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Mothers and babies in Australia
AIHW data shows positive trends in antenatal health and outcomes, with regional variations and a caution about rates of overweight and obesity.
The AIHW report shows positive trends in the health of mothers and babies in Australia, although there are some areas that could be further improved.
The Australian Institute of Health and Welfare (AIHW) recently released its report, Australia’s mothers and babies 2017, presenting key statistics from its National Perinatal Data Collection.
The report reveals the number of women giving birth in Australia reached 301,095 in 2017, an increase of 4% since 2007. While this resulted in more babies overall, the rate of women giving birth actually decreased over this same period, from 66 per 1000 women of reproductive age (defined as 15–44 years) to 60.
Australian women are also continuing to give birth later in life, with the average age at all births rising from 29.9 years in 2007 to 30.6 years in 2017. This trend was further reflected in age of first-time birth, which rose from 28.2 to 29.2, while the proportion of mothers aged 35 and over increased from 22% to 24%. Concomitantly, the proportion of mothers aged under 25 fell from 19% to 14%.
The report shows good news in terms of mothers attending antenatal care, with 99.9% of women who gave birth in 2017 having at least one antenatal visit, 94% having five or more, and 58% having 10, the number recommended by the Australian pregnancy care guidelines (the Guidelines) for first-time mothers with an uncomplicated pregnancy.
The Guidelines also recommend that first antenatal visits take place within the first 10 weeks of pregnancy, a condition met by 56% of mothers. Only 8% did not begin antenatal care until after 20 weeks of gestation.
Socioeconomic status and remoteness did have some impact on access. Fewer mothers in lower socioeconomic areas attended antenatal care than those in higher socioeconomic area. But proportions for both did show significant increase of attendance since 2012, from 67% to 69% among lower-socioeconomic mothers and 69% to 76% for higher-socioeconomic mothers.
Proportions of mothers who had five or more antenatal visits were high across the board, but varied slightly according to remoteness and socioeconomic status – 95% of mothers in major cities and 96% in the highest socioeconomic areas compared to 91% of women in very remote areas and 93% in the lowest socioeconomic areas.
Mothers born in non-English-speaking countries were less likely to attend antenatal care in their first trimester, at 66%, compared to 74% of those born in Australia or other English-speaking countries. However, these mothers had similar attendance rates of five or more antenatal visits throughout their pregnancies.
Smoking rates during pregnancy continue to fall, with only one in 10 mothers smoking during pregnancy, down from 14.6% in 2009.
Two-thirds of Australian mothers gave birth vaginally in 2017 while the remaining third had caesareans. Most vaginal births were non-instrumental, but this category of birth decreased with maternal age and increased slightly with each category of remoteness. Socioeconomic status also appeared to influence the likelihood of non-instrumental vaginal birth, with mothers in the highest socioeconomic areas experiencing a rate of 50% compared to 57% of mothers in the lowest socioeconomic.
One in 18 of all babies born in 2017 was Aboriginal and/or Torres Strait Islander, and these mothers tended to be younger than non-Indigenous mothers, with three in four aged under 30.
Overall outcomes showed positive trends for this demographic, with a greater number of Aboriginal and Torres Strait Islander mothers accessing antenatal care in their first trimester – 63% compared to 50% in 2012 – while 88% attended at least five antenatal visits, an increase from 86% in 2012.
Like their non-Indigenous counterparts, the numbers of Aboriginal and Torres Strait Islander mothers smoking during pregnancy decreased, to about two in five compared to half in 2009. This appeared to be influenced by location, with rates of smoking highest among these mothers in remote and very remote locations, and lowest in major cities.
Aboriginal and Torres Strait Islander mothers also had the highest rates of non-instrumental vaginal births, at 64%, and the lowest for caesarean at 29%, although these caesarean rates have increased from 24% in 2007.
However, there are still a number of disparities across a range of maternal and perinatal measures between Aboriginal and Torres Strait Islander mothers and babies and their non-Indigenous counterparts. For example, Aboriginal and Torres Strait Islander mothers are eight times more likely to be teenagers and 1.2 times more likely to have gestational diabetes, while their babies are 1.5 times as likely to be admitted to a neonatal intensive care unit and 1.6 times as likely to be stillborn.
One serious health concern that is rising across the Australian population is the increase in overweight and obesity during pregnancy, which leads to increased risk to mothers and babies, including of thromboembolism and pre-eclampsia during pregnancy and congenital abnormality among babies.
Almost half of all mothers who gave birth were overweight or obese at their first antenatal visit in 2017. Broken down further, 20% of all mothers were classified as obese, 25.6% were overweight, 50% were in the normal weight range and 3.9% were underweight.
Overweight and obesity increased with maternal age (37% of mothers under 20 compared to 51% of mothers aged 40 and over), and mothers who had a caesarean section were more likely to be overweight or obese, at 53%.
The RACGP offers a number of resources to assist GPs in delivering quality antenatal and postnatal care.
For preventive activities relating to prenatal and antenatal care:
Relating to maternity and post-natal care:
AIHW Antenatal care Child and maternity health Maternity care Reproductive health
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