National Core Maternity Indicators

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. For more information, see Clinical commentary.

This indicator looks at caesarean section for selected women giving birth for the first time.

The interactive data visualisation below presents data on caesarean section for selected women giving birth for the first time by selected maternal characteristics. Click the Data tables button to view the data between 2004 and 2020 and use the radio buttons to see how each characteristic has changed during this time.

Clinical commentary

A caesarean section is an operation where a baby is born through an incision made through the mother’s abdomen and the uterus (RANZCOG 2021). A caesarean section may be planned (elective), or unplanned (emergency) if complications develop and delivery needs to be hastened.

Caesarean section is one of the most common interventions in pregnancy and is safer now than in the past, however, a small risk of serious morbidity and mortality for both the mother and the baby remains (Betran et al. 2016; Villar et al. 2007; Keag et al. 2018).

The WHO states that at the population-level, caesarean section rates higher than 10% are not associated with reductions in maternal and newborn mortality rates (WHO 2015). The WHO also states that caesarean sections are effective at saving lives when required for medically indicated reasons, and every effort should be made to provide caesarean sections to women in need, rather than striving to achieve a specific rate (WHO 2015). The caesarean section rate has increased internationally between 2000 and 2017 (OECD 2019). Australia’s caesarean section rate was higher than the OECD average over this time and ranked 27th out of 34 OECD countries in 2017, with a rate of 33.7 per 100 live births (ranked from lowest to highest) (OECD 2019). In 2020, 37% of all women giving birth in Australia had a caesarean section (AIHW 2022). The increasing rates of caesarean sections may be influenced by several maternal and clinical factors and medico legal concerns, however, the reasons for the steep rise remain unexplained. Besides this general increase in caesarean section, a large variation between countries, regions and hospitals has been documented (Betran et al. 2016; Bragg et al. 2010; Librero et al. 2000). 

Whether the operation is a planned elective procedure or an unplanned emergency procedure, receiving clear information on the benefits of the operation and the short- and long-term risks is important to enable an informed decision as to whether to proceed with the caesarean section or not.

More information on caesarean section for all women giving birth can be found in Australia’s mothers and babies.