Technical notes
Terminology
Sex and gender terminology
This report uses the terms ‘woman’, ‘women’, ‘mother’ and ‘mothers’ to mean females who were pregnant or gave birth. ‘Woman’ and ‘women’ typically refers to groups of people aged 18 years and over; however, in this report, people who were pregnant or gave birth aged less than 18 are included.
It is acknowledged that this report includes people who do not identify as women or mothers, and that individual parents and families may use different words to those used in this report. This may include transgender men, intersex people, non-binary and gender diverse people.
First Nations terminology
The AIHW uses ‘First Nations people’ to refer to Aboriginal and/or Torres Strait Islander people in this report.
Data sources
National Perinatal Data Collection
Analysis in this report uses data from the National Perinatal Data Collection (NPDC) for 2020 to 2022, including voluntary mental health screening items contributed by states and territories under the 2020–21, 2021–22 and 2022–23 National Best Endeavours Data Set (NBEDS).
See Availability of perinatal data for more information about what perinatal data are available in the NPDC and NBEDS.
See Australia's mothers and babies for more information on how data are collected for the NPDC and its structure.
Table 3: Overview of state and territory health authorities that supplied the mental health and family violence data items, 2020 and 2022
| Year | Vic | Qld | WA | Tas | ACT | Per cent of mothers from supplying state and territory health authorities with a stated result(a)(b) (%) | Per cent of all mothers nationally with a stated result(a) (%) |
|---|---|---|---|---|---|---|---|
2020 | ✓ | ✓ | ✓ | ✓ | 96.5 | 33.8 | |
2021 | ✓ | ✓ | ✓ | ✓ | 96.8 | 33.9 | |
2022 | ✓(b) | ✓ | ✓ | ✓ | ✓(c) | 93.9(c) | 45.3(c) |
| Year | Vic | Qld | WA | Tas | ACT | Per cent of mothers from supplying state and territory health authorities with a stated result(a)(b) (%) | Per cent of all mothers nationally with a stated result(a) (%) |
|---|---|---|---|---|---|---|---|
2020 | ✓ | ✓ | ✓ | 75.7 (99% of 'Yes' Antenatal mental health risk screening status) | 18.3 | ||
2021 | ✓ | ✓ | ✓ | 75.3 (99% of 'Yes' Antenatal mental health risk screening status) | 18.1 | ||
2022 | ✓(b) | ✓ | ✓ | ✓(c) | 61.2 (99% of 'Yes' Antenatal mental health risk screening status)(c) | 22.9 |
| Year | Vic | Qld | WA | Tas | ACT | Per cent of mothers from supplying state and territory health authorities with a stated result(a)(b) (%) | Per cent of all mothers nationally with a stated result(a) (%) |
|---|---|---|---|---|---|---|---|
2020 | ✓ | ✓ | ✓ | 100 | 24.1 | ||
2021 | ✓ | ✓ | ✓ | 100 | 24.0 | ||
2022 | ✓(b) | ✓ |
| ✓ | ✓(c) | 98.8(c) | 36.9 |
| Year | Vic | Qld | WA | Tas | ACT | Per cent of mothers from supplying state and territory health authorities with a stated result(a)(b) (%) | Per cent of all mothers nationally with a stated result(a) (%) |
|---|---|---|---|---|---|---|---|
2020 | ✓ | ✓ | 99.6 | 12.9 | |||
2021 | ✓ | ✓ | 99.6 | 21.9 | |||
2022 | ✓(b) | ✓ | ✓ | ✓ | 91.1(c) | 42.0(c) |
Source: AIHW analysis of the NPDC, 2020 to 2022.
Notes:
- Stated results exclude mothers with ‘Unknown’, ‘Not stated/inadequately described’ or missing results. For instance, for the Total EPDS score item, stated results include a score of 0 to 30.
- Victoria supplied data from 1 July 2022. Denominator of ‘Per cent of mothers from supplying jurisdictions with a stated result’ excludes births in Victoria prior to 1 July 2022.
- Data for births occurring during the 2022 calendar year are based on complete data for 7 jurisdictions and a compilation of data for the ACT. The ACT’s data consists of their 2022 data for January to October, supplemented by their 2021 data for November and December. Care should be taken if comparing data across time and jurisdictions.
Perinatal Mental Health pilot Collection
Analysis in this report uses detailed antenatal mental health and family violence risk factor screening contributed to the Perinatal Mental Health pilot collection, for mothers screened in New South Wales public maternity services between July 2019 and June 2022.
See Risk factors in New South Wales antenatal mental health and family violence screening on this page for details on specific items reported.
Methods
Analysis in this report and supporting data tables presents maternal and pregnancy characteristics of:
- all mothers who gave birth in Australia between 2020 and 2022
- all mothers who gave birth in Queensland, Tasmania and the Australian Capital Territory
- mothers who gave birth in:
- New South Wales public hospitals
- New South Wales private hospitals
- Public hospitals from states and territories other than New South Wales
- mothers who received antenatal mental health and family violence screening in NSW public health services
the maternal and pregnancy characteristics, and EPDS screening results for:
- all mothers who gave birth in Queensland, Tasmania and the Australian Capital Territory and had a recorded antenatal mental health screening result.
- mothers who received antenatal mental health and family violence screening in NSW public health services
and additional psychosocial risk factor results for mothers who received antenatal mental health and family violence screening in NSW public health services
In most cases, proportions, percentages and rates for maternal characteristics exclude cases where the variable of interest is missing, recorded as not stated, or is inadequately described.
New South Wales, South Australia, Western Australia, and the Northern Territory did not supply data on the use of assisted reproductive technologies to the NPDC for 2020–2022.
New South Wales and Western Australia did not supply data on previous pregnancies resulting in live birth and previous still birth to the NPDC for 2020–2022.
New South Wales did not supply data on alcohol consumed during first 20 weeks and alcohol consumed after 20 weeks to the NPDC for 2020–2022.
States and territories that did not supply data for specific data items are excluded from the calculations for all mothers.
Where a pregnancy resulted in multiple births (twins, triplets, and so on), birth setting and gestational age from the first birth are reported. Where any birth resulted in stillbirth, birth outcomes are reported as ‘any stillbirth’. Birth outcomes are reported as ‘all live births’ where all babies were live born, regardless of subsequent survival or death in the perinatal and postnatal periods.
This report uses the Australian Statistical Geography Standard (ASGS) Remoteness Structure which classifies geographical areas based on their relative access to services.
Remoteness Areas are assigned to the smallest statistical geography unit in the ASGS, Statistical Area 1 (SA1), describing an area with a population of between approximately 200 and 800 people.
This report uses ASGS Remoteness Areas mapped to the Statistical Area 2 (SA2) of mother’s usual residence. As Remoteness Areas are assigned at the SA1 level, which aggregate to form SA2s, some SA2s include more than one Remoteness Area. For mothers in an SA2 containing more than one Remoteness Area, counts of mothers were proportionally assigned based to Remoteness Areas based on the estimated percentage of persons in each Remoteness Area within the SA2. Remoteness areas were derived by applying ABS ASGS Edition 3 (2021) to SA2 of mother's usual residence for New South Wales, Victoria, Queensland and Tasmania in 2022, and by applying ABS ASGS Edition 2 (2016) to SA2 of mother's usual residence for remaining jurisdictions in 2022 and all jurisdictions in 2020 and 2021.
In this report, remoteness is not reported for mothers not usually resident in Australia or where the mother’s SA2 or state of usual residence was not stated, inadequately described, was unable to be mapped to a Remoteness Area, or was in a territory other than Northern Territory or Australian Capital Territory. Table 4 shows the number of mothers for whom remoteness is not reported.
State of baby’s birth | N (%) |
|---|---|
New South Wales | 2,242 (0.8) |
Victoria | 221 (0.1) |
Queensland | 91 (0.1) |
South Australia | 33 (0.1) |
Western Australia | 1,751 (1.8) |
Tasmania | – |
Northern Territory | 4 (0.0) |
Australian Capital Territory | 2 (0.0) |
See the Australian Statistical Geography Standard (ASGS): volume 5 - remoteness structure, July 2016 (ABS 2018a) and Australian Statistical Geography Standard (ASGS) Edition 3 (ABS 2021a) for further information on Remoteness Areas.
The Socio-Economic Indexes for Areas (SEIFA) summarises a range of variables to rank geographic areas of Australia according to relative socio-economic advantage or disadvantage. This report uses the Index of Relative Socioeconomic Disadvantage (IRSD) developed by the Australian Bureau of Statistics for use at Statistical Area Level 2 (SA2), defined geographic areas generally containing between 3,000 and 25,000 people. SEIFA quintiles were derived by applying the ABS 2021 IRSD to SA2 of mother’s usual residence for New South Wales, Victoria, Queensland and Tasmania in 2022, and by applying ABS 2016 SEIFA IRSD to SA2 of mother’s usual residence for remaining jurisdictions in 2022 and all jurisdictions in 2020 and 2021.
The IRSD is a summary measure for a geography area and describes the average level of disadvantage in that area. Socio-economic advantage and disadvantage varies at the individual level within each SA2. A SEIFA rank does not apply to an individual but summarises characteristics of the geographic area such as income and opportunities in education and employment.
This report uses SEIFA quintiles, five approximately equal sized groups ranking geographic areas from the least advantaged (Q1) to the most advantaged (Q5). Mothers are classified into SEIFA quintiles based on their SA2 of usual residence.
In this report, SEIFA scores are not reported for mothers not usually resident in Australia or where the mother’s SA2 or state of usual residence was not stated, inadequately described, was unable to be mapped to a SEIFA score, or was in a territory other than Northern Territory or Australian Capital Territory. Table 5 shows the number of mothers for whom SEIFA is not reported.
State of baby’s birth | N (%) |
|---|---|
New South Wales | 2,477 (0.9) |
Victoria | 269 (0.1) |
Queensland | 78 (0.1) |
South Australia | 395 (0.7) |
Western Australia | 1,820 (1.9) |
Tasmania | – |
Northern Territory | 34 (0.3) |
Australian Capital Territory | 392 (2.1) |
See Socio-Economic Indexes for Areas (SEIFA), Australia, 2021 (ABS 2018c) and Socio-Economic Indexes for Areas (ABS 2023) for further information on SEIFA.
Country of birth is recorded using the Standard Australian Classification of Countries (SACC) a four-digit hierarchical structure classifying countries into major and minor groups country. Mothers born in Australia are identified using the minor group and country codes for Australia and its external territories (11, 1101, 1102 & 1199).
Gestational age uses the number of completed weeks of pregnancy at the time of birth. In this report, mothers were classified as pre-term if they gave birth at between 20 and 36 completed weeks of pregnancy, as at term if they gave birth between 37 and 41 weeks, and post-term if they gave birth at 42 or more completed weeks of pregnancy.
Age-standardised rates enable comparisons to be made between populations that have different age structures. Data tables for this report include age-standardised rates using direct standardisation, in which the age-specific rates are applied to a constant population.
Age-standardised rates in supporting data tables use the June 2001 Australian female estimated resident population aged 15–44 as the reference population using five-year age groups. Limited 10-year age groups were used for some characteristics due to small numbers (tables 6 and 7).
Age-standardised rates are not reported for post-term births due to small numbers.
| Characteristic of mother or pregnancy | Age groups |
|---|---|
| 15–24, 25–29, 30–34, 35–39 and 40–44 |
| 15–19, 20–24, 25–29, 30–34, 35–44 |
| 15–19, 20–24, 25–29, 30–34, 35–39 and 40–44 |
Risk factors | Age groups |
|---|---|
| 15–24, 25–29, 30–34, 35–39 and 40–44 |
| 15–24, 25–29, 30–34, 35–44 |
Risk factors reported for New South Wales detailed antenatal mental health screening data includes risks derived from the Safe Start and Edinburgh Postnatal Depression Scale (EPDS) screening tools. EPDS screening is provided as a component of Safe Start screening, but analysis also includes EPDS results from screening conducted under the Perinatal Integrated Psychosocial Assessment study (PIPA) at Sydney's Royal Hospital for Women. Other data items from PIPA screening have not been included in the analysis.
Where multiple screens are recorded for a mother, results are reported for each pregnancy. Risk factors are reported if they were recorded in any screen during a pregnancy, and the screening date and maternal age from the first screen for a pregnancy are used.
Table 8 outlines the tools and data items used to derive risk factors.
Table 8: Risk factors from detailed New South Wales antenatal screening data
| Risk factor | Tool | Definition |
|---|---|---|
| Lack of emotional support | Safe Start | Responded to Safe Start item 2 (Do you have someone you are able to talk to about your feelings or worries?) with "No". |
| Major stressors in past year | Safe Start | Responded to Safe Start item 3 "Have you had any major stressors, changes or losses recently (i.e. in the last 12 months) such as, financial problems, someone close to you dying, or any other serious worries?)" with "Yes" or any specific stressor. |
| History of mental health problems | Safe Start | Responded "Yes" to Safe Start item 6a "Have you ever felt anxious, miserable, worried or depressed for more than a couple of weeks?" and responded "Yes" to either Safe Start item 6b "If so, did it seriously interfere with your work and your relationships with friends and family?" or Safe Start item 7 "Are you currently receiving, or have you in the past received, treatment for any emotional problems?" |
| Adverse childhood experiences (physical, emotional or sexual abuse) | Safe Start | Responded "Yes" to Safe Start item 10, "Now that you are having a child of your own, you may think more about your own childhood and what it was like. As a child were you hurt or abused in any way (physically, emotionally, sexually)?" |
| Domestic violence | Safe Start | Responded "Yes" to either Safe Start item 11 "Within the last year have you been hit, slapped, or hurt in other ways by your partner or ex‑partner?" or Safe Start item 12 "Are you frightened of your partner or ex‑partner?" or provided a response indicating being frightened by specifically their partner or ex-partner. |
| High risk of depression | EPDS | Completed EPDS with total score of 13 or higher. |
| Possible symptoms of anxiety | EPDS | Completed EPDS items 3, 4 and 5, with total sum for these items of 5 or higher. |
| Thoughts of self-harm | EPDS | Responded to EPDS item 10 (The thought of harming myself has occurred to me) with "Hardly ever", "Sometimes", or "Yes, quite often". |
Australian Bureau of Statistics (ABS) (2018a) Australian Statistical Geography Standard (ASGS): volume 5 - remoteness structure, July 2016, ABS, Australian Government, accessed 26 September 2023.
ABS (2018c) Socio-Economic Indexes for Areas (SEIFA), Australia, 2016, ABS, Australian Government, accessed 26 September 2023.
ABS (2021a) Australian Statistical Geography Standard (ASGS) Edition 3, ABS, Australian Government, accessed 24 October 2024.
ABS (2023) Socio-Economic Indexes for Areas (SEIFA), Australia, ABS, Australian Government, accessed 24 October 2024.