1.1 Early planned births without medical or obstetric indication
Early planned births are when babies are born before 39 weeks of pregnancy by planned caesarean section or induced labour. Find out about early planned births in the Fourth Australian Atlas of Healthcare Variation 2021.
At at glance
- When planning for birth by caesarean section or induction of labour, waiting until at least 39 weeks gestation results in better outcomes for the baby, unless there are medical or obstetric reasons for earlier birth
- Compared to those born at term, babies born before 39 weeks gestation have higher risks of respiratory problems and the need for intensive care at birth. They may also have higher risks of attention deficit hyperactivity disorder (ADHD) and learning problems in the longer term
- In 2017, the rates for caesarean sections without a medical or obstetric indication varied between states and territories. The estimated ranges across states and territories (excluding the Northern Territory) as percentages of all caesarean sections at these gestational ages, were:
- <37 weeks, 13.3–19.3%
- <38 weeks, 24.8–32.7%
- <39 weeks, 42.8–56.1%.
- Despite a number of data limitations, the estimates suggest that the percentage of caesarean sections performed before 39 weeks without a medical or obstetric indication may be substantial. Action is needed to reduce these rates
- Strategies to reduce rates of early planned caesarean section include changing policies of state and territory governments, hospitals and insurers to stop booking of early planned births without a medical or obstetric indication before 39 weeks
- Rates of induction of labour without a medical or obstetric indication were also examined: in contrast to caesarean section, these percentages were very low, ranging from 0.2% to 6% in 2017 in six reporting states and territories.
Interactive graphs and data
Data show variation in rates by state or territory. To use the interactive graphs hover or click on graphs for details of data points. Learn more about using the interactive Atlas.
Caesarean section data
State and territory
Rates by funding status
//viz.aihw.gov.au/t/Public/views/Perinatalindicators_updated/publicprivate?:iid=1&:isGuestRedirectFromVizportal=y&:embed=y
Rates for Aboriginal and Torres Strait Islander people
//viz.aihw.gov.au/t/Public/views/Perinatalindicators_updated/Indigenousstatus?:iid=1&:isGuestRedirectFromVizportal=y&:embed=y
About the data
About the data - Induction of labour without medical or obstetric indication
A number of limitations with this indicator should be noted.
Data on the reason for early planned birth (by any method) are not available at the national level. Therefore this indicator uses data collected on the reason for induction as a proxy measure for early planned birth.
Differences exist between states and territories in definitions and methods used for collection of data on the main reasons for induction. For this reason, data are not comparable across states and territories.
Some state and territory health departments found in their review of data that recording of the main reason for caesarean section was not always updated as the clinical situation evolved. For example, medical or obstetric indications for early birth, such as fetal compromise, were not always recorded as the main indication for early caesarean section if a caesarean section had already been planned for other reasons. Similarly, clinical events such as pre-labour rupture of membranes may lead to an unplanned early caesarean section, but these were not always recorded if the caesarean section had already been planned for other reasons. This means that the count of planned caesarean sections performed before 39 weeks without medical or obstetric indication is an overestimate for some states. This may also apply to the recording of the reason for induction of labour.
Induction of labour without medical or obstetric indication
The numerator for this indicator is induction of labour ‘without medical or obstetric indication’ at less than 39 completed weeks gestation for the following reasons:
- Administrative or geographical indication
- Maternal choice in the absence of any obstetric, medical, fetal, administrative or geographical indication.
The denominator is the total number of women who gave birth following induction of labour at less than 39 completed weeks gestation.
Data source and subanalyses
Data are sourced from the National Perinatal Data Collection, which includes births that occur in hospitals, birth centres and the community (such as home births), for patients with public or private elected accommodation status. Because of small numbers, data are reported only at the state and territory level. Reporting by smaller geographical area, remoteness and socioeconomic disadvantage is not possible.
Data availability
Data were available for publication for six states and territories for the induction of labour indicator. Nationally, there were 37,278 inductions before 39 weeks gestation without established labour (denominator for this indicator) in 2017. Of these, 26,992 inductions (72.4%) were from the six reporting states and territories; 10,286 (27.6%) were from other states and territories and are not included in the analysis.
State and territory
Rates by funding status
//viz.aihw.gov.au/t/Public/views/Perinatalindicators_updated/publicprivate?:iid=1&:isGuestRedirectFromVizportal=y&:embed=y
Rates for Aboriginal and Torres Strait Islander people
//viz.aihw.gov.au/t/Public/views/Perinatalindicators_updated/Indigenousstatus?:iid=1&:isGuestRedirectFromVizportal=y&:embed=y
About the data
About the data - Induction of labour without medical or obstetric indication
A number of limitations with this indicator should be noted.
Data on the reason for early planned birth (by any method) are not available at the national level. Therefore this indicator uses data collected on the reason for induction as a proxy measure for early planned birth.
Differences exist between states and territories in definitions and methods used for collection of data on the main reasons for induction. For this reason, data are not comparable across states and territories.
Some state and territory health departments found in their review of data that recording of the main reason for caesarean section was not always updated as the clinical situation evolved. For example, medical or obstetric indications for early birth, such as fetal compromise, were not always recorded as the main indication for early caesarean section if a caesarean section had already been planned for other reasons. Similarly, clinical events such as pre-labour rupture of membranes may lead to an unplanned early caesarean section, but these were not always recorded if the caesarean section had already been planned for other reasons. This means that the count of planned caesarean sections performed before 39 weeks without medical or obstetric indication is an overestimate for some states. This may also apply to the recording of the reason for induction of labour.
Induction of labour without medical or obstetric indication
The numerator for this indicator is induction of labour ‘without medical or obstetric indication’ at less than 39 completed weeks gestation for the following reasons:
- Administrative or geographical indication
- Maternal choice in the absence of any obstetric, medical, fetal, administrative or geographical indication.
The denominator is the total number of women who gave birth following induction of labour at less than 39 completed weeks gestation.
Data source and subanalyses
Data are sourced from the National Perinatal Data Collection, which includes births that occur in hospitals, birth centres and the community (such as home births), for patients with public or private elected accommodation status. Because of small numbers, data are reported only at the state and territory level. Reporting by smaller geographical area, remoteness and socioeconomic disadvantage is not possible.
Data availability
Data were available for publication for six states and territories for the induction of labour indicator. Nationally, there were 37,278 inductions before 39 weeks gestation without established labour (denominator for this indicator) in 2017. Of these, 26,992 inductions (72.4%) were from the six reporting states and territories; 10,286 (27.6%) were from other states and territories and are not included in the analysis.
Induction data
Rates by state and territory
About the data
About the data - Induction of labour without medical or obstetric indication
A number of limitations with this indicator should be noted.
Data on the reason for early planned birth (by any method) are not available at the national level. Therefore this indicator uses data collected on the reason for induction as a proxy measure for early planned birth.
Differences exist between states and territories in definitions and methods used for collection of data on the main reasons for induction. For this reason, data are not comparable across states and territories.
Some state and territory health departments found in their review of data that recording of the main reason for caesarean section was not always updated as the clinical situation evolved. For example, medical or obstetric indications for early birth, such as fetal compromise, were not always recorded as the main indication for early caesarean section if a caesarean section had already been planned for other reasons. Similarly, clinical events such as pre-labour rupture of membranes may lead to an unplanned early caesarean section, but these were not always recorded if the caesarean section had already been planned for other reasons. This means that the count of planned caesarean sections performed before 39 weeks without medical or obstetric indication is an overestimate for some states. This may also apply to the recording of the reason for induction of labour.
Induction of labour without medical or obstetric indication
The numerator for this indicator is induction of labour ‘without medical or obstetric indication’ at less than 39 completed weeks gestation for the following reasons:
- Administrative or geographical indication
- Maternal choice in the absence of any obstetric, medical, fetal, administrative or geographical indication.
The denominator is the total number of women who gave birth following induction of labour at less than 39 completed weeks gestation.
Data source and subanalyses
Data are sourced from the National Perinatal Data Collection, which includes births that occur in hospitals, birth centres and the community (such as home births), for patients with public or private elected accommodation status. Because of small numbers, data are reported only at the state and territory level. Reporting by smaller geographical area, remoteness and socioeconomic disadvantage is not possible.
Data availability
Data were available for publication for six states and territories for the induction of labour indicator. Nationally, there were 37,278 inductions before 39 weeks gestation without established labour (denominator for this indicator) in 2017. Of these, 26,992 inductions (72.4%) were from the six reporting states and territories; 10,286 (27.6%) were from other states and territories and are not included in the analysis.
Rates by state and territory
About the data
About the data - Induction of labour without medical or obstetric indication
A number of limitations with this indicator should be noted.
Data on the reason for early planned birth (by any method) are not available at the national level. Therefore this indicator uses data collected on the reason for induction as a proxy measure for early planned birth.
Differences exist between states and territories in definitions and methods used for collection of data on the main reasons for induction. For this reason, data are not comparable across states and territories.
Some state and territory health departments found in their review of data that recording of the main reason for caesarean section was not always updated as the clinical situation evolved. For example, medical or obstetric indications for early birth, such as fetal compromise, were not always recorded as the main indication for early caesarean section if a caesarean section had already been planned for other reasons. Similarly, clinical events such as pre-labour rupture of membranes may lead to an unplanned early caesarean section, but these were not always recorded if the caesarean section had already been planned for other reasons. This means that the count of planned caesarean sections performed before 39 weeks without medical or obstetric indication is an overestimate for some states. This may also apply to the recording of the reason for induction of labour.
Induction of labour without medical or obstetric indication
The numerator for this indicator is induction of labour ‘without medical or obstetric indication’ at less than 39 completed weeks gestation for the following reasons:
- Administrative or geographical indication
- Maternal choice in the absence of any obstetric, medical, fetal, administrative or geographical indication.
The denominator is the total number of women who gave birth following induction of labour at less than 39 completed weeks gestation.
Data source and subanalyses
Data are sourced from the National Perinatal Data Collection, which includes births that occur in hospitals, birth centres and the community (such as home births), for patients with public or private elected accommodation status. Because of small numbers, data are reported only at the state and territory level. Reporting by smaller geographical area, remoteness and socioeconomic disadvantage is not possible.
Data availability
Data were available for publication for six states and territories for the induction of labour indicator. Nationally, there were 37,278 inductions before 39 weeks gestation without established labour (denominator for this indicator) in 2017. Of these, 26,992 inductions (72.4%) were from the six reporting states and territories; 10,286 (27.6%) were from other states and territories and are not included in the analysis.