Assessing Australia’s maternal health

Amanda Lyons

25/10/2018 3:52:47 PM

The AIHW’s reports on maternal health reveals caesarean sections are rising, low birthweights are falling, and there are significant variances between women in rural and metropolitan areas.

The AIHW reports show that caesareans and birthweights are both increasing in Australia, while pregnancy smoking rates are falling.
The AIHW reports show that caesareans and birthweights are both increasing in Australia, while pregnancy smoking rates are falling.

The Australian Institute of Health and Welfare (AIHW) has released two reports tracking maternal health in Australia.
The first, National core maternity indicators (NCMI), presents information on measures of clinical activities and outcomes, and is designed to monitor and evaluate Australian practice with a goal towards improvement. It divides data on 12 indicators into three topic areas – antenatal period, labour and birth, and birth outcomes.
NCMI found that rates of women smoking in the first 20 weeks of their pregnancy, a risk factor for issues such as placental complications and perinatal death of their baby, have declined from a rate of 12.9% to 9.5% between 2011–16. Three out of four women who did smoke in the first 20 weeks, continued to do so after this period.
However, the percentage of women and babies receiving antenatal care in the first trimester after birth rose for the first time since 2011, increasing by almost 3% to a rate of 68.6% in 2016.
The numbers of women having caesarean sections when giving birth for the first time rose from 25.3% in 2004 to 28.5% in 2016. This increase is in line with international trends, but places Australia 26th out of the 33 Organisation for Economic Co-operation and Development (OECD) countries and far outstrips the rate necessary for improvements in maternal and newborn mortality.
Conversely, rates of non-instrumental vaginal births, which tend to result in fewer postnatal complications, fell from 51.9% in 2004 to 45.5% in 2016. Within this number, however, the number of women who had episiotomies rose by 4.6% from 16.2% in 2004 to 20.8% in 2016.
The birth outcome measures detailed by NCMI yielded mixed results: the rate of babies with low Apgar scores, which measure a baby’s condition shortly after birth, increased to 1.4% in 2016 from 0.9% in 2004. Also, the rate of mothers experiencing third-degree and fourth-degree tears, which are the most severe, increased slightly from 5.2% in 2013 to 5.3% in 2016 – although this represented a decrease from 2015, when they measured at 5.6%.
The numbers of small babies born declined significantly, from 2.1% in 2004 to 1.4% in 2016.
The second AIHW report, Child and maternal health in 2014–2016, is published on the MyHealthyCommunities website and helps people assess the performance of their local health area and compare it with similar areas.
It tracks and details four key maternal and child health indicators: smoking during pregnancy, child and infant mortality, low birthweight babies, and antenatal visits in the first trimester of pregnancy.
While this report shows many of the same national statistics as NCMI, the localised nature of the data revealed significant discrepancies between women in rural and metropolitan areas in each indicator.
Almost 17% of mothers in rural areas reported smoking at some point during their pregnancy, compared to 7.5% in metropolitan areas, while almost one in two Aboriginal and Torres Strait Islander women smoked during pregnancy.
While the national mortality rate of infants and young children was 3.9 deaths per 1000 live births, rural areas experienced a rate of 4.3, while the rate in metropolitan areas was 1.3. However, the proportion of babies with a low birthweight was the similar in both areas, and close to the national rate of 5%.

AIHW child and maternity health Maternity care reproductive health

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