a known risk factor for neurological and physical disabilities. A baby may be small due to being born early (pre-term) or be small for gestational age, for example, due to fetal growth restriction within the uterus.

In 2019, 6.6% of babies born in Australia had low birthweight (Figure 2), and there has been little change since 2009. Birthweight and gestational age are closely related – low birthweight babies made up 57% of babies who were pre‑term compared with only 2.3% of babies born at term.

Apgar score at 5 minutes

Apgar scores are clinical indicators that determine a baby’s condition shortly after birth. These scores are measured on a 10-point scale for several characteristics. An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well post-birth.

The vast majority (98%) of liveborn babies in 2019 had an Apgar score of 7 or more at 5 minutes after birth (Figure 3). This rate has remained steady since 2009.

Resuscitation

Resuscitation is undertaken to establish independent breathing and heartbeat or to treat depressed respiratory effort and to correct metabolic disturbances. Resuscitation methods range from less intrusive methods like suction or oxygen therapy to more intrusive methods, such as external cardiac massage and ventilation. More than one type of resuscitation method can be recorded.

Almost 1 in 5 (19%) liveborn babies required active resuscitation immediately after birth in 2019. Where resuscitation was required, continuous positive pressure ventilation (CPAP) was reported as the most used method nationally and external cardiac compressions as the least common method.

Babies who required resuscitation were also more likely to have an Apgar score of less than 7, be of low birthweight, be born pre-term, and be born as part of a multiple birth.

A stillbirth is the death of a baby before birth, at a gestational age of 20 weeks or more, or a birthweight of 400 grams or more. A neonatal death is the death of a liveborn baby within 28 days of birth. Perinatal deaths include both stillbirth and neonatal deaths.

In 2019, there were 9.6 perinatal deaths for every 1,000 births, a total of 2,897 perinatal deaths. This included:

• 2,183 stillbirths, a rate of 7.2 deaths per 1,000 births.
• 714 neonatal deaths, a rate of 2.4 deaths per 1,000 live births.

Between 2009 and 2019 the stillbirth and neonatal mortality rates have remained largely unchanged at between 7 and 8 in 1,000 births and between 2 and 3 in 1,000 live births, respectively. Congenital anomaly was the most common cause of perinatal death.

For more information see Stillbirths and neonatal deaths in Australia.

Maternal deaths

Maternal death is the death of a woman while pregnant or within 42 days of the end of pregnancy, irrespective of the duration and outcome of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.

Between 2010 and 2019, the maternal mortality ratio in Australia was relatively stable, ranging from between 5.0 to 8.4 per 100,000 women giving birth.

The most frequent causes of maternal death reported in Australia between 2010 and 2019 were complications of pre-existing cardiovascular disease and non-obstetric haemorrhage (mostly haemorrhage within the brain and haemorrhage from a ruptured aneurysm of the splenic artery).

For more information see Maternal deaths.

Congenital anomalies

Congenital anomalies encompass a wide range of atypical bodily structures or functions that are present at or before birth. They are a cause of child death and disability, and a major cause of perinatal death.

In 2016, over 8,900 (3%) babies were born with a congenital anomaly, almost 1 in 31 babies. Circulatory system anomalies (these are anomalies of the heart and major blood vessels) were the most common type of anomaly, 29% of babies with any anomaly having a circulatory system anomaly. Most (91%) babies with an anomaly survived their first year.

Congenital anomaly rates were higher in:

• babies born pre-term (before 37 weeks’ gestation), at a rate of 107 per 1,000 births
• babies born with low birthweight (less than 2,500 grams), at a rate of 123 per 1,000 births
• babies that were small for gestational age (that is with a birthweight below the 10th percentile for their gestational age and sex), at a rate of 45 per 1,000 births.

For more information see Congenital anomalies 2016.

Maternity models of care

A maternity model of care describes how a group of women are cared for during pregnancy, birth, and the postnatal period.

In 2021, around 830 maternity models of care were reported across Australian maternity services, and they can be grouped into 11 major model categories. Amongst them:

• The most common major model category is public hospital maternity care with 41% of all models of care falling into this category.
• 45% of all models of care have a midwife employed in the public health system as the designated carer.
• 62% of models have continuity of carer in any stage of the maternity period.

Around 500 (61%) models of care are targeted at specific groups of women who share a common characteristic or set of characteristics. Aboriginal or Torres Strait Islander identification is a target group in 11% of models.

For more information, read the full Maternal models of care report.

Where do I go for more information?

For more information on the health of mothers and babies, see:

• Australia’s mothers and babies  
• Stillbirths and neonatal deaths
• Maternal deaths
• National Core Maternity Indicators
• Older mothers in Australia
• Antenatal care during COVID-19    
• Congenital anomalies
• Maternal models of care

References

AHMAC (Australian Health Ministers’ Advisory Council) (2011) National Maternity Services Plan, Department of Health and Ageing, Australian Government, accessed 16 March 2022.

AIHW (Australian Institute of Health and Welfare) (2021) Australia's mothers and babies, AIHW, Australian Government, accessed 16 March 2022.

Department of Health (2021a) Clinical practice guidelines: pregnancy care, Department of Health, Australian Government, accessed 16 March 2022.

Department of Health (2021b) COVID-19 temporary MBS telehealth services, Department of Health, Australian Government, accessed 6 March 2022.

RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) (2021) A message for pregnant women and their families, RANZCOG, accessed 6 March 2022

RCOG (Royal College of Obstetricians and Gynaecologists) (2022) Coronavirus (COVID-19) infection in pregnancy. Information for healthcare professionals, RCOG website, accessed 7 March 2022.

WHO RHR (World Health Organization Department of Reproductive Health and Research) (2015) WHO statement on caesarean section rates. WHO website, accessed 3 March 2022.