Caesarean section

Chart title: Caesarean section for selected women giving birth for the first time, by State/territory of birth and all Australia, 2004 to 2018.

This chart shows the proportion of women receiving a Caesarean section for selected women giving birth for the first time, by state/territory of birth, 2004 to 2018.  Data can be viewed for each state/territory of birth, and for all Australia. The proportion for selected women giving birth for the first time receiving a Caesarean section increased from 25.3% in 2004 to 30.1% in 2018.

Selected women

Selected women include those aged between 20 and 34 years, whose baby’s gestational age at birth was between 37 and 41 completed weeks, with a singleton baby in the vertex presentation.

Comparison of ‘selected’ groups of women allows for an indication of standard practice. Selected women, for this indicator, refers to a cohort of mothers who are expected to have reduced labour complications and better birth outcomes. The proportion of selected women is approximately one-third (29.1%) of all women who gave birth in 2018.

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 2016). A caesarean section may be planned (elective) if there is a reason that prevents the baby being born by a vaginal birth, 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 caesarean section rate has increased internationally between 2000 and 2015 (OECD 2015). Australia’s caesarean section rate was higher than the OECD average over this time and ranked 26th out of 33 OECD countries in 2015, with a rate of 32 per 100 live births (ranked from lowest to highest) (OECD 2015). The increasing rates of caesarean sections may be influenced by a number of 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.

Indicator specifications and data

Excel source data tables are available from the Data tab.

For more information refer to Specifications and notes for analysis in the technical notes.