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<pre>
 
 

 
 

 
 

 
 

 
 

 
  

 
 

For more information 

SA Health 
Pregnancy Outcome (Statistics) Unit 
Epidemiology Branch 
162 Grenfell Street 
Adelaide 5000 South Australia 

Postal Address 
SA Health 
Pregnancy Outcome (Statistics) Unit 
PO Box 6, Rundle Mall, 
Adelaide 5000 South Australia 
Telephone: (08) 8226-6382 
Fax: (08) 8226-6291 
Web: www.health.sa.gov.au/pehs/pregnancyoutcome.htm 

www.dh.sa.gov.au/pehs/pregnancyoutcome.htm 

E-mail: Pregnancy.Stats@health.sa.gov.au 

Non-English speaking: for information in languages other than English, call the 
interpreting and Translating Centre and ask them to call The Department of Health. This 
service is available at no cost to you, contact (08) 8226 1990. 

  Department of Health, Government of South Australia. 

All rights reserved. ISSN: 0819-3835 

FIS: 9255.1. Printed January 2010.
 



 
  

Pregnancy 

Outcome
 

in South Australia 
2008 

December 2009 

Pregnancy Outcome Unit, 
Epidemiology Branch, SA Health 



 
 

 
 

 
 

 
 

 
 

 
 

 

 

  
  

 

December 2009 
Pregnancy Outcome in South Australia 2008 
  SA Health 

Address: 
Pregnancy Outcome (Statistics) Unit 
Epidemiology Branch 
SA Health, Government of South Australia 
162 Grenfell Street 
Adelaide 5000 
South Australia 

Postal Address: 
Pregnancy Outcome (Statistics) Unit 
SA Health, Government of South Australia 
PO Box 6, Rundle Mall, 
Adelaide 5000 
South Australia 

Telephone:  (08) 8226-6382 
Fax:  (08) 8226-6291 

Web: 	 www.health.sa.gov.au/pehs/pregnancyoutcome.htm 
www.dh.sa.gov.au/pehs/pregnancyoutcome.htm 

E-mail: Pregnancy.Stats@health.sa.gov.au 
ISSN 0819-3835 

Suggested citation: Chan A, Scott J, Nguyen A-M, Sage L. Pregnancy Outcome in South Australia 2008. 
Adelaide: Pregnancy Outcome Unit, SA Health, Government of South Australia, 2009. 



 
 

Pregnancy Outcome in 

South Australia 2008
 

Annabelle Chan 

Joan Scott
 

Anh-Minh Nguyen
 
Leonie Sage
 

December 2009
 

Pregnancy Outcome Unit
 
SA Health
 



 
  

 

 

 

 

  

  

 

   

 

 

 

 

 

  
   

Acknowledgements 

Acknowledgements 

We would like to thank all midwives and nurses in South Australia who completed and submitted the Supplementary 
Birth Records on which the perinatal data collection is based. We thank them also for responding so efficiently to 
our queries. 

We would also like to express our sincere thanks to the following: 

&gt; doctors who notified births with congenital abnormalities and those who notified terminations of pregnancy; 

&gt; the pathology departments of teaching hospitals for autopsy information; 

&gt; the Cytogenetics and Molecular Genetics Unit, Women s and Children s Hospital, for cytogenetics reports; 

&gt; the Births, Deaths and Marriages Registration Division for data and perinatal death certificates; 

&gt; the Coroner s Office for Coroner s findings and autopsy reports; 

&gt; Kevin Priest of the Health Statistics Unit for his assistance in programming and provision of perinatal data to the 
National Perinatal Statistics Unit and in data linkage; 

&gt;	 Ann-Marie Twisk, Anh-Minh Nguyen, Graeme Tucker and Britt Catcheside of the Health Statistics Unit for assistance 
with responding to data  requests and in data linkage; 

&gt; Maureen Fisher and the Communications Division of SA Health for the graphics. 

Staff 

Annabelle Chan Head/Senior medical consultant 
Clinical Associate Professor, Discipline of Obstetrics and Gynaecology, University of Adelaide 

Joan Scott Senior midwife 

Leonie Sage Senior midwife, Abortion statistics 

Maureen Fisher Administrative officer 

Judith Thompson Administrative officer 

Kerry Jolly Midwife 

Robyn Kennare Senior midwife, 
Maternal, Perinatal &amp; Infant Mortality Committee 

page 2 Pregnancy Outcome in South Australia 2008 



 
 
 

 

 

 

 

 

 

 

 

 

 

 

 

 
 

 

 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Contents 

Contents 

Acknowledgements 2
 

Executive Summary 10
 
1. Numbers and fertility rates ............................................................................................................................. 10
 

2. Place of birth.................................................................................................................................................. 10
 

3. Teenage women............................................................................................................................................. 10
 

4. Older women and first time mothers.............................................................................................................. 10
 

5. Country of birth and race............................................................................................................................... 10
 

6. Smoking during pregnancy and Body Mass Index ........................................................................................... 10
 

7. Antenatal care and length of stay................................................................................................................... 11
 

8. Aboriginal women ......................................................................................................................................... 11
 

9. Procedures ..................................................................................................................................................... 11
 

10. Method of birth ........................................................................................................................................... 11
 

11. Multiple births.............................................................................................................................................. 11
 

12. Abortions..................................................................................................................................................... 11
 

13. Perinatal mortality ........................................................................................................................................ 12
 

I. Introduction 13
 
1. The Perinatal Statistics Collection ................................................................................................................... 13
 

2. The Abortion Statistics Collection ................................................................................................................... 13
 

II. Mothers and Babies: Characteristics and Outcomes 14
 
1. Place of residence of mother .......................................................................................................................... 14
 

2. Place of birth of baby ..................................................................................................................................... 15
 

3. Maternal race................................................................................................................................................. 21
 

4. Maternal age ................................................................................................................................................. 22
 

5. Country of birth ............................................................................................................................................. 24
 

6. Marital status and type of patient................................................................................................................... 26
 

7. Occupation of father and mother................................................................................................................... 27
 

8. Previous pregnancy outcomes ........................................................................................................................ 28
 

9a. Gestation at first antenatal visit .................................................................................................................... 29
 

9b. Body Mass Index (BMI) ................................................................................................................................. 29
 

9c. Antenatal visits ............................................................................................................................................. 30
 

9d. Type of antenatal care .................................................................................................................................. 31
 

10. Smoking ...................................................................................................................................................... 31
 

11. Medical conditions ....................................................................................................................................... 33
 

12. Obstetric complications ................................................................................................................................ 33
 

13. Procedures performed in current pregnancy ................................................................................................. 34
 

14a. Onset of labour .......................................................................................................................................... 34
 

page 3Pregnancy Outcome in South Australia 2008 



 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 

 

 

 

 

 

 

 

 
 

 

 
 

 
 

 

 

 

 

Contents 

14b. Reasons for induction of labour.................................................................................................................. 35
 

15a. Presentation and method of birth............................................................................................................... 36
 

15b. Reason for caesarean section ..................................................................................................................... 38
 

16. Complications of labour and birth and perineal status after birth.................................................................. 40
 

17. Fetal monitoring during labour..................................................................................................................... 40
 

18. Analgesia for labour and anaesthesia for birth.............................................................................................. 41
 

19. Postnatal length of stay of women............................................................................................................... 41
 

20. Sex of baby .................................................................................................................................................. 42
 

21. Birthweight and gestation ............................................................................................................................ 43
 

22. Birth injuries................................................................................................................................................. 43
 

23. Treatment given in neonatal period .............................................................................................................. 44
 

24. Level of care utilised..................................................................................................................................... 44
 

25. Length of stay of babies ............................................................................................................................... 44
 

26. Congenital abnormalities ............................................................................................................................. 45
 

27. Multiple births.............................................................................................................................................. 47
 

28. Perinatal mortality ........................................................................................................................................ 48
 

29. Home births ................................................................................................................................................. 51
 

30. Birthing unit births ....................................................................................................................................... 53
 

III. Terminations of Pregnancy 55
 
1. Numbers and rates......................................................................................................................................... 55
 

2. Age of women............................................................................................................................................... 57
 

3. Marital status ................................................................................................................................................. 59
 

4. Place of residence and place where termination performed ............................................................................ 60
 

5. The reason for termination............................................................................................................................. 61
 

6. Gestation, method and complications ............................................................................................................ 61
 

7. Previous terminations. Total abortion rate and Total first abortion rate ............................................................ 62
 

IV. Obstetric Profiles by Hospital Category 64
 

V. Clinical and Maternity Performance Indicators 74
 
1. Clinical indicators ........................................................................................................................................... 74
 

2. Maternity performance indicators, hospitals with at least 500 births per year ................................................. 77
 

VI. Trends in Perinatal Statistics in South Australia,1981 2008 81
 
Trends in Perinatal Statistics in South Australia (SA), 1985   2008....................................................................... 85
 

VII. Summary statistics for 2008 88
 
1. Number of births............................................................................................................................................ 88
 

2. Place of birth.................................................................................................................................................. 88
 

3. Sex................................................................................................................................................................. 88
 

4. Plurality and condition at birth ....................................................................................................................... 88
 

5. Race of women.............................................................................................................................................. 88
 

page 4 Pregnancy Outcome in South Australia 2008 



 
 

 

 

 

 

 
  

 

   

   

   

   

   

 

 

 

   

  
  

  

   
  

   

  

   

  

   

   

  

   

   

   

Tables 

6. Obstetric interventions in 19,672 women who gave birth............................................................................... 89
 

7. Low birthweight (&lt;2,500g) ............................................................................................................................ 89
 

8. Congenital abnormalities ............................................................................................................................... 89
 

9. Perinatal morality rates (numbers of deaths in parentheses)............................................................................ 89
 

10. Terminations of pregnancy ........................................................................................................................... 89
 

References 90
 

Publications 90
 
Annual Reports ................................................................................................................................................. 90
 

Other reports/papers .......................................................................................................................................... 91
 

1. Birth defects ........................................................................................................................................ 91
 

2. Termination of pregnancy .................................................................................................................... 93
 

3. Perinatal epidemiology......................................................................................................................... 93
 

4 Perinatal mortality................................................................................................................................ 96
 

5. Caesarean section................................................................................................................................ 96
 

Appendix 1: Definitions 97 

Appendix 2: 2008 Supplementary Birth Record Form 101 

Appendix 3: Congenital Abnormality Form 102 

Tables 

Table 1: Births and crude birth rate by CURB regions, South Australia, 2008 ........................................ 14 

Table 2: Total births notified in 2008, by place of birth and plurality, South Australia 
(based on Supplementary Birth Records).................................................................................... 15 

Table 3a: Hospital births by category of hospital, South Australia, 2008 ................................................. 17 

Table 3b: Hospital births in South Australia in 2008 by race and hospital (as indicated by returned 
SBRs for hospital births) ............................................................................................................... 18
 

Table 4a: Race of women who gave birth, South Australia, 2008............................................................. 21
 

Table 4b: Race and birthplace category of women who gave birth, South Australia, 2008.................... 21
 

Table 4c: Age and race of women who gave birth, South Australia, 2008 .............................................. 22
 

Table 4d: Age-specific fertility rates, South Australia, 2008 ...................................................................... 23
 

Table 5a: Country of birth, major groups, women who gave birth, South Australia, 2008 .................... 24
 

Table 5b: Specified country of birth, women who gave birth, South Australia, 2008 ............................. 25
 

Table 6a: Marital status and age, women who gave birth, South Australia, 2008 .................................. 26
 

Table 6b: Type of patient and marital status, women who gave birth, South Australia, 2008 ............... 26
 

Table 7: Occupation of father and mother, women who gave birth, South Australia, 2008 ................ 27
 

Table 8a: Parity by race, women who gave birth, South Australia, 2008 ................................................. 28
 

page 5Pregnancy Outcome in South Australia 2008 



   
  

  
  

  

  

   

  
  

 
  

   

   

   
  

   

  

  
  

   

   

  
  

   
  

   

  

   

   

 
  

   
  

   

   

   

   

   

Tables 

Table 8b: Previous pregnancy outcomes, women who gave birth, South Australia, 2008 


Table 9a: Gestation at first antenatal visit, women who gave birth, by race, 


Table 10a: Tobacco smoking status at first antenatal visit, non-Aboriginal and Aboriginal women 


Table 10b: Average number of tobacco cigarettes smoked per day in the second half of pregnancy, 


Table 14c: Augmentation of labour after spontaneous onset, women who gave birth, 


Table 15c: Method of birth in breech presentation, by plurality, all births, South Australia, 


Table 19a: Postnatal length of stay by type of patient, women who gave birth in 


Table 19b: Average postnatal length of stay by type of patient &amp; type of birth, women who gave 


(multigravidae only, n=13,711).................................................................................................... 28
 

South Australia, 2008 (n=19,672) ................................................................................................ 29
 

Table 9b: BMI of women who gave birth, South Australia, 2008.............................................................. 30
 

Table 9c: Antenatal visits by race, women who gave birth, South Australia, 2008 ................................. 30
 

Table 9d: Type of antenatal care, women who gave birth, South Australia, 2008 (n=19,672)................ 31
 

who gave birth, South Australia, 2008........................................................................................ 32
 

non-Aboriginal and Aboriginal women who gave birth, South Australia, 2008 ..................... 32
 

Table 11: Medical conditions in current pregnancy, women who gave birth, South Australia, 2008.....33
 

Table 12: Frequency of some obstetric complications, women who gave birth, South Australia, 2008.33
 

Table 13: Procedures performed in current pregnancy, women who gave birth, 

South Australia, 2008 ................................................................................................................... 34
 

Table 14a: Onset of labour, women who gave birth, South Australia, 2008.............................................. 34
 

Table 14b: Method of induction of labour, women who gave birth, South Australia, 2008..................... 35
 

South Australia, 2008 ................................................................................................................... 36
 

Table 15a: Method of birth, women who gave birth, South Australia, 2008............................................. 36
 

Table 15b: Method of birth by presentation, all births, South Australian 2008 (n=19,970) ...................... 37
 

2008 (n=969) ................................................................................................................................. 38
 

Table 16: Frequency of some complications of labour and birth, women who gave birth, 

South Australia, 2008 ................................................................................................................... 40
 

Table 17a: CTG performed during labour, women who gave birth, South Australia, 2008 ...................... 40
 

Table 17b:  Fetal scalp pH taken during labour, women who gave birth, South Australia, 2008 ............. 40
 

Table 18a: Analgesia for labour, women who gave birth, South Australia, 2008...................................... 41
 

Table 18b: Anaesthesia for birth, women who gave birth, South Australia, 2008..................................... 41
 

South Australian hospitals, 2008 ................................................................................................. 42
 

birth in South Australian hospitals, 2008.................................................................................... 42
 

Table 20: Sex of baby, all births, South Australia, 2008 ............................................................................. 42
 

Table 21: Birthweight distribution of all births, South Australia, 2008 .................................................... 43
 

Table 22: Birth injuries in 19,819 live births, South Australia, 2008 .......................................................... 43
 

Table 23: Neonatal treatment given, all live births, South Australia, 2008 .............................................. 44
 

Table 24: Level of nursery care utilised by birthweight, all live births, South Australia, 2008 ................ 44
 

page 6 Pregnancy Outcome in South Australia 2008 



  

  
  

   

  

  

   

   

  

   

  

  

   

   

   

   

   

   

  

  

  

   

   

  

   

  

  

   

  

  

  
  

  

  

Tables 

Table 25: Length of stay of liveborn babies in hospital, South Australia, 2008 ....................................... 45
 

Table 26: Selected congenital abnormalities notified to the perinatal statistics collection, 

1998-2008, South Australia .......................................................................................................... 46
 

Table 27a: Birthweight by plurality, all births, South Australia, 2008......................................................... 47
 

Table 27b: Gestation at birth by plurality, all births, South Australia, 2008 ............................................... 48
 

Table 27c: Perinatal outcome by plurality, all births, South Australia, 2008 .............................................. 48
 

Table 28a: Perinatal mortality by birthweight, all births, South Australia, 2008 ....................................... 49
 

Table 28b: Perinatal mortality by gestational age at birth, South Australia, 2008 .................................... 50
 

Table 28c: Perinatal mortality, South Australia, 2008 (all births of specified birthweight/gestation)...... 50
 

Table 28d: Perinatal mortality by race, all births, South Australia, 2008 ................................................... 51
 

Table 29: Planned home births by age of women, South Australia, 2008 ................................................ 51
 

Table 30: Method of birth in planned home births, South Australia, 2008.............................................. 52
 

Table 31: Birthweight distribution of planned home births, South Australia, 2008 ................................ 52
 

Table 32: Perinatal outcome in planned home births, South Australia, 2008 .......................................... 52
 

Table 33: Planned birthing unit births by age of women, South Australia, 2008 .................................... 53
 

Table 34: Method of birth in planned birthing unit births, South Australia, 2008 .................................. 53
 

Table 35: Birthweight distribution of planned birthing unit births, South Australia, 2008 .................... 54
 

Table 36: Perinatal outcome in planned birthing unit births, South Australia, 2008 .............................. 54
 

Table 37: Abortion rate per 1,000 women aged 15-44 years, South Australia, 1970 2008 ..................... 55
 

Table 38: Terminations of pregnancy by age, South Australia, 2008 ........................................................ 57
 

Table 39: Abortion and live birth rates and abortion proportions by age, South Australia, 2008 ......... 58
 

Table 40: Terminations by marital status, South Australia, 2008............................................................... 59
 

Table 41: Terminations by place of residence, South Australia, 2008 ....................................................... 60
 

Table 42: Terminations by hospital category, South Australia, 2008......................................................... 60
 

Table 43: Terminations by category of doctor, South Australia, 2008....................................................... 60
 

Table 44: Reason for termination for fetal reasons, South Australia, 2008.............................................. 61
 

Table 45: Complications of terminations, South Australia, 2008............................................................... 61
 

Table 46a: Women with previous terminations by age, South Australia, 2008.......................................... 62
 

Table 46b: Calculation of total abortion rate (TAR) for 2008 for South Australia ..................................... 62
 

Table 46c: Calculation of total first abortion rate (TFAR) for 2008 for South Australia ............................ 63
 

Table 47: Obstetric profiles by hospital category, South Australia, 2008: live births of any 

gestation and stillbirths of &gt;=400g or &gt;=20 weeks gestation ................................................... 65
 

Table 48: Socio-demographic aspects of perinatal statistics, South Australia, 1981 and 1999 2008 ...... 82
 

Table 49: Obstetric aspects of perinatal statistics, South Australia, 1981 and 1999   2008 ..................... 83
 

page 7Pregnancy Outcome in South Australia 2008 



  

  

   

   

   

   

   

   

  

   

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Figures 

Figures 

Figure 1a: Map showing SA hospitals with obstetric beds in 2008 ............................................................ 15
 

Figure 1b: Map showing Central Regions of SA (as at 30th June 2008) .................................................... 16
 

Figure 2: Distribution of hospital births by hospital category, South Australia, 2008 (n=19,869) ......... 17
 

Figure 3: Age and race of women who gave birth, 2008 (n=19,672) ...................................................... 23
 

Figure 4: Reasons for induction of labour, SA, 2008 (n=5,634) ................................................................ 35
 

Figure 5a: Method of birth, women who gave birth, South Australia, 2008 (n=19,672) ......................... 37
 

Figure 5b: Reason for caesarean section, 2008 (n=6,334) ........................................................................... 38
 

Figure 5c: Reason for elective caesarean section, 2008 (n=3,022) ............................................................. 39
 

Figure 5d: Reason for emergency caesarean section, 2008 (n=3,312)........................................................ 39
 

Figure 6: Perinatal mortality rate by birthweight, all births, South Australia, 2008............................... 49
 

Figure 7: Abortion rate in South Australia, 1970 2008 ............................................................................ 56
 

Figure 8a: Abortions and live births by age, South Australia, 2008........................................................... 58
 

Figure 8b: Teenage pregnancy, abortion and birth rates, South Australia, 1970 2008............................ 59
 

Figure 9: Percentage of Aboriginal women by hospital category ........................................................... 67
 

Figure 10: Percentage of women with &lt;7 antenatal visits by hospital category ...................................... 67
 

Figure 11: Percentage of teenage women by hospital category ............................................................... 67
 

Figure 12: Percentage of women 35 years or more by hospital category ................................................ 68
 

Figure 13: Percentage of single women by hospital category ................................................................. 68
 

Figure 14: Percentage of women with 4 or more prior livebirths by hospital category .......................... 68
 

Figure 15: Percentage of women with 1 or more prior perinatal deaths by hospital category............... 69
 

Figure 16: Percentage of women with obstetric complications by hospital category ............................. 69
 

Figure 17: Percentage of women with complications during labour or birth by hospital category ....... 69
 

Figure 18: Percentage of women with induction of labour by hospital category .................................... 70
 

Figure 19: Percentage of women having epidural analgesia by hospital category .................................. 70
 

Figure 20: Percentage of breech births by hospital category .................................................................... 70
 

Figure 21: Percentage of emergency caesarean sections by hospital category......................................... 71
 

Figure 22: Percentage of elective caesarean sections by hospital category .............................................. 71
 

Figure 23: Percentage of total caesarean sections by hospital category ................................................... 71
 

Figure 24: Percentage of births with birthweight below 2,500g by hospital category ............................ 72
 

Figure 25: Percentage of births with gestation less than 37 weeks by hospital category........................ 72
 

Figure 26: Percentage of births with prolonged hospitalisation by hospital category ............................ 72
 

Figure 27: Percentage of live births requiring neonatal intensive care by hospital category.................. 73
 

page 8 Pregnancy Outcome in South Australia 2008 



  

 
  

 
  

  
  

 
  

 
  

 
  

 
  

 

 

 

 

 
  

 

 

 

Figures 

Figure 28: Percentage of births with birth defects by hospital category .................................................. 73
 

Figure 29a: Induction of labour proportion for selected primiparae, SA hospitals 


Figure 29b: Caesarean section rate for selected primiparae, SA hospitals with 


Figure 29c: VBAC: Proportion of women who had a vaginal birth following a previous primary (first) 


Figure 29d: PRIMIP no repair: proportion of primiparous women not requiring surgical repair 


Figure 29e: TERM NICU: proportion of term babies admitted to NICU for reasons other than 


Figure 29f: SPMR (Standardized Perinatal Mortality Ratio) for all births, SA hospitals with 


Figure 29g: SPMR (Standardized Perinatal Mortality Ratio) for all births, SA hospitals with 


with &gt;=500 births per year, 2008 ................................................................................................ 78
 

&gt;=500 births per year, 2008......................................................................................................... 78
 

caesarean section &amp; no intervening births, SA hospitals with &gt;=500 births per year, 2008....79
 

following vaginal birth, SA hospitals with &gt;=500 births per year, 2008 .................................. 79
 

congenital abnormality, SA hospitals with &gt;=500 births per year, 2008 .................................. 79
 

&gt;=500 births per year, 2008 ........................................................................................................ 80
 

&gt;=500 births per year, 2004-2008................................................................................................ 80
 

Figure 30.1: Percentage of teenage women among women giving birth in SA......................................... 85
 

Figure 30.2: Percentage of women aged 35 years and over among women giving birth in SA................ 85
 

Figure 30.3: Percentage of primiparous women aged 35 years and over in SA.......................................... 85
 

Figure 30.4: Percentage of Aboriginal women and Asian women among women giving birth in SA.....86
 

Figure 30.5: Percentage of women never married and with no de facto partner among women 

giving birth in SA......................................................................................................................... 86
 

Figure 30.6: Percentage of multiple births among births in SA ................................................................... 86
 

Figure 30.7: Percentage of low birthweight babies among births in SA..................................................... 87
 

Figure 30.8: SA standardised perinatal mortality ratio (SPMR) .................................................................... 87
 

page 9Pregnancy Outcome in South Australia 2008 



 
 

 

Executive Summary 

Executive Summary 

This report on pregnancy outcome in South Australia for 2008 provides statistics derived mainly from the 
South Australian perinatal statistics collection of births. These are notified by hospital and homebirth midwives 
and neonatal nurses. 

For a more complete picture of pregnancy outcome, some statistics from the abortion statistics collection are also 
included. More statistics on abortions in the state in 2008 are available in the Sixth Annual Report of the Abortion 
Reporting Committee. Comparisons of selected pregnancy characteristics and outcomes are provided for five different 
hospital categories in the state. Individual hospital reports (Pregnancy and Neonatal Care Bulletins) with these 
comparisons made in greater detail are provided to hospitals in the state with at least 100 births per year. Group 
reports are provided for hospitals with smaller numbers of births. Comparisons of maternity performance indicators 
are also provided for hospitals with at least 500 births per year. 

1. Numbers and fertility rates 
The number of births notified in South Australia in 2008 was 19,970, which was 213 more than the previous year. 
The number of women who gave birth was 19,672. The total fertility rate was 1.91 live births per woman, the same 
as in 2007 and the highest in more than a decade. The fertility rate increased in the 20-24 years, 35-39 years and 40 
44 years age groups, remaining highest in the 30-34 years age group, followed by the 25-29 years age group. When 
compared with 2007, the greatest increase in rate occurred in the age group 40-44 years (about 8%). 

2. Place of birth 
There were increases in the numbers of  births in metropolitan teaching hospitals, of more than 500 at Lyell McEwin 
Hospital and 160 at Women s and Children s Hospital, after the closure of obstetric services at Modbury Hospital. 
Six percent of women (1,237 women) gave birth in birthing units in teaching hospitals and 94 women (0.5%) had 
planned home births. 

3. Teenage women 
885 teenage women gave birth, accounting for 4.5% of women who gave birth, and 964 teenage women had 
terminations of pregnancy, accounting for 18.9% of terminations. In 2008, the proportion of  known  pregnancies 
terminated was 52% for teenagers compared with 20% for women of all ages. The teenage pregnancy rate declined 
in the 1970s and 1980s, but increased in the early 1990s. It declined again after 1996. The teenage pregnancy rate of 
35.4 per 1,000 women in 2008 was slightly higher than the rate of 35.0 in 2007, which was the lowest rate recorded 
since 1970. 

4. Older women and first time mothers 
The mean age of women giving birth increased from 26.55 years in 1981 to 30.11 years in 2008, and, among first 
time mothers, from 24.42 years to 28.24 years. The proportion of women aged 35 years or more increased from 
4.6% in 1981 to 21.1% in 2008. Among first time mothers, this proportion increased from 1.2% to 12.7%.  As in 
the previous seven years, more women gave birth in the 30-34 years than in the 25-29 years age group. 

5. Country of birth and race 
Eighty-two percent of women who gave birth in 2008 were Australian-born.  Of women born overseas who gave 
birth, the largest proportions came from the United Kingdom and Ireland (3.1% of women), Vietnam (1.5%), 
New Zealand and India (1.1% each), the Philippines (0.9%) and China (0.8%). Seven percent of women (1,385 
women) who gave birth in the state in 2008 were Asian, compared with 2% in 1981. They gave birth mainly in 
teaching hospitals. 

6. Smoking during pregnancy and Body Mass Index 
The proportion of women smoking at the first antenatal visit has declined steadily from 25% in 1998 to 16% in 2008. 
About 4% each year quit smoking before the first antenatal visit. 

While statistics on Body Mass Index were available only for 58% of women who gave birth in 2008 and must be 
interpreted with caution, these show that 26% of women were overweight and 24% were obese, including 10% 
who were severely or morbidly obese. 

page 10 Pregnancy Outcome in South Australia 2008 



 
Executive Summary 

7. Antenatal care and length of stay 
Statistics on gestation at first antenatal visit were available only for 86% of women who gave birth. These show that 
73% of women attended for antenatal care within the first 14 weeks of pregnancy. Nearly 92% attended at least 
seven antenatal visits. Although many women had more than one type of antenatal care, the most common types 
used were hospital clinics (44%), obstetricians in private practice (33%) and general practitioners (18%). Thirty-two 
percent of women were private patients. The median length of stay of women after a birth was three days; it was 
three days for those who had a vaginal birth and five days for those who had a caesarean section.  It was two days 
longer among private patients for vaginal births and one day longer for caesarean births. 

8. Aboriginal women 
624 Aboriginal women gave birth in South Australia in 2008, accounting for 3.2% of all women who gave birth in 
the state. Twenty-one percent of Aboriginal women were teenagers (compared with 4% of non-Aboriginal women). 
Only 45% of Aboriginal women attended for antenatal care within the first 14 weeks of pregnancy (compared with 
74% of non-Aboriginal women) and 64% attended at least seven antenatal visits during pregnancy (compared with 
93% of non-Aboriginal women). Smoking during pregnancy was more prevalent and heavier among Aboriginal 
women, with 57% smoking at the first antenatal visit compared with 14.5% of non-Aboriginal women. While the 
proportion of non-Aboriginal women smoking during pregnancy has declined steadily from 24% in 1998 to 15% 
in 2008, no decline has been seen during this period in the proportion of Aboriginal women smoking. In 2008 their 
proportions of preterm births (&lt;37 weeks gestation), and low birthweight births (&lt;2,500g) remained twice as high as 
those of non-Aboriginal births. The perinatal mortality rate of babies of Aboriginal women was also more than twice 
as high as that of babies of non-Aboriginal women (23.5 compared with 9.7 per 1,000 births). 

9. Procedures 
Ninety-eight percent of women who gave birth had an ultrasound examination; 29% had labour induced while 
another 22% had spontaneous labour augmented; epidurals were used for pain relief during labour for 31% of 
women, and 11% had an episiotomy (17% of women who gave birth vaginally). The main reasons for induction 
of labour were prolonged pregnancy (20%), hypertension (14%), diabetes or gestational diabetes (7%), poor fetal 
growth (5%) and premature rupture of membranes (3.5%). Fifty-two percent of inductions of labour were performed 
for other than defined indications. 

10. Method of birth 
Fifty-six percent of women had normal spontaneous vaginal births. Seven percent gave birth by ventouse and 4% 
by forceps (compared with 1% and 15% respectively in 1981). In 2008 the proportion of women giving birth 
by caesarean section was 32.2%, a proportion which has been relatively stable for four years. Of those who had 
previously given birth, 30% had previously had a caesarean section. Only 18% of women had a vaginal birth 
following a previous first caesarean without intervening births, compared with 30% in 1998. The main reasons 
given for caesarean section were previous caesarean section (37%), failure to progress in labour or cephalopelvic 
disproportion (28%), fetal distress (16%) and malpresentation (12%). 

11. Multiple births 
Multiple births accounted for 3.0% of births; women with twins or triplets accounted for 1.4% of women who gave 
birth in 2008. These proportions increased in the 1980s and 1990s as a result of the use of assisted conception and 
the increasing proportion of older women, who have higher rates of multiple pregnancies than younger women. 
However, the peak proportion of multiple births was recorded in 2002 and 2003 (3.6%). The subsequent  decline 
in the proportion of multiple births was probably related to the increasing use of single embryo transfer in assisted 
conception practice. 

12. Abortions 
5,101 terminations of pregnancy were notified, 217 more than in 2007. The abortion rate was 16.0 per 1,000 
women aged 15-44 years, a slight increase above the previous three years. It has declined significantly since 2001, 
when it was 17.7 per 1,000 women. Approximately 93% of terminations were performed in metropolitan public 
hospitals, including the Pregnancy Advisory Centre, and 78% were performed by doctors in family advisory clinics 
in these hospitals. Ninety-three percent of terminations were performed within the first 14 weeks of pregnancy and 
1.7% (87) were late terminations (at or after 20 weeks gestation). Fifty-six percent of these late terminations were for 
fetal abnormalities. Approximately 20% of known pregnancies ended as terminations in 2008. 

page 11Pregnancy Outcome in South Australia 2008 



Executive Summary 

13. Perinatal mortality 
The perinatal mortality rate for all births in 2008 was 10.1 per 1,000 births, the stillbirth rate 7.6 per 1,000 births and 
the neonatal mortality rate 2.6 per 1,000 live births. For international comparison, the World Health Organisation 
recommends including only births of at least 1,000g birthweight (or 28 weeks gestation if birthweight unavailable ) 
and early neonatal deaths within the first 7 days of life (instead of 28 days) in calculating the perinatal mortality rate. 
This rate for international comparison for South Australia for 2008 was 3.4 per 1,000 births, with an early neonatal 
mortality rate of 0.6 per 1,000 live births, the same as in 2007 and the lowest ever recorded in the state. This rate has 
declined by 76% from 2.5 per 1,000 live births in 1981. 

page 12 Pregnancy Outcome in South Australia 2008 



 
 

 
  

 

 

Introduction 

I. Introduction 

This Report summarizes the statistics for 2008 from the South Australian perinatal statistics collection and the 
South Australian abortion statistics collection, both of which are held in the Pregnancy Outcome Unit. Some 
definitions used by the Unit are provided in Appendix 1. Guidelines1 with some of these definitions are issued to 
all South Australian obstetric units to promote the uniform completion of forms. 

1. The Perinatal Statistics Collection 
This collection utilises notifications of births in South Australia made by hospital and homebirth midwives and 
hospital neonatal nurses on the Supplementary Birth Record (SBR - Appendix 2). The SBRs are checked manually 
for completeness and data discrepancies and then go through a series of automated validation procedures during 
data entry. 

Information on congenital abnormalities detected at birth or in the neonatal period (within 28 days of birth) is 
provided by doctors using the Congenital Abnormality Form (Appendix 3). Few statistics on birth defects are included 
in this report as these are reported annually by the South Australian Birth Defects Register at the Women s and 
Children s Hospital.2 The Register complements statistics on birth defects from the perinatal and abortion statistics 
collections with statistics on birth defects detected and notified after discharge from the birth hospital up to the 
child s fifth birthday. 

Perinatal data are provided under legislation, the South Australian Health Commission (Pregnancy Outcome Statistics) 
Regulations 1999, now Health Care Regulations 2008. The South Australian perinatal statistics collection includes all 
births occurring in South Australia, including those to women who normally reside interstate, mainly in New South 
Wales near the South Australian border and in the Northern Territory. Births of South Australian residents which occur 
in other states are not included. The perinatal data have been collected since 1981, but there have been changes in 
the data items collected over the years. 

Perinatal death certificates are obtained from the Births, Deaths and Marriages Registration Division, chromosome 
analysis reports from the Cytogenetics and Molecular Genetics Unit at Women s and Children s Hospital,  autopsy 
reports from pathology departments and Coroner s autopsy reports and findings from the Coroner s Office. All these 
are linked with the SBRs to provide more complete information on births and deaths. All maternal, perinatal and 
infant deaths in the state are reviewed by the Maternal, Perinatal and Infant Mortality Committee and details of 
these are reported in the annual report of the Committee entitled  Maternal, Perinatal and Infant Mortality in South 
Australia 2008.3 

2. The Abortion Statistics Collection 
Notifications made by doctors of medical terminations of pregnancy under the Criminal Law Consolidation (Medical 
Termination of Pregnancy) Regulations 1996, are included in this collection. It has been in existence since 1970, when 
specific abortion legislation was introduced under the Criminal Law Consolidation Act. Termination of pregnancy 
became legal in the state if performed in a prescribed hospital by a medical practitioner for a woman who has been 
resident at least two months in the state. The practitioner and another medical practitioner must have examined 
the woman and formed the opinion that the continuation of the pregnancy would involve greater risk to her life 
or greater risk of injury to her physical or mental health than if the pregnancy were terminated; or that there is a 
substantial risk that if the pregnancy were not terminated and the child were born, the child would suffer from 
such physical or mental abnormalities as to be seriously handicapped. A termination may not be performed on a 
woman who is pregnant with a child  capable of being born alive  unless it is performed to save the woman s life. 
The legislation states that evidence that a woman has been pregnant for a period of 28 weeks or more is prima facie 
proof that she was pregnant with a child that was capable of being born alive. 

page 13Pregnancy Outcome in South Australia 2008 



 
 

 

  
 

 
 

Mothers and Babies 

II. Mothers and Babies: Characteristics and Outcomes 

The births in 2008 in South Australia described in this Report include live births of any gestation and stillbirths 
(including terminations of pregnancy mainly for congenital abnormalities) of at least 400g birthweight or 
20 weeks gestation. 

There were four births of unknown birthweight. One was a stillbirth at 30 weeks gestation, the second of twins. 
The other three were live births at term. Fifty-eight births of less than 400g birthweight have been included, consisting 
of 47 stillbirths and eleven live births. The eleven live births were born at 18-23 weeks gestation and all died in the 
neonatal period. SBRs were received for all 19,970 births reported by hospital and home birth midwives in their 
monthly notification lists. These comprised 19,819 live births and 151 stillbirths. The number of women who gave 
birth was 19,672, an increase of 201 from 2007. Findings relating to Aboriginal women and babies in the text of this 
Report have been italicised for easy identification, in response to the request of the Aboriginal Health Council. 

1. Place of residence of mother 
South Australia is divided into nine CURB (Committee for Uniform Regional Boundaries) Regions, comprising five 
country Regions and four Central Regions. Each of the Central Regions (Northern, Eastern, Western, Southern) has a 
Metropolitan (Adelaide) and a non-Metropolitan component (Figures 1a and 1b). The distribution of births according 
to the mother s place of residence by CURB Regions is provided in Table 1 together with the estimated resident 
population and crude birth rate. The crude birth rate in 2008 for South Australia was 12.4 per 1,000 population. 
It was lowest in the Murraylands and the Central Eastern Regions. It was highest in the Central Northern Region and 
was also high in the South East Region and Eyre. 

Table 1: Births and crude birth rate by CURB regions, South Australia, 2008 

CURB Region 
(Mother s residence) 

Total births Live births 
Estimated resident 

population, 
June 30, 2008+ 

Crude birth 
rate per 1,000 

population
Number Percent Number Number 

Central Northern 5,900 29.6 5,860 421,251 13.9 

Central Western 2,579 12.9 2,558 220,682 11.6 

Central Eastern 3,147 15.8 3,121 282,452 11.0 

Central Southern 4,528 22.7 4,501 381,805 11.8 

Yorke &amp; Lower North 522 2.6 520 46,396 11.2 

Murraylands 780 3.9 768 70,125 11.0 

South East 894 4.5 887 65,402 13.6 

Northern 1,002 5.0 990 80,074 12.4 

Eyre 460 2.3 457 35,174 13.0 

Interstate 158 0.8 157 na* na * 

Total 19,970 100.0 19,819 1,603,361 12.4 

+ Australian Bureau of Statistics. Population estimates by age and sex, South Australia, 2008. Canberra: ABS, 2009 (Catalogue No 3235.0 

*na: not applicable 

page 14 Pregnancy Outcome in South Australia 2008 



                  
                  

 
  

 

 

 
 

Mothers and Babies 

2. Place of birth of baby 
Of the 19,970 births in 2008, 101 (0.5%) were home births and of those 94 were planned homebirths. The 
remaining 19,869 births occurred in hospitals or (in 76 cases) before arrival at hospitals into which the women had 
been booked. These 76  Born Before Arrival  (or BBA) births have been included in the statistics for those hospitals. 
The distribution of births by place of birth (home or hospital) and plurality is provided in Table 2. Locations of 
South Australian hospitals with obstetric beds in 2008 are provided in Figures 1a and 1b. 

Table 2: Total births notified in 2008, by place of birth and plurality, South Australia (based on 
Supplementary Birth Records) 

Condition at birth 
Home births Hospital births 

Total 
Singleton Twin Singleton Twin Triplet 

Live birth 100 0 19,140 576 3 19,819 

Stillbirth 1 0 134 16 0 151 

Total births 101 0 19,274 592 3 19,970 

Figure 1a: Map showing SA hospitals with obstetric beds in 2008 

NT 

W
A

 

N
SW

 
NORTHERN 

EYRE 

Ceduna 

Q
LD

V
ic

 

Kangaroo Island 

Pt Lincoln 

Pt Augusta 
Pt Pirie YORKE &amp; 

LOWER 
NORTH 

MURRAY 
LANDS 

Wallaroo 

Whyalla 

Clare 

Riverland 
Regional 

(Berri) 

Murray Bridge 

Naracoorte 

Millicent 
Mt Gambier 

SOUTH EAST 

SEE INSET 
Figure 1b 

CENTRAL REGIONS 

0  40  80 120 160 Km 

Metropolitan Adelaide 

CURB Regions - Boundaries 

&gt; 2000 births per annum 

1000-1999 births per annum 

500-999 births per annum 

100-399 births per annum 

&lt; 100 births per annum 

* The six centres near the 
north-western border 
are Aboriginal clinics 

Pregnancy Outcome in South Australia 2008 page 15 



Mothers and Babies 

Of the 19,869 hospital births, 79.7% occurred in metropolitan hospitals (teaching and private) and 20.3% in country 
hospitals. This distribution is summarized in Table 3a and Figure 2 and the numbers of births and women by race in 
individual hospitals are provided in Table 3b. Metropolitan hospitals are listed in order of number of births and country 
hospitals in alphabetic order in their category of number of births. Fifty-three percent of births in South Australia in 
2008 occurred in metropolitan teaching hospitals. Level III teaching hospitals - the Women s and Children s Hospital 
and Flinders Medical Centre - provide a high risk pregnancy service and neonatal intensive care. The Lyell McEwin 
Hospital has a special care (Level II) neonatal unit. These levels are defined in the Report  Operational Policy, Guidelines 
and Standards for Maternal and Neonatal Services in South Australia.4 

Compared with 2007, the numbers of births in 2008 increased in Level III teaching hospitals. There was a large 
increase of more than 500 births at the Lyell McEwin Hospital and of 160 births at W&amp;CH following the closure 
of birthing services at Modbury Hospital on 31st January 2008. The total number of births in metropolitan private 
hospitals remained about the same, increasing at Ashford and Burnside and decreasing at North Eastern Community 

The total number of births in country hospitals increased overall by 45. Increases occurred at some hospitals with 100 
399 births per year, eg  Gawler Health Service, Mount Barker, and South Coast (Victor Harbor) and at some smaller 
country centres such as Ceduna and Kangaroo Island. Numbers of births  fell at Whyalla, Port Augusta and Kapunda. 

Figure 1b: Map showing Central Regions of SA (as at 30th June 2008) 

CENTRAL EASTERN 
Mt Barker 

SCDH 
(Victor Harbor) 

CENTRAL WESTERN 
(includes Kangaroo Island) 

0 10 20 30 40 

Metropolitan Adelaide 
Hospital abbreviations 
as in Table 3B 

&gt; 2000 births per annum 

1000-1999 births per annum 

500-999 births per annum 

100-399 births per annum 

&lt; 100 births per annum 

kilometres 

CENTRAL NORTHERN 

CENTRAL SOUTHERN 

Tanunda 

Kapunda 

Gawler Health Service 

Lyell 
McEwin 

FMC 

Calvary 

Ashford 
Flinders 
Private 

W&amp;CH 
BWMH 

NECH 

page 16 Pregnancy Outcome in South Australia 2008 



Mothers and Babies 

Table 3a: Hospital births by category of hospital, South Australia, 2008 

Hospital category Number of births Percent hospital births 

Metropolitan teaching 10,578 53.2

 Level III (7,751) (39.0)

 Other teaching (2,827) (14.2) 

Metropolitan private 5,258 26.5 

Country 4,033 20.3

 Major country (858) (4.3)

 100-399 births per annum (2,675) (13.5)

 50-99 births per annum (377) (1.9)

 &lt;50 births per annum (123) (0.6) 

Total 19,869 100.0 

Figure 2: Distribution of hospital births by hospital category, South Australia, 2008 (n=19,869) 

W&amp;CH FMC LMH MOD 
25.8% 13.2% 13.9% 0.3% 

Teaching 53.2% 
hospitals 

a Ashford 7.8% 
b Burnside 6.6% 
c Calvary 4.5% 
d Flinders Private 3.8% 

Metropolitan 
e North Eastern Community 3.8% 26.5%private 

hospitals 
r Mt Gambier 2.8% 
s Gawler 1.9% 
t Mount Barker 1.9% 
u Port Lincoln 1.5% 
v Whyalla 1.5% 
w Port Augusta 1.5%Country 

20.3% x Other hospitals with 100-399 births per year 6.7% 
y Hospitals with 50-99 births per year 1.9% 
z Hospitals with &lt;50 births per year 0.6% 

hospitals 

a 

r s t u v w x y z 

b c ed 

0  10  20 30  40 50 60 

Percentage of hospital births 

Note: Hospital abbreviations as in Table 3b 

Pregnancy Outcome in South Australia 2008 page 17 



  

 
 

 

Mothers and Babies 

Table 3b: Hospital births in South Australia in 2008 by race and hospital (as indicated by returned SBRs for 
hospital births) 

Hospital Caucasian Aboriginal Asian Other 
Total 
births 

Total number 
of women who 

gave birth 

Metropolitan teaching 

Women s &amp; Children s 
Hospital (W&amp;CH) 

3,677 206 825 424 5,132 5,005 

Flinders Medical 
Centre (FMC) 

2,354 73 119 73 2,619 2,575 

Lyell McEwin Hospital 
(LMH)** 

2,359 115 199 93 2,766 2,733 

Modbury Hospital (MOD) 46 1 6 7 60 60 

Southern Adelaide 
Health Service 
(Noarlunga) 

1 0 0 0 1 1 

Total 8,437 395 1149 597 10,578 10,374 

Metropolitan private 

Ashford** 1,482 2 46 15 1,545 1,511 

Burnside War Memorial 
(BWMH)** 

1,247 0 61 7 1,315 1,301 

Calvary** 856 0 35 5 896 889 

Flinders Private** 725 0 19 9 753 742 

North Eastern 
Community (NECH)** 

724 0 17 8 749 744 

Total 5,034 2 178 44 5,258 5,187 

Country 

Major country 

Mt. Gambier** 530 17 10 9 566 557 

Whyalla 267 11 5 9 292 291 

Subtotal 797 28 15 18 858 848 

Table 3b continued 

page 18 Pregnancy Outcome in South Australia 2008 



 
 

 

Mothers and Babies 

Table 3b continued 

Hospital Caucasian Aboriginal Asian Other Total births 
Total number 

of women who 
gave birth 

100-399 births per annum 

Barossa Health 
(Tanunda Centre) 

155 1 4 0 160 160 

Gawler Health 
Service*** 

361 5 5 5 376 372 

Lower North Health 
Centre (Clare) 

115 1 0 0 116 116 

Mt. Barker 364 1 9 7 381 380 

Murray Bridge Soldiers' 
Memorial 

205 29 4 7 245 245 

Naracoorte 161 3 7 4 175 174 

Pt. Augusta 192 82 5 9 288 283 

Pt. Lincoln 251 26 7 5 289 289 

Pt. Pirie 167 12 3 2 184 184 

Riverland Regional 
(Berri) 

185 15 6 7 213 212 

South Coast District 
(Victor Harbor) 

140 2 3 1 146 146 

Northern Yorke 
Peninsula Regional 
Health Service 
(Wallaroo) 

95 3 2 2 102 101 

Subtotal 2,391 180 55 49 2,675 2,662 

** These hospitals have neonatal special care nurseries. 

*** This is a metropolitan hospital situated at the metropolitan/country boundary; it has the characteristics of a country hospital and has been included 
as such. 

Table 3b continued 

page 19Pregnancy Outcome in South Australia 2008 



Table 3b continued

 

 

 

Mothers and Babies 

Table 3b continued 

Total number 
Hospital Caucasian Aboriginal Asian Other Total births of women who 

gave birth 

50-99 births per annum 

Ceduna 26 23 1 0 50 50 

Kapunda 49 0 0 1 50 50 

Loxton 69 2 0 0 71 71 

Millicent 94 0 1 0 95 95 

Southern Flinders 
Health Service 56 1 0 0 57 57 
(Crystal Brook) 

Waikerie 49 3 0 2 54 54 

Subtotal 343 29 2 3 377 377 

1-49 births per annum 

Bordertown 0 0 0 1 1 1 

Central Yorke 
Peninsula (Maitland) 

1 0 0 0 1 1 

Cleve 1 0 0 0 1 1 

Cummins 6 0 0 0 6 6 

Kangaroo Island 46 0 0 2 48 48 

Kingston SE 1 0 0 0 1 1 

Mannum 1 0 0 0 1 1 

Meningie 0 0 0 1 1 1 

Mid North Health 
(Booleroo Health 4 0 0 0 4 4 
Service) 

Mid North Health 
(Jamestown Campus) 

35 0 0 0 35 35 

Peterborough 4 1 0 0 5 5 

Quorn 9 1 0 0 10 10 

Roxby Downs 0 0 1 0 1 1 

Southern Yorke 
Peninsula (Yorketown) 

8 0 0 0 8 8 

Subtotal 116 2 1 4 123 123 

Total (country) 3,647 239 73 74 4,033 4,010 

Grand total 17,118 636 1,400 715 19,869 19,571 

page 20 Pregnancy Outcome in South Australia 2008 



 
 

Mothers and Babies 

3. Maternal race 
The distribution of women who gave birth, by race is provided in Table 4a and also by category of birthplace in Table 
4b. In these tables and all others where distribution by race is shown,  Aboriginal  includes Aboriginal (609 women), 
Torres Strait Islander (6 women) and those who are Aboriginal and Torres Strait Islander (9 women). Aboriginal 
women accounted for 3.2% of women and gave birth mainly in metropolitan teaching hospitals and country 
hospitals. Asian women accounted for 7.0% of women and gave birth mainly in metropolitan teaching hospitals but 
12.9% gave birth in private hospitals. 

Table 4a: Race of women who gave birth, South Australia, 2008 

Race Number of women % Women 

Caucasian 16,955 86.2 

Aboriginal 624 3.2 

Asian 1,385 7.0 

Other 708 3.6 

Total 19,672 100.0 

Table 4b: Race and birthplace category of women who gave birth, South Australia, 2008 

Birthplace Race of women 
Total 

Caucasian Aboriginal Asian Other 

Number % Number % Number % Number % Number % 

Metropolitan 
teaching hospital 

8,266 48.8 384 61.5 1,134 81.9 590 83.3 10,374 52.7 

Metropolitan 
private hospital 

4,963 29.3 2 0.3 178 12.9 44 6.2 5,187 26.4 

Country hospital 3,627 21.4 237 38.0 73 5.3 73 10.3 4,010 20.4 

Home 99 0.6 1 0.2 0 0 1 0.1 101 0.5 

Total 16,955 (86.2) 624 (3.2) 1,385 (7.0) 708 (3.6) 19,672 100.0 

page 21Pregnancy Outcome in South Australia 2008 



Mothers and Babies 

4. Maternal age 
Among the five-year age groups the largest number of women who gave birth was in the 30-34 years age group 
(Table 4c). The proportion of women in this age group (31.1%) has exceeded that of the 25-29 years age group 
(27.6%) since 2001. Teenage women accounted for 4.5% of women who gave birth and older women aged 35 years 
or more accounted for 21.1% (Table 4c and Figure 3). Aboriginal women were generally younger than non-Aboriginal 
women: 21.3% were teenagers and only 8.8% were 35 years or older. Among Asian women, on the other hand, only 
1.1% were teenagers but 23.3% were 35 years or older. 

The age-specific fertility rates have increased in the 20-24, 35-39 and 40-44 age groups and decreased in the 
teenage, 25-29 and 30-34 age groups, when compared with 2007 (Table 4d). The rate was highest in the age group 
30-34 years (124.6 per 1,000 women), followed by the 25-29 years age group (108.2 per 1,000 women). The 
greatest increase in rate occurred in the 40-44 years age group (about  8%). The general fertility rate (see Appendix 
1) was 62.0 per 1,000 women aged 15-44 years, similar to 2007. The total fertility rate (see Appendix 1) was 1.91 live 
births per woman, remaining the same as 2007 and the highest for more than a decade, but still below replacement 
level (2.1). 

Table 4c: Age and race of women who gave birth, South Australia, 2008 

Age (years) Race of women 
Total 

Caucasian Aboriginal Asian Other 

Number % Number % Number % Number % Number % 

&lt;15 2 0.0 7 1.1 0 0 0 0 9 0.0 

15-19 700 4.1 126 20.2 15 1.1 35 4.9 876 4.4 

20-24 2,548 15.0 211 33.8 157 11.3 164 23.2 3,080 15.7 

25-29 4,657 27.5 130 20.8 437 31.6 209 29.5 5,433 27.6 

30-34 5,370 31.7 95 15.2 453 32.7 199 28.1 6,117 31.1 

35-39 3,069 18.1 48 7.7 254 18.3 84 11.9 3,455 17.6 

40-44 571 3.4 7 1.1 65 4.7 17 2.4 660 3.4 

45+ 38 0.2 0 0 4 0.3 0 0 42 0.2 

Total 16,955 (86.2) 624 (3.2) 1,385 (7.0) 708 (3.6) 19,672 100.0 

page 22 Pregnancy Outcome in South Australia 2008 



 
 

  

Mothers and Babies 

Figure 3: Age and race of women who gave birth, 2008 (n=19,672) 

0% 

20% 

40% 

60% 

80% 

100% 

Pe
rc

en
ta

g
e 

o
f 

w
o

m
en

 

Caucasian Aboriginal Asian Other Total 
n=16,955 n=624 n=1,385 n=708 n=19,672 

35+ Age (years)14-19 20-24 25-29 30-34 

Table 4d: Age-specific fertility rates, South Australia, 2008 

Age (years) Number of live births 
Estimated resident female 

population* 

Age-specific fertility 
rate per 1,000 women 

(ASFR)*** 

15-19 879** 52,072 16.9** 

20-24 3,090 54,525 56.7 

25-29 5,456 50,443 108.2 

30-34 6,173 49,531 124.6 

35-39 3,504 56,360 62.2 

40-44 706** 56,534 12.5** 

Total 19,808** 319,465 62.0** 

* Australian Bureau of Statistics. Population Estimates by Age and Sex, South Australia 2008. Canberra: ABS, 2009 (Catalogue No 3235.0). 

** the number of live births and fertility rate for women aged 15-19 years include live births for younger ages, and the number and rate for women 
aged 40-44 years include live births for older ages, while the total number and rate (general fertility rate) include all live births. Live births in this 
table exclude terminations of pregnancy. 

*** Sum of 5-year ASFRs = 381.1 per 1,000 women. Total fertility rate = 381.1 x 5 = 1,905.5 live births per 1,000 women = 1.91 live births 
per woman. 

Pregnancy Outcome in South Australia 2008 page 23 



 
Mothers and Babies 

5. Country of birth 
The distribution of women by major country of birth groups is provided in Table 5a and by specified countries of 
birth, with 40 or more women who gave birth, in Table 5b. Of the 17.6% of women born outside Australia, the 
largest proportion was born in the United Kingdom and Ireland (3.1%). Other countries contributing relatively large 
proportions of migrant women were Vietnam (1.5% of women ), India and New Zealand (1.1%), the Philippines 
(0.9%), China (0.8%), Sudan (0.6%), Afghanistan and Cambodia (0.5% each), Malaysia and South Africa (0.4% 
each), Indonesia, Japan, Thailand and the United States of America (0.3% each), and Canada, Germany, Poland and 
South Korea (0.2% each). 

Table 5a: Country of birth, major groups,* women who gave birth, South Australia, 2008 

Country of birth Number % 

1 Oceania and Antarctica 16,474 83.7 

2 Europe and the USSR 987 5.0 

3 The Middle East and North Africa 262 1.3 

4 Southeast Asia 815 4.1 

5 Northeast Asia 295 1.5 

6 Southern Asia 414 2.1 

7 Northern America 92 0.5 

8 
South America, Central America 
and the Caribbean 

86 0.4 

9 Africa (excluding North Africa) 247 1.3 

Total 19,672 100.0 

* Australian Bureau of Statistics. Australian Standard Classification of Countries for Social Statistics (ASCCSS).  Canberra: ABS, 1990 (Catalogue No 
1269.0). 

page 24 Pregnancy Outcome in South Australia 2008 



 
 

Mothers and Babies 

Table 5b: Specified country of birth,* women who gave birth, South Australia, 2008 

Specified country of birth Number % of women 
% of migrant 

women who gave 
birth (n=3,470) 

1100 Australia 16,202 82.4 na 

6101 Afghanistan 89 0.5 2.6 

4102 Cambodia 101 0.5 2.9 

7102 Canada 41 0.2 1.2 

5101 China 152 0.8 4.4 

2305 Germany 46 0.2 1.3 

6104 India 226 1.1 6.5 

4103 Indonesia 66 0.3 1.9 

5103 Japan 52 0.3 1.5 

4105 Malaysia 86 0.4 2.5 

1301 New Zealand 217 1.1 6.3 

4107 Philippines 171 0.9 4.9 

2504 Poland 46 0.2 1.3 

9220 South Africa 74 0.4 2.1 

3207 Sudan 127 0.6 3.7 

5105 South Korea 41 0.2 1.2 

4109 Thailand 59 0.3 1.7 

2101-2107 
The United Kingdom 
and Ireland 

610 3.1 17.6 

7104 United States of America 50 0.3 1.4 

4110 Vietnam 291 1.5 8.4 

All other countries 925 4.7 26.7 

Total 19,672 100.0 100.0 

* ASCCSS, Australian Bureau of Statistics 

page 25Pregnancy Outcome in South Australia 2008 



Mothers and Babies 

6. Marital status and type of patient 
While 88.1% women who gave birth in 2008 were married or in a de facto relationship, 11.9% were single (10.7% 
were never married and 1.2% were widowed, separated or divorced, Table 6a). Of never married women, over a fifth 
were teenagers and a third were in the early twenties age group. Relatively more single women were hospital/public 
patients than married women and women in de facto relationships (93.7% v 64.4%, Table 6b). Nearly a third of all 
women were private patients (32.1%). 

Table 6a: Marital status and age, women who gave birth, South Australia, 2008 

Age (years) 

Marital status of women 

Total 
Never married Married/de facto 

Widowed/ 
separated/ 
divorced 

Unknown 

Number % Number % Number  % Number % Number % 

&lt;20 467 22.2 415 2.4 3 1.3 0 0 885 4.5 

20-24 736 34.9 2,309 13.3 33 14.0 2 50.0 3,080 15.7 

25-29 425 20.2 4,947 28.6 61 25.8 0 0 5,433 27.6 

30-34 291 13.8 5,754 33.2 70 29.7 2 50.0 6,117 31.1 

35-39 151 7.2 3,258 18.8 46 19.5 0 0 3,455 17.6 

40-44 33 1.6 606 3.5 21 8.9 0 0 660 3.4 

45+ 3 0.1 37 0.2 2 0.8 0 0 42 0.2 

Total 2,106 (10.7) 17,326 (88.1) 236 (1.2) 4 (0.0) 19,672 100.0 

Table 6b: Type of patient and marital status, women who gave birth, South Australia, 2008 

Type of 
patient 

Marital status of women 

Total 
Never married Married/de facto 

Widowed/ 
separated/ 
divorced 

Unknown 

Number % Number % Number  % Number % Number % 

Hospital/ 
public 

1,974 93.7 11,161 64.4 211 89.4 3 75.0 13,349 67.9 

Private 132 6.3 6,165 35.6 25 10.6 1 25.0 6,323 32.1 

Total 2,106 (10.7) 17,326 (88.1) 236 (1.2) 4 (0.0) 19,672 100.0 

page 26 Pregnancy Outcome in South Australia 2008 



 
 

Mothers and Babies 

7. Occupation of father and mother 
This distribution is based on the Australian Statistical Classification of Occupations (ASCO) of the Australian Bureau of 
Statistics and is provided in Table 7. Unclassified occupations have been assigned a separate category (Category 9). 

A much larger proportion of mothers than fathers (24.8 v 0.5%) was included in the occupation  home duties . Larger 
proportions were also found for the groups of clerks and salespersons and personal service workers. More fathers 
were managers and administrators, tradespersons, plant and machine operators and labourers. Occupation was 
unknown for 9.3% of fathers and 4.1% of mothers. 

Table 7: Occupation of father and mother,* women who gave birth, South Australia, 2008 

Occupation 
Father Mother 

Number % Number % 

1 Managers and administrators 3,161 16.1 1,488 7.6 

2 Professionals 2,931 14.9 2,845 14.4 

3 Para professionals 968 4.9 1,167 5.9 

4 Tradespersons 3,617 18.4 616 3.1 

5 Clerks 536 2.7 2,495 12.7 

6 
Salespersons and personal 
service workers 

1,085 5.5 3,022 15.3 

7 
Plant and machine 
operators and drivers 

1,270 6.5 90 0.5 

8 Labourers and related workers 2,614 13.3 617 3.1 

9 Students 374 1.9 666 3.4 

Pensioners 95 0.5 40 0.2 

Home duties 97 0.5 4,876 24.8 

Unemployed 773 3.9 760 3.9 

Other 318 1.6 188 1.0 

Unknown 1,833 9.3 802 4.1 

Total 19,672 100.0 19,672 100.0 

* Australian Bureau of Statistics. ASCO. First Edition. Occupation Definitions. Canberra: ABS,1990. (Catalogue No. 1223.0). 

page 27Pregnancy Outcome in South Australia 2008 



  

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8. Previous pregnancy outcomes 
Forty-one percent of women had no previous birth and 30.3% were pregnant for the first time. Among Aboriginal 
women and those of  other  races, these proportions were lower, with 30.9% and 36.0% respectively giving birth for 
the first time. The proportion of women giving birth for the first time was the highest among Asian women (48.3%). 

The proportion of women of parity 4 or greater was much higher among Aboriginal women (14.1%) and women of 
 other  races (12.7%), than among Caucasian women (2.8%) and Asian women (1.9%) (Table 8a). 

Table 8a: Parity by race, women who gave birth, South Australia, 2008 

Parity Race of women 
Total 

Caucasian Aboriginal Asian Other 

Number % Number % Number % Number % Number % 

0-Primigravida 5,125 30.2 139 22.3 506 36.5 191 27.0 5,961 30.3 

0-Multigravida 1,915 11.3 54 8.6 163 11.8 64 9.0 2,196 11.2 

1 6,011 35.5 170 27.2 482 34.8 206 29.1 6,869 34.9 

2 2,540 15.0 94 15.1 153 11.0 96 13.6 2,883 14.7 

3 895 5.3 79 12.7 55 4.0 61 8.6 1,090 5.5 

4 275 1.6 43 6.9 16 1.2 41 5.8 375 1.9 

?5 194 1.1 45 7.2 10 0.7 49 6.9 298 1.5 

Total 16,955 (86.2) 624 (3.2) 1,385 (7.0) 708 (3.6) 19,672 100.0 

Among women with previous pregnancies (multigravid women), the proportions who had had previous specified 
adverse pregnancy outcomes are shown in Table 8b. A third of the women had had a miscarriage and nearly a fifth 
had had a termination of pregnancy. 

Table 8b: Previous pregnancy outcomes, women who gave birth, South Australia, 2008 (multigravidae only, 
n=13,711) 

Previous pregnancy outcome Number % 

Miscarriage 4,596 33.5 

Termination of pregnancy 2,655 19.4 

Stillbirth 190 1.4 

Neonatal death 93 0.7 

Ectopic pregnancy 276 2.0 

Of the 11,515 women who had previously given birth, 3,438 (29.9%) had had a previous caesarean section. 

page 28 Pregnancy Outcome in South Australia 2008 



Mothers and Babies 

9a. Gestation at first antenatal visit 
In 2007 information about a woman s gestation and height and weight at her first antenatal visit was requested for 
the first time in the Supplementary Birth Record. 

Table 9a shows that in 2008 gestation at the first antenatal visit was reported as  unknown  for 13.7% of women, 
a pleasing decrease from the 34.8% reported as  unknown  in 2007. If the  unknowns  are excluded, among the 
remaining women, 73.4% attended within the first 14 weeks. This proportion was much lower for Aboriginal women 
(45.1%) than for non-Aboriginal women (74.4%). 

Table 9a: Gestation at first antenatal visit, women who gave birth, by race, South Australia, 2008 (n=19,672) 

Gestation 
at first 
antenatal 
visit 

Race of women 
Total 

Non-Aboriginal Aboriginal 

Number % 

Adjusted % 
(excluding 
 unknown ) 
(n=16,438) 

Number % 

Adjusted % 
(excluding 
 unknown ) 

(n=548) 

Number % 

Adjusted 
% 

(excluding 
 unknown ) 
(n=16,986) 

&lt;14 weeks 
gestation 

12,225 64.2 74.4 247 39.6 45.1 12,472 63.4 73.4 

14 weeks 
or greater* 

4,213 22.1 25.6 301 48.2 54.9 4,514 22.9 26.6 

Unknown 2,610 13.7 - 76 12.2 - 2,686 13.7 -

Total 19,048 (96.8) 100.0 624 (3.2) 100.0 19,672 (100.0) 100.0 

*includes 40 women with no antenatal care 

9b. Body Mass Index (BMI) 
Reported height and weight at the first antenatal visit were used to calculate the BMI (Body Mass Index, see Appendix 
1) for women who gave birth. This was considered valid only for women who attended the first antenatal visit before 
20 weeks gestation. Among these 15,674 women (79.7% of women who gave birth), height and weight were not 
reported for 4,294 women (21.8%), so that BMI could only be calculated for 11,380 women who gave birth in 2008 
(57.8%). Table 9b shows that of these women, 5,698 ( 50.1%) were overweight or at least obese (BMI &gt;=25.0), 
2,703 (23.8%) were at least obese (BMI &gt;=30.0) and 1,154 (10.1%) were severely or morbidly obese (BMI &gt;=35.0). 

It is hoped that with interest in this area and wider use of the South Australian Pregnancy Record, reporting of 
gestation at first antenatal visit and height and weight will improve. 

page 29Pregnancy Outcome in South Australia 2008 



  

Mothers and Babies 

Table 9b: BMI of women who gave birth, South Australia, 2008 

BMI (based on height and weight at 
first antenatal visit where gestation at 

first antenatal visit was &lt;20 weeks) 
Number % 

Adjusted % (excluding 
 unknown ) (n=11,380) 

&lt;18.5 (underweight) 367 2.3 3.2 

18.5   24.9 (normal) 5,315 33.9 46.7 

25.0   29.9 (overweight) 2,995 19.1 26.3 

30.0   34.9 (obese) 1,549 9.9 13.6 

35.0   39.9 (severely obese) 697 4.5 6.1 

40 or more (morbidly obese) 457 2.9 4.0 

Unknown 4,294 27.4 -

Total 15,674 100.0 100.0 

9c. Antenatal visits 
Women who gave birth are grouped in Table 9c according to the number of reported antenatal visits: no visits, only 
1 - 6 visits, 7 or more visits. However, for 5.8% of women (8.5% of Aboriginal women), the number of antenatal 
visits made was not known. If we exclude women for whom the number of antenatal visits was unknown, 36.1% of 
Aboriginal women compared with 6.6% of Caucasian women were reported to have made less than 7 visits. Among 
Asian women this proportion was 12.4%. A low frequency of antenatal visits may be taken, particularly in term births, 
as an indication of inadequate antenatal care. It is hoped that the proportion of  unknown  number of antenatal visits 
will be reduced by wider use of the Pregnancy Record,5 which will also facilitate continuity of care. 

Table 9c: Antenatal visits by race, women who gave birth, South Australia, 2008 

Antenatal 
visits 

Race of women 
Total 

Caucasian Aboriginal Asian Other 

Number % Number % Number % Number % Number % 

None 20 0.1 17 2.7 2 0.1 1 0.1 40 0.2 

1-6 1,033 6.1 189 30.3 158 11.4 84 11.9 1,464 7.4 

?7 14,953 88.2 365 58.5 1,131 81.7 585 82.6 17,034 86.6 

Unknown 949 5.6 53 8.5 94 6.8 38 5.4 1,134 5.8 

Total 16,955 (86.2) 624 (3.2) 1,385 (7.0) 708 (3.6) 19,672 100.0 

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Mothers and Babies 

9d. Type of antenatal care 
Table 9d shows that the main types of antenatal care used were hospital clinics (43.8%), obstetricians in private 
practice (32.6%), general practitioners (18.4%) and birth centres (7.7%). There were 40 women (0.2%) who had no 
antenatal care at all. Individual women may have used more than one type of antenatal care. 

Table 9d: Type of antenatal care, women who gave birth, South Australia, 2008 (n=19,672) 

Type of care Number % 

No antenatal care 40 0.2 

Hospital clinic 8,625 43.8 

Obstetrician in private practice 6,409 32.6 

General practitioner (GP) 3,623 18.4 

Birth centre 1,516 7.7 

Home birth midwife 105 0.5 

Obstetrician/midwife (shared care) in private practice 318 1.6 

GP/midwife (shared care) 1,162 5.9 

Midwifery Group Practice (W&amp;CH) 927 4.7 

Northern Women s Community Health Centre (NWCHC) 125 0.6 

Other 50 0.3 

Not stated 18 0.1 

10. Smoking 
Table 10a shows that 15.9% of all women were reported to be smokers at their first antenatal visit, and 4.2% had 
quit smoking before their first visit.  Smoking status was unknown for 1.5% of women. Among age groups, the 
highest rates of smoking were among teenagers (37.3%) and women aged 20-24 years (28.3%). A much higher 
proportion of Aboriginal women was reported to be smokers at the first antenatal visit   57.4% compared with 
14.5% among non-Aboriginal women. Smoking rates were high among all age groups of Aboriginal women varying 
from 42.9% among women aged 40-44 years to 61.6% among those aged 20-24 years. 

The proportion of all women smoking during pregnancy has been declining in the state, from 25% in 1998 to 15.9% 
in 2008. However, there has been no decline in the proportion of Aboriginal women smoking during pregnancy: this 
was 55.0% in 1998 compared with 57.4% in 2008, although this proportion has fluctuated between these years. 

In the second half of pregnancy (Table 10b), 14.3% of women (2,805 women) were reported to be smokers and 
0.5% (92 women) smoked more than 20 cigarettes per day, but the number of cigarettes smoked was not known 
for 2.4% of women. In the second half of pregnancy, 52.7% of Aboriginal women smoked, compared with 13.0% 
of non-Aboriginal women. A higher proportion of Aboriginal women (1.6% compared with 0.4%) was also smoking 
more than 20 cigarettes per day, but the number of cigarettes smoked was not known for 5.3% of Aboriginal women 
and 2.3% of non-Aboriginal women. 

page 31Pregnancy Outcome in South Australia 2008 



 
 

 

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Table 10a: Tobacco smoking status at first antenatal visit, non-Aboriginal and Aboriginal women who gave 
birth, South Australia, 2008 

Smoking status Non-Aboriginal Aboriginal Total 

Number % Number % Number % 

Smoker 2,770 14.5 358 57.4 3,128 15.9 

Quit before 1st visit 780 4.1 41 6.6 821 4.2 

Non-smoker 15,213 79.9 213 34.1 15,426 78.4 

Unknown 
smoking status 

285 1.5 12 1.9 297 1.5 

Total 19,048 (96.8) 624 (3.2) 19,672 100.0 

Table 10b: Average number of tobacco cigarettes smoked per day in the second half of pregnancy, non-
Aboriginal and Aboriginal women who gave birth, South Australia, 2008 

Average number of 
tobacco cigarettes 
smoked per day 

Non-Aboriginal Aboriginal Total 

Number % Number % Number % 

None 16,134 84.7 262 42.0 16,396 83.4 

Occasional (&lt;1) 57 0.3 8 1.3 65 0.3 

1-10 1,695 8.9 236 37.8 1,931 9.8 

11-20 642 3.4 75 12.0 717 3.6 

21-30 74 0.4 10 1.6 84 0.4 

31-40 6 0.0 0 0 6 0.0 

41+ 2 0.0 0 0 2 0.0 

Unknown 438 2.3 33 5.3 471 2.4 

Total 19,048 (96.8) 624 (3.2) 19,672 100.0 

page 32 Pregnancy Outcome in South Australia 2008 



Mothers and Babies 

11. Medical conditions 
A medical condition was recorded in the current pregnancy for 6,164 women (31.3%). The frequencies of specified 
medical conditions are provided in Table 11. 

Table 11: Medical conditions in current pregnancy, women who gave birth, South Australia, 2008 

Medical condition Number % of women (n=19,672) 

1 None 13,508 68.7 

2 Anaemia 1,132 5.5 

3 Urinary tract infection 480 2.3 

4 Hypertension (pre-existing) 230 1.1 

5 Diabetes (pre-existing) 116 0.6 

6 Epilepsy 130 0.6 

7 Asthma 1,137 5.5 

8 Other 4,014 19.4 

12. Obstetric complications 
An obstetric complication was recorded for 6,444 women who gave birth (32.8%). The reported frequencies of the 
more common complications are presented in Table 12. 

There were no direct or indirect  maternal deaths (cf definition in Appendix 1), notified to the Maternal, Perinatal and 
Infant Mortality Committee in 2008.3 

Table 12: Frequency of some obstetric complications, women who gave birth, South Australia, 2008 

Obstetric complication Number % of women (n = 19,672) 

No complication 13,228 67.2 

Threatened miscarriage 358 1.7 

Antepartum haemorrhage (APH) -
Abruption 

97 0.5 

APH - Placenta praevia 113 0.5 

APH   Other &amp; unknown causes 466 2.2 

Pregnancy hypertension 1,353 6.4 

Intrauterine growth restriction (suspected) 655 3.1 

Gestational diabetes 989 4.7 

Other complications (including 11 women 
with impaired glucose tolerance) 

3,792 18.0 

page 33Pregnancy Outcome in South Australia 2008 



Mothers and Babies 

13. Procedures performed in current pregnancy 
Procedures performed are listed as reported in Table 13. At least one ultrasound examination was performed for 
97.8% of women, amniocentesis for 3.8% and chorion villus sampling for 0.7%. 

For a proportion of women, it was not known whether a specific procedure had been performed, eg 2.3% for 
maternal serum alpha feto-protein (MSAFP) screening. It is hoped that the increasing use of the Pregnancy Record will 
reduce the number of  unknown  entries. The listing of procedures on the Supplementary Birth Record will also be 
improved, eg to distinguish first from second trimester Down syndrome screening. 

Table 13: Procedures performed in current pregnancy, women who gave birth, South Australia, 2008 

Procedure 
Yes No Unknown 

Number % Number % Number % 

MSAFP (Neural tube 
defect screen etc) 

7,042 35.8 12,171 61.9 459 2.3 

Triple/Quadruple screen 
(Down syndrome etc) 

11,061 56.2 7,883 40.1 728 3.7 

Ultrasound 19,248 97.8 308 1.6 116 0.6 

Chorion villus sampling 133 0.7 19,202 97.6 337 1.7 

Amniocentesis 738 3.8 18,596 94.5 338 1.7 

Cordocentesis 5 0.0 19,321 98.2 346 1.8 

Other surgical 
procedure 

65 0.3 19,607 99.7 0 0 

14a. Onset of labour 
Labour occurred spontaneously in 54.2% of women who gave birth (Table 14a). It was induced in 28.6%, and the 
methods of induction used were artificial rupture of membranes (ARM) in 65.4% of inductions, prostaglandins in 
62.1% and oxytocics in 49.0% (Table 14b). More than one method was used in many cases. 

Table 14a: Onset of labour, women who gave birth, South Australia, 2008 

Onset of labour Number % 

Spontaneous 10,661 54.2 

No labour   caesarean section 3,377 17.2 

Induction 5,634 28.6 

Total 19,672 100.0 

page 34 Pregnancy Outcome in South Australia 2008 



*includes diabetes mellitus, gestational diabetes and glucose intolerancet

   

 

Mothers and Babies 

Table 14b: Method of induction of labour, women who gave birth, South Australia, 2008 

Method of 
induction 

Number 
% of women 

(n=19,672) 
% of inductions 

(n=5,634) 

No induction 14,038 71.4 -

ARM 3,686 18.7 65.4 

Oxytocics 2,758 14.0 49.0 

Prostaglandins 3,497 17.8 62.1 

14b. Reasons for induction of labour 
Up to two reasons could be provided for reason for induction. These reasons for induction of labour are the ones 
defined (see page 74) in  The Australian Council on Healthcare Standards Obstetrics Indicators - Clinical Indicator 
Users  Manual Version 5 for use in 2007 . 

Fig 4 demonstrates that 20.0% of women were induced for prolonged pregnancy (41 or more completed weeks), 
14.4% for hypertension, 6.9% for diabetes (including gestational diabetes and glucose intolerance), 5.1% for 
intrauterine growth restriction (IUGR) and 3.5% for premature rupture of membranes (PROM). Other defined reasons 
accounted for smaller proportions. Other than defined reasons accounted for 54.8%. 

Figure 4: Reasons for induction of labour, SA, 2008 (n=5,634) 

Diabetes* 

PROM 

Hypertensive disorders 

IUGR 

Isoimmunisation 

Fetal distress 

Fetal death 

Chorioamnionitis 

Prolonged pregnancy 

Other 

0  10  20  30  40  50  

Percentage 

*includes diabetes mellitus, gestational diabetes and glucose intolerancet 

Labour was augmented for 4,348 (40.8%) of the 10,661 women who went into spontaneous labour. Methods used 
in augmentation were artificial rupture of membranes (ARM) (75.1%), oxytocics (40.3%) and prostaglandins (1.4%). 
More than one method may be used for a woman. It should be noted that prostaglandins are not recommended 
by the manufacturers as a method of augmenting labour. The proportion of women giving birth who had labour 
augmented was 22.1%. 

page 35Pregnancy Outcome in South Australia 2008 

60 



Mothers and Babies 

Table 14c: Augmentation of labour after spontaneous onset, women who gave birth, South Australia, 2008 

Method of 
augmentation 

Number % of women (n=19,672) 
% of augmentations 

(n=4,348) 

Any augmentation 4,348 22.1 100.0 

1 ARM 3,267 16.6 75.1 

2 Oxytocics 1,752 8.9 40.3 

3 Prostaglandins 60 0.3 1.4 

15a. Presentation and method of birth 
Of the women who gave birth, 56.0% had normal spontaneous vaginal births (Table 15a and Figure 5A). Caesarean 
section was performed for 32.2% of women, with 15.4% of women having elective sections; forceps were utilised 
for 4.2%, ventouse for 7.1% and breech birth for the remaining 0.5%. The method of birth given for women who 
had multiple births is that for the first birth. The method of birth by presentation for all births is provided in Table 15b. 
Breech presentation occurred in 4.9% of births and caesarean section was the method of birth for 87.8% of breech 
presentations. Caesarean section was utilised for 88.5% of breech presentations in singletons (Table 15c). 

Table 15a: Method of birth, women who gave birth, South Australia, 2008 

Method of birth Number % 

Normal spontaneous vaginal 11,016 56.0 

Forceps 832 4.2 

Assisted breech (no forceps) 41 0.2 

Caesarean section (elective) 3,022 15.4 

Caesarean section (emergency) 3,312 16.8 

Ventouse 1,394 7.1 

Breech extraction 3 0.0 

Breech spontaneous 52 0.3 

Total 19,672 100.0 

page 36 Pregnancy Outcome in South Australia 2008 



 
 

 

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Figure 5a: Method of birth, women who gave birth, South Australia, 2008 (n=19,672) 

Breech delivery (0.5%) 

LSCS (32.2%) 

Ventouse (7.1%) 

Normal 
spontaneous 
vaginal (56.0%) 

Forceps (4.2%) 

Table 15b: Method of birth by presentation, all births, South Australian 2008 (n=19,970) 

Method Presentation 
Total of birth 

Vertex Breech Other Unknown 

Number % Number % Number % Number % Number % 

1. Normal 
spontaneous 

11,014 58.7 0 0 32 17.3 7 18.0 11,053 55.4 

2. Forceps 832 4.4 0 0 11 6.0 0 0 843 4.2 

3. Assisted 
breech 
(no forceps) 

0 0 48 5.0 0 0 0 0 48 0.2 

4. Elective 
caesarean 

2,564 13.7 518 53.5 36 19.5 16 41.0 3,134 15.7 

5. Emergency 
caesarean 

2,969 15.8 333 34.4 100 54.1 16 41.0 3,418 17.1 

6. Ventouse 1,398 7.5 0 0 4 2.2 0 0 1,402 7.0 

7. Breech 
extraction 

0 0 7 0.7 2 1.1 0 0 9 0.1 

8. Breech   
spontaneous 

0 0 61 6.3 0 0 0 0 61 0.3 

9. Assisted 
breech   
(forceps) 

0 0 2 0.2 0 0 0 0 2 0.0

    Total 18,777 (94.0) 969 (4.9) 185 (0.9) 39 (0.2) 19,970 100.0 

page 37Pregnancy Outcome in South Australia 2008 



 
Mothers and Babies 

Table 15c: Method of birth in breech presentation, by plurality, all births, South Australia, 2008 (n=969) 

Plurality Assisted* 
breech 

Elective 
caesarean 

Emergency 
caesarean 

Breech 
extraction 

Breech 
spontaneous 

Total 

Singleton 39 431 269 3 49 791 

Twins 11* 86 64 4 12 177 

Triplets 0 1 0 0 0 1 

Total 50 (5.2%) 518 (53.5%) 333 (34.4%) 7 (0.7%) 61 (6.3%) 969 (100.0%) 

* in two of the assisted breech births forceps were applied to the head. 

15b. Reason for caesarean section 
Up to two reasons may be provided on the supplementary birth record for caesarean section, and these have been 
collated in Figure 5b (all caesarean sections), Figure 5c (elective sections only) and Figure 5d (emergency sections 
only). The main reasons given for all caesarean sections were previous caesarean section (37.2%), failure to progress/ 
cephalopelvic disproportion (CPD) (28.2%), fetal distress (16.2%) and malpresentation (12.0%). The main reasons 
for elective sections were previous caesarean section (66.5%), malpresentation (14.3%) and CPD (3.5%), and the 
main reasons given for emergency sections were failure to progress or CPD (50.8%), fetal distress (30.8%), previous 
caesarean section (10.6%) and malpresentation (9.8%). 

Figure 5b: Reason for caesarean section, 2008 (n=6,334) 

CPD/Failure to progress 

Previous caesarean 

Fetal distress 

Malpresentation 

Pregnancy hypertension/hypertension 

APH 

Multiple pregnancy 

IUGR 

Other 

0  10  20  30  40  50  60 

Percentage 

page 38 Pregnancy Outcome in South Australia 2008 



 
Mothers and Babies 

Figure 5c: Reason for elective caesarean section, 2008 (n=3,022) 

CPD 

Previous caesarean 

Fetal distress 

Malpresentation 

Pregnancy hypertension/hypertension 

APH 

Multiple pregnancy 

IUGR 

Other 

0  10  20  30  40  50  60  70 

Percentage 

Figure 5d: Reason for emergency caesarean section, 2008 (n=3,312) 

CPD/Failure to progress
 

Previous caesarean
 

Fetal distress
 

Malpresentation 

Pregnancy hypertension/hypertension 

APH 

Multiple pregnancy 

IUGR 

Other 

0  10  20  30  40  50  60 

Percentage 

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16. Complications of labour and birth and perineal status after birth 
A complication of labour or birth was recorded for 7,303 women who gave birth (37.1%). The reported frequency of 
some complications is presented in Table 16. Among all 19,672 women who gave birth, episiotomy was performed 
for 2,235 (11.4%). Among the 13,338 women who gave birth vaginally, 3,811 (28.6%) had an intact perineum after 
birth, 5,696 (42.7%) had a repair of a perineal tear, of whom 383 (2.9%) had a third or a fourth degree tear; 16.7% 
had an episiotomy. 

Table 16: Frequency of some complications of labour and birth, women who gave birth, 
South Australia, 2008 

Complication of labour Number of women % of women (n=19,672) 

None 12,369 62.9 

Post-partum haemorrhage (PPH)   primary 
(amount not specified) 

55 0.3 

PPH - 600-999ml 1,306 6.6 

PPH   1,000 ml or more 770 3.9 

Fetal distress 2,327 11.8 

Retained placenta 298 1.5 

Prolonged labour 185 0.9 

Cord prolapse 20 0.1 

Wound infection 33 0.2 

Third degree tear (360) or fourth degree tear (25) 385 2.0 

Failure to progress 2,596 13.2 

Other 4,753 24.2 

17. Fetal monitoring during labour 
Cardiotocography (CTG) was performed during labour for 62.1% of women who gave birth. The majority of these 
(52.2% of women) were external CTGs (Table 17a) while a scalp clip was used for 9.9%. 

A fetal scalp pH was taken during labour in 172 women who gave birth (0.9%, Table 17b). 

Table 17a: CTG performed during labour, women who gave birth, South Australia, 2008 

CTG during labour Number of women % of women (n=19,672) 

1 None 7,461 37.9 

2 External 10,266 52.2 

3 Scalp clip 1,945 9.9 

Table 17b: Fetal scalp pH taken during labour, women who gave birth, South Australia, 2008 

Fetal scalp pH taken Number of women % of women (n=19,672) 

1 No 19,500 99.1 

2 Yes 172 0.9 

page 40 Pregnancy Outcome in South Australia 2008 



Mothers and Babies 

18. Analgesia for labour and anaesthesia for birth 
These distributions are provided in Tables 18a and 18b. Epidurals were used for analgesia in labour for 31.0% and 
for anaesthesia for birth for 25.4% of women. The proportion of women who had an epidural for either was 32.2% 
(6,330 women). The proportion of women who had a spinal anaesthetic increased between 1991 and 2008 from 
0.2% to 0.8% for analgesia and from 0.5% to 23.0% for anaesthesia. General anaesthesia was used for 2.1% of 
births. It was used in 6.4% of caesarean sections. Approximately 36% of women who gave birth received none of the 
specified methods for analgesia during labour. 

Table 18a: Analgesia for labour,* women who gave birth, South Australia, 2008 

Analgesia Number % of women 

1 None 7,135 36.3 

2 Nitrous oxide and oxygen 7,355 37.4 

3 Narcotic (parenteral) 3,970 20.2 

4 Epidural (lumbar/caudal) 6,103 31.0 

5 Spinal 162 0.8 

6 Other 240 1.2 

7 Combined spinal-epidural 12 0.1 

* more than one method may be used for each woman 

Table 18b: Anaesthesia for birth,* women who gave birth, South Australia, 2008 

Anaesthesia Number % of women 

1 None 7,326 37.2 

2 Local anaesthesia 2,517 12.8 

3 Pudendal 183 0.9 

4 Epidural (lumbar/caudal) 5,002 25.4 

5 Spinal 4,529 23.0 

6 General anaesthesia 412 2.1 

7 Other 175 0.9 

8 Combined spinal-epidural 59 0.3 

* more than one method may be used for each woman 

19. Postnatal length of stay of women 
The distribution of length of stay of women who gave birth in hospitals is presented in Table 19a for public and 
private patients. The median duration for all women was three days. It was three days for vaginal births and five days 
for caesarean births (Table 19b). The median duration of stay was two days longer for private patients for vaginal and 
one day longer for caesarean births (four and five days respectively for private patients compared with two and four 
days respectively for public patients). 

page 41Pregnancy Outcome in South Australia 2008 



  

 

  

 

 
 

 
 

   
  

   
 

 

 

 

Mothers and Babies 

Table 19a: Postnatal length of stay by type of patient, women who gave birth in South Australian 
hospitals, 2008 

Postnatal length Public Private Total 

of stay (days) 
Number % Number % Number % 

&lt;1 612 4.6 34 0.5 646 3.3

 1 2,169 16.3 76 1.2 2,245 11.5

 2 3,246 24.4 221 3.5 3,467 17.7

 3 3,047 22.9 700 11.2 3,747 19.1

 4 2,304 17.3 2,470 39.5 4,774 24.4

 5 1,208 9.1 1,900 30.4 3,108 15.9

 6 409 3.1 641 10.2 1,050 5.4

  7 or more 319 2.4 215 3.4 534 2.7 

Total 13,314 100.0 6,257 100.0 19,571 100.0 

Table 19b: Average postnatal length of stay by type of patient &amp; type of birth, women who gave birth in 
South Australian hospitals, 2008 

Average Public Private Total 

length 
of stay 

Vaginal 
(n= 

9,532) 

Caesarean 
(n= 

3,782 

Total 
(n= 

13,314) 

Vaginal 
(n= 

3,705) 

Caesarean 
(n= 

2,552) 

Total 
(n= 

6,257) 

Vaginal 
(n= 

13,237) 

Caesarean 
(n= 

6,334) 

Total  
(n= 

19,571) 

Mean 
number 2.33 4.31 2.89 3.86 5.17 4.39 2.75 4.66 3.37
of days 

( SD) ( 1.61) ( 2.41) ( 2.07) ( 1.06) ( 1.01) ( 1.23) ( 1.63) ( 2.02) ( 1.97) 

Median 
number 2 4 3 4 5 4 3 5 3 
of days 

20. Sex of baby 
The sex distribution of babies is provided in Table 20; the male:female sex ratio was 1.04:1. 

Table 20: Sex of baby, all births, South Australia, 2008 

Sex of baby Number % 

Male 10,164 50.9 

Female 9,806 49.1 

Total 19,970 100.0 

page 42 Pregnancy Outcome in South Australia 2008 



Mothers and Babies 

21. Birthweight and gestation 
The birthweight distribution of all births is presented in Table 21. The percentage of low birthweight babies (&lt;2,500g) 
was 7.0%, and that of very low birthweight babies (&lt;1,500g) was 1.6%. The mean birthweight was 3,343g (SD 
623.9g), with birthweights ranging from 100g to 5,500g. The proportion of low birthweight babies was 17.6% 
among babies of Aboriginal women compared with 6.6% among babies of non-Aboriginal women. Among live born 
babies, these proportions were 16.3% and 6.0% respectively. 

Table 21: Birthweight distribution of all births, South Australia, 2008 

Birthweight (g) Number of births Percentage of births 

&lt;400 58 0.3 

400-499 34 0.2 

500-749 51 0.3 

750-999 53 0.3 

1,000-1,499 117 0.6 

1,500-1,999 274 1.4 

2,000-2,499 804 4.0 

2,500-2,999 3,049 15.3 

3,000-3,499 7,195 36.0 

3,500-3,999 6,091 30.5 

4,000-4,499 1,932 9.7 

4,500+ 308 1.5 

Unknown 4 0.0 

Total 19,970 100.0 

In 2008, 1,391 babies (7.0%) were of low birthweight and 1,711 (8.6%) were preterm (&lt;37 weeks gestation). The 
proportion of preterm births was 15.1% among babies of Aboriginal women compared with 8.4% among babies of 
non-Aboriginal women. 

22. Birth injuries 
Birth injuries were reported in 146 live births (0.7%). The most common injury reported was cephalhaematoma. 
Fracture and nerve injury occurred less frequently (Table 22). 

Table 22: Birth injuries* in 19,819 live births, South Australia, 2008 

Birth injury Number of live births % of live births 

None 19,673 99.3 

Fracture 14 0.1 

Nerve Injury 8 0.0 

Cephalhaematoma 97 0.5 

Other 29 0.1

 * more than one injury may occur in each birth 

Pregnancy Outcome in South Australia 2008 page 43 



 
 

   

Mothers and Babies 

23. Treatment given in neonatal period 
The proportions of live births who received specified treatments in the neonatal period are provided in Table 23: 
84.8% of neonates did not receive any of these treatments. 

Table 23: Neonatal treatment given, all live births, South Australia, 2008 

Neonatal treatment Number % of live births 

None of the treatments 
listed below 

16,800 84.8 

Oxygen therapy for more 
than 4 hours 

975 4.9 

Phototherapy for jaundice 1,477 7.4 

Gavage feeding more than once 1,562 7.9 

Any intravenous therapy 1,724 8.7 

24. Level of care utilised 
Table 24 shows that 84.4% of neonates utilised Level I care only. Level II care was used by 15.4% of neonates, Level 
III care at the Women s and Children s Hospital or Flinders Medical Centre by 2.5% and paediatric intensive care at 
the Women s and Children s Hospital by 0.3% of neonates. As would be expected, with decreasing birthweight, an 
increasing percentage of babies required Level II and Level III care. 

Table 24: Level of nursery care utilised by birthweight, all live births, South Australia, 2008 

Level of care utilised 

Birthweight (g) 

&lt;1,500 
(n=210) 

1,500-2,499 
(n=1,057) 

2,500+ 
(n=18,549) 

Total 
(n=19,819*) 

Number % Number % Number % Number % 

Level I only 24 11.4 197 18.6 16,501 89.0 16,725* 84.4 

Level II 172 81.9 851 80.5 2,033 11.0 3,056 15.4 

Level III (W&amp;CH &amp; FMC) 170 81.0 165 15.6 157 0.9 492 2.5 

Level III (W&amp;CH 
Paediatric intensive care) 

4 1.9 11 1.0 40 0.2 55 0.3 

*includes three births of unknown birthweight born at 42 weeks gestation 

25. Length of stay of babies 
Table 25 shows the distribution of length of stay of liveborn babies in hospital for preterm (&lt;37 weeks gestation) and 
term births (?37 weeks gestation). The mean duration of stay for all liveborn babies was 5.1 days (SD 10.8) and the 
median duration 4 days. The mean duration was 3.6 days (SD 4.9) for term births and 22.3 days (SD 29.2) for preterm 
births, while the median durations were 3 and 14 days respectively. 

page 44 Pregnancy Outcome in South Australia 2008 



 
 

Mothers and Babies 

Table 25: Length of stay of liveborn babies in hospital, South Australia, 2008 

Length of Preterm births Term births Total 

stay (days) 
Number % Number % Number % 

&lt;1 30 1.9 576 3.2 606 3.1

 1 17 1.1 2,087 11.5 2,104 10.7

 2 43 2.7 3,171 17.5 3,214 16.3

 3 65 4.1 3,465 19.1 3,530 17.9

 4 96 6.0 4,432 24.4 4,528 23.0

 5 105 6.6 2,786 15.4 2,891 14.7

 6 109 6.9 899 5.0 1,008 5.1

 7-13 319 20.1 554 3.1 873 4.4

 14-20 273 17.2 81 0.4 354 1.8

 21-27 157 9.9 33 0.2 190 1.0

  28 or more 376 23.6 45 0.2 421 2.1 

Total 1,590 100.0 18,129 100.0 19,719 100.0 

26. Congenital abnormalities 
Among the 19,970 births in 2008 there were 547 births (2.7%) notified with congenital abnormalities; 515 (2.6%) 
of these births had abnormalities notified in the congenital anomalies range 74000-75999 of the British Paediatric 
Association (BPA) Classification of Diseases. This is a 5-digit extension of the 4-digit classification of the ICD-9 
(International Classification of Diseases. Manual of the International Statistical Classification of Diseases,    
Injuries and Causes of Death, 1975 Revision. Geneva: World Health Organisation, 1977). Table 26 includes births 
with the more readily identifiable defects used for international monitoring (sentinel defects) notified to the perinatal 
statistics collection in 1998-2008. 

Terminations of pregnancy are not included in this table unless they meet a criterion for inclusion in the perinatal data 
collection, ie at least 400g birthweight or 20 weeks gestation. Notifications of births with birth defects identified after 
discharge from the hospital of birth but within the first five years of life are made to the South Australian Birth Defects 
Register at the Women s and Children s Hospital, and more complete statistics on birth defects in South Australia are 
available from the Register s Annual Report.2 

page 45Pregnancy Outcome in South Australia 2008 



  

 

 

 

Mothers and Babies 

Table 26: Selected congenital abnormalities notified to the perinatal statistics collection, 
1998-2008, South Australia 

Congenital 
abnormality 

Year 

BPA* CODE 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 

Number of 
births = 

18,734 18,519 17,871 17,704 17,745 17,844 17,522 18,196 18,803 19,757 19,970 

74000-74029 
Anencephalus 

1 2 3 1 4 0 1 0 1 1 1 

74100-74199 
Spina bifida 

9 4 5 9 4 7 5 5 8 5 4 

74200-74209 
Encephalocele 

0 1 0 0 1 0 0 1 1 2 1 

74230-74239 
Hydrocephalus 

5 7 4 4 3 7 6 9 10 12 11 

74900-74909 
Cleft palate 

16 8 10 14 17 9 10 15 11 12 9 

74910-74929 
Cleft lip and palate 
(Total cleft lip) 

20 17 16 15 16 14 17 9 16 30 28 

75030-75038 
Tracheo 
oesophageal 
fistula, 
oesophageal 
atresia and stenosis 

7 6 2 10 3 2 2 5 4 12 5 

75120-75124 
Atresia and 
stenosis of large 
intestine, rectum 
and anal canal 

13 5 9 3 9 6 6 12 4 7 9 

75260-75261 
Hypospadias and 
epispadias 

46 43 40 40 42 34 41 38 29 41 40 

75300-75301 
Renal agenesis 
and dysgenesis 

2 4 5 7 5 10 4 12 8 8 3 

75520-75549 Limb 
reduction defects 

9 9 11 6 7 5 8 8 13 18 9 

75660-75669 
Anomalies of 
diaphragm 

3 4 7 6 7 4 4 7 12 7 9 

75670-75679 
Anomalies of 
abdominal wall 

12 8 8 13 10 13 12 9 10 7 9 

75800-75809 
Down syndrome 

25 25 19 21 19 13 14 19 17 17 21 

* British Paediatric Association Classification of Diseases. London: The British Paediatric Association, 1979. 

Pregnancy Outcome in South Australia 2008 page 46 



Mothers and Babies 

27. Multiple births 
Among women who gave birth there were 296 twin and 1 triplet pregnancy compared with 19,375 singleton ones. 
Thus there was one twin pregnancy in every 66 pregnancies and one triplet pregnancy in every 19,672 pregnancies 
among women who gave birth. Women who gave birth with twins or triplets comprised 1.5% of all women who 
gave birth. The total number of multiple births was 595 (3.0% of total births). 

A comparison of multiple births with singleton ones shows that multiple births were of lower birthweight (with 
53.4% being of low birthweight compared with 5.5% for singletons, Table 27a), and gestation (with 59.3% being 
preterm births compared with 7.0% for singletons, Table 27b). The proportion of live births in hospital at 28 days was 
20% for multiple births compared with 1.6% for singletons, and the perinatal death rate for multiple births was also 
elevated (33.6 compared with 9.4 deaths per 1,000 births for singletons, Table 27c). 

Table 27a: Birthweight by plurality, all births, South Australia, 2008 

Birthweight (g) 

Singleton births Multiple births 

Number % Number % 

&lt;400 49 0.3 9 1.5 

400-499 31 0.2 3 0.5 

500-749 44 0.2 7 1.2 

750-999 39 0.2 14 2.4 

1,000-1,499 91 0.5 26 4.4 

1,500-1,999 194 1.0 80 13.4 

2,000-2,499 625 3.2 179 30.1 

2,500-2,999 2,852 14.7 197 33.1 

3,000-3,499 7,123 36.8 72 12.1 

3,500-3,999 6,084 31.4 7 1.2 

4,000-4,499 1,932 10.0 0 0 

4,500+ 308 1.6 0 0 

Unknown 3 0.0 1 0.2 

Total 19,375 100.0 595 100.0 

page 47Pregnancy Outcome in South Australia 2008 



 
 

 

Mothers and Babies 

Table 27b: Gestation at birth by plurality, all births, South Australia, 2008 

Gestation 
Singleton births Multiple births Total 

(weeks) 
Number % Number % Number % 

&lt;24 98 0.5 8 1.3 106 0.5 

24-27 72 0.4 17 2.9 89 0.4 

28-31 114 0.6 43 7.2 157 0.8 

32-36 1,074 5.5 285 47.9 1,359 6.8 

37-41 17,938 92.6 242 40.7 18,180 91.0 

42+ 79 0.4 0 0 79 0.4 

Total 19,375 100.0 595 100.0 19,970 100.0 

Table 27c: Perinatal outcome by plurality, all births, South Australia, 2008 

Perinatal 
Singleton births Multiple births Total 

outcome 
Number % Number % Number % 

Stillbirth 135 0.7 16 2.7 151 0.8 

Discharged 
within 28 days 

18,878 97.4 456 76.6 19,334 96.8 

In hospital at 
28 days 

315 1.6 119 20.0 434 2.2 

Neonatal death 47 0.2 4 0.7 51 0.3 

Total 19,375 100.0 595 100.0 19,970 100.0 

28. Perinatal mortality 
The decline in perinatal mortality with increasing birthweight is demonstrated in Table 28a and Figure 6. There was an 
increase in the perinatal mortality rate above that of the birthweight group with the lowest mortality (0.5 per 1,000 
births for 4,000-4,499g) for the birthweight group 4,500g and above (3.2 per 1,000 births). The perinatal mortality 
rate for babies of normal birthweight (2,500g or more) was 1.9 per 1,000 births. The decline in perinatal mortality 
with increasing gestational age is demonstrated in Table 28b. 

page 48 Pregnancy Outcome in South Australia 2008 



 
&lt;5
00

 

50
0-

75
0-

10
00

-

15
00

-

20
00

-

25
00

-

30
00

-

35
00

-

40
00

+

 45
00

+

 

Mothers and Babies 

Table 28a: Perinatal mortality by birthweight, all births, South Australia, 2008 

Birthweight 
(g) 

Total 
births 

Live 
births 

Stillbirths Neonatal dealths Perinatal deaths 

Number 
Deaths 

per 1,000 
births 

Number 
Deaths 

per 1,000 
live births 

Number 
Deaths 

per 1,000 
births 

&lt;400 58 11 47 810.3 11 1,000.0 58 1,000.0 

400-499 34 11 23 676.5 6 545.5 29 852.9 

500-749 51 32 19 372.5 11 343.8 30 588.2 

750-999 53 47 6 113.2 5 106.4 11 207.5 

1,000-1,499 117 109 8 68.4 2 18.3 10 85.5 

1,500-1,999 274 266 8 29.2 2 7.5 10 36.5 

2,000-2,499 804 791 13 16.2 5 6.3 18 22.4 

2,500-2,999 3,049 3,042 7 2.3 3 1.0 10 3.3 

3,000-3,499 7,195 7,182 13 1.8 3 0.4 16 2.2 

3,500-3,999 6,091 6,086 5 0.8 2 0.3 7 1.1 

4,000-4,499 1,932 1,931 1 0.5 0 0 1 0.5 

4,500+ 308 308 0 0 1 3.2 1 3.2 

Unknown 4 3 1* na 0 0 1* na 

Total 19,970 19,819 151 7.6 51 2.6 202 10.1 

* this stillbirth was a twin born at 30 weeks gestation 

na: not applicable 

Figure 6: Perinatal mortality rate by birthweight, all births, South Australia, 2008 

1000  

100  

10  

1

Pe
ri

n
at

al
 d

ea
th

s 
p

er
 1

,0
00

 b
ir

th
s

(l
o

g
ar

it
h

m
ic

 s
ca

le
) 

0.1 

Birthweight (g) 

page 49Pregnancy Outcome in South Australia 2008 



   

 

 

Mothers and Babies 

Table 28b: Perinatal mortality by gestational age at birth, South Australia, 2008 

Gestational 
age at birth 
(weeks) 

Total 
births 

Live 
births 

Stillbirths Neonatal deaths Perinatal deaths 

Number 
Deaths 

per 1,000 
births 

Number 
Deaths per 
1,000 live 

births 
Number 

Deaths 
per 1,000 

births 

&lt;24 106 26 80 754.7 24 923.1 104 981.1 

24-27 89 77 12 134.8 8 103.9 20 224.7 

28-31 157 146 11 70.1 3 20.5 14 89.2 

32-36 1,359 1,343 16 11.8 7 5.2 23 16.9 

37-41 18,180 18,148 32 1.8 9 0.5 41 2.3 

42+ 79 79 0 0 0 0 0 0 

Total 19,970 19,819 151 7.6 51 2.6 202 10.1 

High crude perinatal mortality rates were associated with low birthweight births (Table 28a), low gestation births 
(Table 28b) and multiple births (Table 27c). The perinatal mortality rate for all births (livebirths of any gestation and 
stillbirths of at least 400g birthweight/20 weeks gestation) in 2008 was 10.1 per 1,000 births. The stillbirth rate was 
7.6 per 1,000 births and the neonatal mortality rate was 2.6 per 1,000 live births. The perinatal mortality rates for 
other specified minimum birthweights or gestational ages (where birthweight was unavailable) are provided in Table 
28c. The perinatal mortality rate recommended by the World Health Organisation (WHO) for use in international 
comparison refers only to births of at least 1,000g birthweight (or, if birthweight is unavailable, 28 weeks gestation) 
and to (early) neonatal deaths within the first 7 days of life. This rate was 3.4 per 1,000 births in 2008, with a stillbirth 
rate of 2.8 per 1,000 births and an early neonatal mortality rate of 0.6 per 1,000 live births. This early neonatal 
mortality rate was the same as in 2007, the lowest on record in the state. The perinatal mortality rate for births to 
Aboriginal women was 23.5 per 1,000 births in 2008 compared with 9.7 per 1,000 births for births to 
non-Aboriginal women (Table 28d). 

Table 28c: Perinatal mortality, South Australia, 2008 (all births of specified birthweight/gestation) 

Specified 

Total 
births 

Live 
births 

Stillbirths Neonatal deaths Perinatal deaths 

birthweight/ Deaths Deaths per Deaths 

gestation Number Number Number per 1,000 Number 1,000 live Number per 1,000 
births births births 

?400g/20 
weeks* 19,970 19,819 151 7.6 51 2.6 202 10.1 

?500g/22 
weeks 19,878 19,797 81 4.1 34 1.7 115 5.8 

(WHO 
National 25** 1.3 106** 5.3 
Statistics) 

?1,000g/28 
weeks 19,774 19,718 56 2.8 18 0.9 74 3.7 

(WHO 
International 11** 0.6 67** 3.4 
Statistics) 

* includes live births of any gestation. There were 58 births of birthweight &lt;400g 

** only neonatal deaths within the first 7 days of life are included 

Pregnancy Outcome in South Australia 2008 page 50 



Mothers and Babies 

Table 28d: Perinatal mortality by race, all births, South Australia, 2008 

Race 

Total births Stillbirths 
Neonatal 

deaths 
Alive at 28 

days 
Perinatal deaths 

Number Number Number Number Number Deaths per 1,000 births 

Caucasian 17,217 124 39 17,054 163 9.5 

Aboriginal 637 11 4 622 15 23.5 

Asian 1,400 12 5 1,383 17 12.1 

Other 716 4 3 709 7 9.8 

Total 19,970 151 51 19,768 202 10.1 

29. Home births 
Supplementary Birth Records were received from home birth midwives for 94 planned home births which occurred 
at home in 2008. There were seven unplanned home births in South Australia in 2008 which have been excluded 
from the planned home birth statistics. Five of these were to women who received antenatal care with the Midwifery 
Group Practice at the Women s and Children s Hospital. The other two unplanned home births were to women who 
had no antenatal care. Both of these resulted in perinatal deaths. 

Ascertainment of planned home births occurring at home in South Australia for the year 2008 is estimated to be 
88.7% (94 out of 106 home births). This estimate has been derived from a comparison with data from the Births, 
Deaths and Marriages Registration Division on births registered, which did not occur in hospital (and were not BBAs 
- babies born before arrival at the hospital into which the woman had been booked). In addition, 21 women who 
planned to birth at home were transferred to hospital care before birth. Statistics for all 115 planned home births in 
2008 are provided in Tables 29-32, by place of birth. 

Table 29: Planned home births by age of women, South Australia, 2008 

Age (years) 

Birthed at home Birthed in hospital Total 

Number % Number % Number % 

&lt;20 0 0 2 9.5 2 1.7 

20-24 7 7.4 0 0 7 6.1 

25-29 26 27.7 5 23.8 31 27.0 

30-34 44 46.8 8 38.1 52 45.2 

35-39 13 13.8 5 23.8 18 15.6 

40-44 4 4.3 1 4.8 5 4.4 

45+years 0 0 0 0 0 0 

Total 94 100.0 21 100.0 115 100.0 

page 51Pregnancy Outcome in South Australia 2008 



 
Mothers and Babies 

Table 30: Method of birth in planned home births, South Australia, 2008 

Method of birth 

Birthed at home Birthed in hospital Total 

Number % Number % Number % 

Normal 
spontaneous 
vaginal 

91 96.8 8 38.1 99 86.1 

Emergency 
caesarean section 0 0 12 57.1 12 10.4 

Assisted breech 
(no forceps) 1 1.1 0 0 1 0.9 

Breech 
spontaneous 2 2.1 1 4.8 3 2.6 

Total 94 100.0 21 100.0 115 100.0 

Table 31: Birthweight distribution of planned home births, South Australia, 2008 

Birthweight (g) 

Birthed at home Birthed in hospital Total 

Number % Number % Number % 

2,500-2,999 4 4.3 2 9.5 6 5.2 

3,000-3,499 30 31.9 1 4.8 31 27.0 

3,500-3,999 39 41.5 8 38.1 47 40.9 

4,000-4,499 16 17.0 5 23.8 21 18.2 

4,500+ 3 3.2 4 19.0 7 6.1 

Unknown 2 2.1 1 4.8 3 2.6 

Total 94 100.0 21 100.0 115 100.0 

Table 32: Perinatal outcome in planned home births, South Australia, 2008 

Perinatal 
outcome 

Birthed at home Birthed in hospital Total 

Number % Number % Number % 

Stillbirth 1 1.1 0 0 1 0.9 

Discharged within 
28 days 

92 97.8 21 100.0 113 98.2 

Prolonged 
hospitalisation (in 
hospital at 28 days) 

1 1.1 0 0 1 0.9 

Total 94 100.0 21 100.0 115 100.0 

page 52 Pregnancy Outcome in South Australia 2008 



 
 

Mothers and Babies 

30. Birthing unit births 
Statistics presented for births in birthing units in South Australia (Tables 33-36) relate to the birthing units at the 
Women s and Children s Hospital, the Lyell McEwin Health Service and Flinders Medical Centre. The units at the 
Women s and Children s Hospital and the Lyell McEwin Health Service were established in 1992 and 1993 respectively 
under the Alternative Birthing Services Programme. In October 1996 the birthing unit at Flinders Medical Centre 
commenced a birthing service. These statistics relate to all 2,377 women for whom it was reported that  birthing 
unit  was their intended place of birth. Of these women, 1,237 gave birth in the birthing units while 1,140 women 
(48.0%) gave birth in labour wards. Some of these women were transferred to labour wards because of medical or 
obstetric complications. With the commencement of the Midwifery Group Practice model of care at Women s and 
Children s Hospital in 2004, more of these women who gave birth in labour wards than previously did so because the 
birthing unit was not available at the time. Among the women who gave birth in labour wards, 27.6% had caesarean 
sections and 15.4% had instrumental births. These statistics have also been included in the statistics for the respective 
hospitals. Sixty-five babies (2.7%) were of low birthweight and there were five perinatal deaths (perinatal mortality 
rate 2.1 per 1,000 births). 

Table 33: Planned birthing unit births by age of women, South Australia, 2008 

Age (years) 

Birthed at home Birthed in hospital Total 

Number % Number % Number % 

&lt;20 89 7.2 65 5.7 154 6.5 

20-24 288 23.3 235 20.6 523 22.0 

25-29 367 29.7 299 26.2 666 28.0 

30-34 311 25.1 323 28.3 634 26.7 

35-39 166 13.4 183 16.1 349 14.7 

40-44 16 1.3 34 3.0 50 2.1 

45+ 0 0 1 0.1 1 0.0 

Total 1,237 100.0 1,140 100.0 2,377 100.0 

Table 34: Method of birth in planned birthing unit births, South Australia, 2008 

Method of birth 

Birthed in birthing unit Birthed in labour ward Total 

Number % Number % Number % 

Normal 
spontaneous vaginal 

1,198 96.8 645 56.6 1,843 77.5 

Forceps 10 0.8 82 7.2 92 3.9 

Assisted breech (no forceps) 0 0 2 0.2 2 0.1 

Caesarean section (elective) 0 0 45 3.9 45 1.9 

Caesarean section 
(emergency) 

0 0 270 23.7 270 11.4 

Ventouse 28 2.3 94 8.2 122 5.1 

Breech spontaneous 1 0.1 2 0.2 3 0.1 

Total 1,237 100.0 1,140 100.0 2,377 100.0 

page 53Pregnancy Outcome in South Australia 2008 



 
Mothers and Babies 

Table 35: Birthweight distribution of planned birthing unit births, South Australia, 2008 

Birthweight (g) 

Birthed in birthing unit Birthed in labour ward Total 

Number % Number % Number % 

&lt;1,500 0 0 7 0.6 7 0.3 

1,500-1,999 0 0 11 1.0 11 0.5 

2,000-2,499 8 0.6 39 3.4 47 2.0 

2,500-2,999 127 10.3 156 13.6 283 11.9 

3,000-3,499 455 36.8 382 33.3 837 35.1 

3,500-3,999 460 37.2 409 35.7 869 36.4 

4,000-4,499 168 13.6 121 10.5 289 12.1 

4,500+ 19 1.5 22 1.9 41 1.7 

Total 1,237 100.0 1,147 100.0 2,384 100.0 

Table 36: Perinatal outcome in planned birthing unit births, South Australia, 2008 

Perinatal outcome 

Birthed in birthing unit Birthed in labour ward Total 

Number % Number % Number % 

Stillbirth 1 0.1 3 0.3 4 0.2 

Discharged within 28 days 1,234 99.7 1,128 98.3 2,362 99.1 

Prolonged hospitalisation  
(in hospital at 28 days) 

2 0.2 15 1.3 17 0.7 

Neonatal death 0 0 1 0.1 1 0 

Total 1,237 100.0 1,147 100.0 2,384 100.0 

page 54 Pregnancy Outcome in South Australia 2008 



 
Termination of Pregnancy 

III. Terminations of Pregnancy 

1. Numbers and rates 
There were 5,101 terminations of pregnancy notified in South Australia in 2008. This was 217 more than in 2007. 
The abortion rate was 16.0 abortions per 1,000 women aged 15-44 years. After specific abortion legislation was 
introduced in 1970, the abortion rate rose to a peak of 13.9 in 1980, followed by a period of relative stability in the 
1980s. Another increase in the abortion rate commenced in 1991 (Table 37 and Fig 7) and reached a peak of 17.9 
in 1999. The rate declined significantly from 17.7 in 2001 to 15.3 in 2005 and was stable for three years before 
increasing to 16.0 in 2008. 

Table 37: Abortion rate per 1,000 women aged 15-44 years, South Australia, 1970 2008 

Year Number of abortions 
Abortions per 1,000 women 

aged 15-44 years 

1970 1,440 6.0 

1971 2,409 9.6 

1972 2,692 10.6 

1973 2,847 11.1 

1974 2,867 10.9 

1975 3,000 11.1 

1976 3,289 11.9 

1977 3,494 12.4 

1978 3,895 13.6 

1979 3,880 13.3 

1980 4,081 13.9 

1981 4,096 13.7 

1982 4,061 13.4 

1983 4,036 13.1 

1984 4,091 13.1 

1985 4,079 12.9 

1986 4,327 13.5 

1987 4,229 13.1 

1988 4,263 13.0 

1989 4,342 13.2 

1990 4,463 13.4 

1991 4,696 14.1 

1992 4,717 14.2 

1993 4,959 15.0 

Table 37 continued 

Pregnancy Outcome in South Australia 2008 page 55 



Year

 

Termination of Pregnancy 

Table 37 continued 

Year Number of abortions 
Abortions per 1,000 women 

aged 15-44 years 

1994 5,140 15.7 

1995 5,475 16.9 

1996 5,545 17.2 

1997 5,609 17.5 

1998 5,488 17.2 

1999 5,679 17.9 

2000 5,580 17.6 

2001 5,579 17.7 

2002 5,467 17.5 

2003 5,216 16.7 

2004 4,931 15.9 

2005 4,715 15.3 

2006 4,889 15.5 

2007 4,884 15.4 

2008 5,101 16.0 

Figure 7: Abortion rate in South Australia, 1970 2008 

0 

4 

8 

12 

16 

20 

Abortions per 1,000 women aged 15-44 years 

19
70

19
72

19
74

19
76

19
78

19
80

19
82

19
84

19
86

19
88

19
90

19
92

19
94

19
96

19
98

20
00

20
02

20
04

20
06

20
08

 

Pregnancy Outcome in South Australia 2008 page 56 



Termination of Pregnancy 

2. Age of women 
The age distribution of women who had terminations is shown in Table 38. Among the five year age groups (Table 
39), the highest abortion rate was among women aged 20-24 years (28.0 per 1,000 women) followed by women 
aged 25-29 years (20.8) and teenage women 15-19 years (18.5 per 1,000 women). Compared with 2007, abortion 
rates have fallen for women aged 25-29 years, but increased for teenage women and those aged 20-24 years and 
30-34 years. The abortion proportion (abortions as a proportion of abortions and live births) was 0.20; it was highest 
among teenagers (0.52), and was also high among women aged 20-24 years (0.33) and older women aged 40 years 
or more (0.26). This indicates that about 52% of known teenage pregnancies were terminated. This proportion was 
highest for younger teenagers (0.74 for those aged &lt;15 years). 

Table 38: Terminations of pregnancy by age, South Australia, 2008 

Age (years) Number % 

13 2 0.0 

14 21 0.4 

15 49 1.0 

16 129 2.5 

17 202 4.0 

18 271 5.3 

19 290 5.7 

20-24 1,524 29.9 

25-29 1,047 20.5 

30-34 771 15.1 

35-39 545 10.7 

40-44 223 4.4 

45+ 27 0.5 

Total 5,101 100.0 

The distribution of abortions and live births by age in South Australia in 2008 (Table 39 and Figure 8a) demonstrates 
that the largest proportion of abortions occurred in the age group 20-24 years while the largest proportion of live 
births occurred among those 30-34 years, who had the highest fertility (live birth) rate of 124.6 per 1,000 women. 
Teenagers accounted for 18.9% of the abortions and 4.4% of the live births in South Australia in 2008. The teenage 
pregnancy rate (per 1,000 women aged 15-19 years) declined in the 1970s and 1980s with the decline in the teenage 
birth rate but increased in the 1990s till 1996. After that it declined again, and, from 2003, this was associated with 
a decline in the teenage abortion rate (Figure 8b). The teenage pregnancy rate in 2008 was 35.4 per 1,000 women, 
slightly higher than the rate of 35.0 in 2007, which was the lowest rate recorded since 1970. 

page 57Pregnancy Outcome in South Australia 2008 



 
 

 

Termination of Pregnancy 

Table 39: Abortion and live birth rates and abortion proportions by age, South Australia, 2008 

Age 
(years) 

Number 
of 

abortions 

Estimated 
resident female 
population June 

30th 2008* 

Abortion 
rate per 

1,000 
women 

Number of 
live births** 

Fertility rate 
per 1,000 
women 

Abortions + 
live births 

Abortion 
proportion 

&lt;15 23 na na 8 na 31 0.74 

15-19 941 52,072 18.5** 871 16.9** 1,812 0.52 

20-24 1,524 54,525 28.0 3,090 56.7 4,614 0.33 

25-29 1,047 50,443 20.8 5,456 108.2 6,503 0.16 

30-34 771 49,531 15.6 6,173 124.6 6,944 0.11 

35-39 545 56,360 9.7 3,504 62.2 4,049 0.13 

40-44 223 56,534 4.4** 664 12.5** 887 0.25 

45+ 27 na na 42 na 69 0.39 

Total 5,101 319,465 16.0** 19,808 62.0** 24,909 0.20 

* Australian Bureau of Statistics. Population Estimates by Age and Sex, South Australia 2008. Canberra: ABS, 2009 (Catalogue No 3235.0). 

** Terminations of pregnancy are excluded from the numbers of live births. The abortion and live birth rates for women aged 15-19 years include 
terminations and live births at younger ages, and the rates for women aged 40-44 years include terminations and live births at older ages, while the 
total rates include all terminations and live births. 

Figure 8a: Abortions and live births by age, South Australia, 2008 

Pe
rc

en
ta

g
e 

o
f 

w
o

m
en

 

100% 

80% 

60% 

40% 

20% 

0% 

Abortions Live births Abortions &amp; Live births 
n=5,101 n=19,808 n=24,909 

&lt; 20 20-24 25-29 30-34 35-39 40+ 

Age (years) 

Pregnancy Outcome in South Australia 2008 page 58 



*Abortions and births to women aged less than 15 years are included in the numerator

 

 

0 

10 

20 

30 

40 

50 

60 

Rate per 1,000 women aged 15-19 years 

Figure 8b: Teenage pregnancy, abortion and birth rates, South Australia, 1970 2008 

Termination of Pregnancy 

70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99
20

00
20

01
20

01
20

02

20
03

20
04

20
05

20
06

20
07

20
08

 

Year 

Pregnancy rate* Birth rate* Abortion rate* 

*Abortions and births to women aged less than 15 years are included in the numerator 

3. Marital status 
Terminations were performed in the majority of cases (62.7%) for single women (Table 40). In 2.5% of cases the 
marital status was not known. 

Table 40: Terminations by marital status, South Australia, 2008 

Marital status Number % 

Never married 2,749 53.9 

Married 1,230 24.1 

De facto 546 10.7 

Widowed 6 0.1 

Divorced/Separated 441 8.6 

Not known 129 2.5 

Total 5,101 100.0 

Pregnancy Outcome in South Australia 2008 page 59 



Termination of Pregnancy 

4. Place of residence and place where termination performed 
While 82.8% of terminations were performed for metropolitan residents (Table 41), a larger proportion (95.2%) 
was performed in metropolitan hospitals (Table 42), which include the Pregnancy Advisory Centre at which 2,856 
terminations (56.0% in the state) were performed. 

Table 41: Terminations by place of residence, South Australia, 2008 

Residence of women Number % 

Metropolitan 4,225 82.8 

Country 876 17.2 

Total 5,101 100.0 

Table 42: Terminations by hospital category, South Australia, 2008 

Hospital where termination performed Number % 

Metropolitan public 4,751 93.2 

Metropolitan private 103 2.0 

Country 247 4.8 

Total 5,101 100.0 

The proportion of terminations performed by obstetricians was 19.0%, which has declined from 68.5% in 1991, 
while the proportion performed by medical practitioners in family advisory clinics has increased from 23.8% in 1991 
to 78.4% in 2008 (Table 43). 

Table 43: Terminations by category of doctor, South Australia, 2008 

Category of doctor performing termination Number % 

Obstetrician/gynaecologist 970 19.0 

Trainee obstetrician/gynaecologist 70 1.4 

Medical practitioner in family advisory clinic 3,999 78.4 

General practitioner 62 1.2 

Total 5,101 100.0 

page 60 Pregnancy Outcome in South Australia 2008 



Termination of Pregnancy 

5. The reason for termination 
The number of terminations performed for fetal reasons was 147 (2.9% of terminations), of which 144 (98.0%) were 
for specified fetal or chromosomal abnormalities (Table 44). 

Table 44: Reason for termination for fetal reasons, South Australia, 2008 

Reason for termination Number % 

Identified chromosomal abnormality 80 54.4 

Other identified fetal abnormality 64 43.5 

Possibility of damage from drugs 2 1.4 

Possibility of hereditary disease 1 0.7 

Total 147 100.0 

6. Gestation, method and complications 
The majority of terminations (92.7%) were performed within the first 14 weeks of pregnancy and most frequently (in 
89.2% of cases) by vacuum aspiration. There were 87 late terminations (performed at 20 weeks gestation or later): 
56.3% of these were performed for fetal reasons. Eighteen women were reported to have had complications (0.4%). 
The types of complications are listed in Table 45. Complications are known to be under-notified as the notification 
forms are usually completed about the time the woman is discharged from hospital after the procedure. The South 
Australian Abortion Reporting Committee reported that 35 other women who had terminations in 2008 had 
complications after discharge, which had not been notified. This was ascertained through linkage of the abortion data 
with the South Australian hospital morbidity collection (ISAAC). 

Table 45: Complications of terminations, South Australia, 2008 

Complications Number % of complications 

Sepsis/endometrits 4 22.2 

Haemorrhage - intra-operative 2 11.1

 - post-operative 1 5.6 

Perforation of or trauma to body of uterus 0 0 

Anaesthetic complication 0 0 

Retained products of conception 7 38.9 

Other 4 22.2 

Total 18 100.0 

page 61Pregnancy Outcome in South Australia 2008 



  

 

Termination of Pregnancy 

7. Previous terminations. Total abortion rate and Total first abortion rate 
Of the 5,101 women who had terminations, 1,860 (36.5%) had had a previous termination (Table 46a). Among the 
teenagers 14.2% had had a previous termination; 35.0% of women  aged 20-24 years and just under half of women 
25-39 years had undergone a previous termination. The total abortion rate (TAR) for 2008 was 485.0 per 1,000 
women aged 15-44 years (Table 46b). This represents the number of abortions 1,000 women would have during their 
lifetime if they experienced the abortion rates of the different age groups for 2008. As a woman may have more than 
one abortion in her lifetime, to estimate how prevalent abortion is at these age-specific abortion rates for 2008, a 
total first abortion rate (TFAR, Table 46c) may be calculated after exclusion of women with repeat terminations. This 
TFAR for 2008 was 308.0 per 1,000 women aged 15-44 years. This suggests that 30.8% of women would have an 
abortion in their lifetime if they experienced the abortion rates of the different age groups for 2008. 

Table 46a: Women with previous terminations by age, South Australia, 2008 

Age (years) Number % % of age group 

&lt; 15 1 0.0 4.4 

15 - 19 136 7.3 14.5 

20 - 24 533 28.7 35.0 

25 - 29 467 25.1 44.6 

30 - 34 366 19.7 47.5 

35 - 39 248 13.3 45.5 

40+ 109 5.9 43.6 

Total 1,860 100.0 36.5 

Further details of abortions in South Australia in 2008 may be obtained from the Sixth Annual Report of the South 
Australian Abortion Reporting Committee   for the year 2008.6 

Table 46b: Calculation of total abortion rate (TAR) for 2008 for South Australia* 

Age (years) 
Number of women 

who had terminations 
Estimated female resident 
population 30th June 2008 

Abortion rate 
per 1,000 women 

15-19* 964* 52,072 18.5* 

20-24 1,524 54,525 28.0 

25-29 1,047 50,443 20.8 

30-34 771 49,531 15.6 

35-39 545 56,360 9.7 

40-44* 250* 56,534 4.4* 

Total 5,101 319,465 16.0

 * In these calculations, abortions for women under 15 years are included in the age group 15-19 yrs and abortions for women aged 45 years or more 
are included in the age group 40-44 years, as is traditional. 

Total abortion rate = sum of abortion rates for 5-year age groups x 5 = 97.0 x 5 = 485.0 per 1,000 women aged 15-44 years. 

page 62 Pregnancy Outcome in South Australia 2008 



  
 

 

Termination of Pregnancy 

Table 46c: Calculation of total first abortion rate (TFAR) for 2008 for South Australia* 

Age 
(years) 

Number of 
women who 

had terminations 
(A) 

Number of women 
who had previous 

terminations 
(B) 

Number of 
women who had 
first termination 

(A)   (B) 

Estimated female 
resident population 

June 30th 2008 

First 
abortion rate 

per 1,000 
women 

15-19 964* 137* 827* 52,072 15.9* 

20-24 1,524 533 991 54,525 18.2 

25-29 1,047 467 580 50,443 11.5 

30-34 771 366 405 49,531 8.2 

35-39 545 248 297 56,360 5.3 

40-44 250* 109* 141* 56,534 2.5* 

Total 5,101 1,860 3,241 319,465 10.1

 * In these calculations, abortions for women under 15 years are included in the age group 15-19 yrs and abortions for women  aged 45 years or more 
are included in the age group 40-44 years, as is traditional. 

Total first abortion rate (TFAR) = sum of first abortion rates for 5-year age groups x 5 = 61.6 x 5 = 308.0  per 1,000 women aged 15-44 yrs. 

page 63Pregnancy Outcome in South Australia 2008 



  

 

 

 

 

 

Obstetric Profiles by Hospital Category 

IV. Obstetric Profiles by Hospital Category 
Obstetric profiles for five hospital categories for 2008 are provided in Table 47 and Figures 9-28. 

These hospital categories are: 

1. Metropolitan teaching Level III hospitals with neonatal intensive care facilities, ie the Women s &amp; Children s Hospital 
and Flinders Medical Centre, 

2. Other metropolitan teaching hospitals, ie the Lyell McEwin Health Service and Modbury Hospital, 

3. Metropolitan private hospitals, 

4. The two major country hospitals (Mount Gambier and Whyalla) and 

5. Other country hospitals (mainly smaller). 

A list of maternal and baby factors identified either as risk factors for poor perinatal outcome in earlier analyses,7 or 
of general interest, is provided with  means  for all state hospital births as well as proportions for the five hospital 
categories. 

The  mean  is the proportion for women who gave birth in all state hospitals (for maternal factors) or births in all 
state hospitals (for baby factors), 

e.g. % Aboriginal women 

Number of Aboriginal women who gave birth in state hospitals 
x 100 

Total women who gave birth in state hospitals 

Where indicated (+) in Table 47, it is the mean (number of women who gave birth, or births) for the 24 hospitals 
or groups of hospitals for which obstetric profiles have been provided, and which have also been included in the 
provision of the 10th and 90th percentile values. These are as follows:

 1. Women s &amp; Children s Hospital

 2. Flinders Medical Centre

 3. Lyell McEwin Hospital

 4. Ashford Hospital 

5. Burnside War Memorial Hospital Inc

 6. Calvary Healthcare Adelaide

 7. Flinders Private Hospital

 8. North Eastern Community Hospital

 9. Mount Gambier &amp; District Health Service Inc 

10. The Whyalla Hospital &amp; Health Services Inc 

11. Barossa Health (Tanunda Centre) 

12. Gawler Health Service 

13. Lower North Health Centre (Clare) 

14. Mount Barker District Soldiers  Memorial Hospital Inc 

15. Murray Bridge Soldiers  Memorial Hospital Inc 

16. Naracoorte Health Service Inc 

17. Northern Yorke Peninsula Regional Health Service (Wallaroo) 

18. Port Augusta Hospital &amp; Regional Health Service Inc 

19. Port Lincoln Health Service Inc 

page 64 Pregnancy Outcome in South Australia 2008 



 
Obstetric Profiles by Hospital Category 

20. Port Pirie Regional Health Service Inc 

21. Riverland Regional Health Service (Berri) 

22. South Coast District Hospital Inc (Victor Harbor) 

23. Country hospitals with 50-99 births per year 

24. Country hospitals with &lt;50 births per year 

The 10th percentile is the proportion below which 10% of the 24 hospital proportions, ie the two lowest hospital 
proportions, would be found if the 24 proportions were ranked from highest to lowest. The 90th percentile is the 
proportion above which 10% of the 24 hospital proportions, ie the two highest proportions, would be found if the 
24 proportions were ranked from highest to lowest. 

The table and figures provide obstetric profiles for the five different categories of hospitals. These have been provided 
since 1986 to hospitals with 100 or more births per year, together with their individual hospital profiles, including 
crude and standardized perinatal mortality ratios8, the latter with exclusion of perinatal deaths from congenital 
abnormalities3 and terminations of pregnancy. For country hospitals with less than 100 births per year, group reports 
have been provided. 

Each hospital s statistics for each factor may be compared with those for state hospitals and for categories of 
hospitals, eg whether a hospital s proportion for any factor falls within the range of the more common proportions 
prevailing in hospitals in the state (ie between the 10th and the 90th percentiles). 

Table 47: Obstetric profiles by hospital category, South Australia, 2008: live births of any gestation and 
stillbirths of &gt;=400g or &gt;=20 weeks gestation 

Factors 

All state hospitals Metropolitan hospitals Country hospitals 

Mean 
10th 

percentile 
90th 

percentile 
Level III 
teaching 

Other 
teaching 

Private Major Other 

Maternal factors 

Women (n=19,571) 815+ 123 2,575 7,580 2,794 5,187 848 3,162 

% Aboriginal women 3.2 0 9.0 3.6 4.1 0.0 3.3 6.6 

% Antenatal visits &lt;7* 8.1 0.1 13.1 12.8 9.9 0.8 10.1 7.0 

% Teenage women 4.5 0.1 13.9 5.0 8.0 0.1 7.7 6.6 

% Women ? 35 years 21.2 12.1 33.9 19.8 13.0 32.5 14.0 15.1 

% Single women 11.9 1.9 20.6 17.3 16.0 1.7 14.4 11.6 

% 4+ prior live births 3.2 0.5 6.5 3.8 5.3 0.5 5.0 3.8 

% 1+ prior perinatal 
deaths 

1.4 0.2 2.0 1.8 1.5 0.7 1.7 1.2 

% Obstetric 
complications 

32.9 16.3 38.9 42.6 34.4 23.8 29.6 24.4 

% Labour 
complications 

37.3 22.0 42.5 40.8 47.0 29.3 26.4 26.9 

% Induction 28.8 21.8 35.0 29.3 24.8 31.0 29.5 27.4 

Table 47 continued 

page 65Pregnancy Outcome in South Australia 2008 



 
Obstetric Profiles by Hospital Category 

Table 47 continued 

Factors 

All state hospitals Metropolitan hospitals Country hospitals 

Mean 
10th 

percentile 
90th 

percentile 
Level III 
teaching 

Other 
teaching 

Private Major Other 

% Emergency 
caesarean 

16.9 11.4 20.2 17.5 16.5 18.5 14.5 14.0 

% Elective caesarean 15.4 10.9 21.4 12.2 11.8 23.0 13.4 14.6 

% Total caesarean 32.4 23.6 41.5 29.7 28.3 41.5 28.0 28.6 

% Ultrasound 
examination* 

98.5 95.9 99.5 98.9 98.1 98.9 97.1 97.9 

% Amniocentesis* 3.8 0.8 5.3 4.6 3.0 4.5 3.0 1.9 

% Episiotomy 11.4 4.9 16.6 10.1 9.9 15.9 9.4 9.0 

% Repair of perineal 
tear 

29.1 17.7 36.8 30.4 23.6 33.0 24.1 25.8 

% Epidural analgesia 31.2 9.2 45.9 33.0 21.4 43.2 27.8 16.6 

% Spinal analgesia 0.8 0.5 2.1 0.4 1.2 0.9 0.9 1.5 

% Private patients 32.0 2.0 100.0 6.9 3.3 100.0 12.6 11.2 

% Primiparous women 41.6 29.7 44.7 43.9 38.2 44.4 38.6 35.0 

% Previous caesarean 17.5 13.6 23.6 15.9 15.5 21.8 15.3 16.6 

% PPH 10.9 3.2 12.1 16.0 13.4 5.1 7.8 6.8 

Baby factors 

Births (n=19,869) 828+ 123 2,619 7,751 2,827 5,258 858 3,175 

% Birthweight 
&lt;2,500g 

7.0 0.8 8.0 11.0 6.4 4.2 5.7 2.8 

% Gestational age 
&lt;37 weeks at birth 

8.6 0.8 8.5 13.4 8.5 5.6 6.5 2.7 

% Prolonged 
hospitalisation 
(&gt;27 days) 

2.2 0 3.3 4.6 1.0 0.5 0.5 0.7 

% Neonatal intensive 
care (Level  III or 
W&amp;CH paediatric 
intensive care) 

2.7 0.5 3.3 5.2 1.4 0.8 1.3 0.9 

% Birth defect 2.8 0.4 3.6 3.9 3.2 1.7 1.7 1.5 

* adjusted for missing values 

+ mean number of women who gave birth, or mean number of births for the 24 hospitals or groups of hospitals 

page 66 Pregnancy Outcome in South Australia 2008 



Obstetric Profiles by Hospital Category 

Figure 9: Percentage of Aboriginal women by hospital category 

10 
90th percentile 

8 

Pe
rc

en
ta

g
e

6 

2 

4 
Mean 

0 
10th percentile 

1 2 3 4 5 

Hospital category 

Figure 10: Percentage of women with &lt;7 antenatal visits by hospital category 

14 
90th percentile 

12 

Pe
rc

en
ta

g
e 10 

8 

6 

4 

2 

0 

1 2 3 4 5 

Hospital category 

Mean 

10th percentile 

Figure 11: Percentage of teenage women by hospital category 

16
 

14
  90th percentile 

12 

Pe
rc

en
ta

g
e

10 

8 

6 

4 

2 

0 

1 2 3 4 5 

Hospital category 

Mean 

10th percentile 

page 67Pregnancy Outcome in South Australia 2008 



 
 

 

8 

Obstetric Profiles by Hospital Category 

Figure 12: Percentage of women 35 years or more by hospital category 

40
 

35
  90th percentile 
30 

Pe
rc

en
ta

g
e 

1 2 3 4 5 

Hospital category 

25 

20 

15 

10 

5 

0 

Mean 

10th percentile 

Figure 13: Percentage of single women by hospital category 

25 

90th percentile 20 

Pe
rc

en
ta

ge
 

15  
Mean 

10 

5 

10th percentile 

0 

1 2 3 4 5 

Hospital category 

Figure 14: Percentage of women with 4 or more prior livebirths by hospital category 

90th percentile 

Pe
rc

en
ta

ge
 6 

4 
Mean 

2 

10th percentile 
0 

1 2 3 4 5 

Hospital category 

page 68 Pregnancy Outcome in South Australia 2008 



 
 

 

Obstetric Profiles by Hospital Category 

Figure 15: Percentage of women with 1 or more prior perinatal deaths by hospital category 

2.5
 

2
 90th percentile 

Pe
rc

en
ta

ge
 

1 .5 Mean
 

1
 

0.5 

10th percentile 

0 

1 2 3 4 5 

Hospital category 

Figure 16: Percentage of women with obstetric complications by hospital category 

50
 

40
  90th percentile 

Mean 

10th percentile 

1 2 3 4 5 

Hospital category 

Pe
rc

en
ta

ge
 

30 

20 

10 

0 

Figure 17: Percentage of women with complications during labour or birth by hospital category 

60
 

50
 

40
 90th percentile 
Mean 

10th percentile 

1 2 3 4 5 

Hospital category 

Pe
rc

en
ta

ge
 

30 

20 

10 

0 

page 69Pregnancy Outcome in South Australia 2008 



 
 

50 

Obstetric Profiles by Hospital Category 

Figure 18: Percentage of women with induction of labour by hospital category 

0 

5 

10 

15 

20 

25 

30 

35 

40 

45 

Pe
rc

en
ta

ge
 

90th percentile 

Mean 

10th percentile 

1 2 3 4 5 

Hospital category 

Figure 19: Percentage of women having epidural analgesia by hospital category 

90th percentile 

Pe
rc

en
ta

ge
 

40 

30 

20 

10 

0 

1 2 3 4 5 

Hospital category 

Mean 

10th percentile 

Figure 20: Percentage of breech births by hospital category 

1.2
 

1
 

Pe
rc

en
ta

ge 0 .8 

0.6 

0.4 

0.2 

0 

1 2 3 4 5 

Hospital category 

90th percentile 

Mean 

10th percentile 

Pregnancy Outcome in South Australia 2008 page 70 



 
 

 

Obstetric Profiles by Hospital Category 

Figure 21: Percentage of emergency caesarean sections by hospital category 

25 

90th percentile 20 

Pe
rc

en
ta

ge
 15 

10 

5 

0 

Mean 

10th percentile 

1 2 3 4 5 

Hospital category 

Figure 22: Percentage of elective caesarean sections by hospital category 

25
 

20
  

15
  

90th percentile 

Mean 

10th percentile 

1 2 3 4 5 

Hospital category 

Pe
rc

en
ta

ge
 

10 

5 

0 

Figure 23: Percentage of total caesarean sections by hospital category 

45 
90th percentile 

40
  

35
  
Mean 

30 

1 2 3 4 5 

Hospital category 

Pe
rc

en
ta

ge
 

25  

20 

15 

10 

5 

0 

10th percentile 

page 71Pregnancy Outcome in South Australia 2008 



 
 

Obstetric Profiles by Hospital Category 

Figure 24: Percentage of births with birthweight below 2,500g by hospital category 

12
 

10
 

8
 90th percentile 

Pe
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en
ta

ge
 

6
 

4
 

2
 

0
 

Mean 

10th percentile 

1 2 3 4 5
 

Hospital category 

Figure 25: Percentage of births with gestation less than 37 weeks by hospital category 

0 

2 

4 

6 

8 

10 

12 

14 

16 

Pe
rc

en
ta

ge

90th percentile 
Mean 

10th percentile 

1 2 3 4 5
 

Hospital category 

Figure 26: Percentage of births with prolonged hospitalisation by hospital category 

0 

0.5 

1 

1.5 

2 

2.5 

3 

3.5 

4 

4.5 

5 

Pe
rc

en
ta

ge
 90th percentile 

Mean 

10th percentile 

1 2 3 4 5
 

Hospital category 

Pregnancy Outcome in South Australia 2008
 page 72 



 
Obstetric Profiles by Hospital Category 

Figure 27: Percentage of live births requiring neonatal intensive care by hospital category 

6
 

5
 

Pe
rc

en
ta

ge

4
 

3
 

2
 

1
 

0
 

90th percentile 

Mean 

10th percentile 

1 2 3 4 5
 

Hospital category 

Figure 28: Percentage of births with birth defects by hospital category 

0 

0.5 

1 

1.5 

2 

2.5 

3 

3.5 

4 

4.5 

Pe
rc

en
ta

ge
 

90th percentile 

Mean 

10th percentile 

1 2 3 4 5
 

Hospital category 

Pregnancy Outcome in South Australia 2008
 page 73 



    

 

     

     

    

 

   

    

  

 

     

 

    

   

 

Clinical and Maternity Performance Indicators 

V. Clinical and Maternity Performance Indicators 

1. Clinical indicators 
These clinical indicators of The Australian Council on Healthcare Standards ( ACHS Obstetrics Indicators - Clinical 
Indicator Users  Manual Version 5 for use in 2007  ) are reported for the state in pages 74-76. They are also reported 
for hospital categories and individual hospitals in the Pregnancy and Neonatal Care Bulletin 2008. 

Indicator 1: Induction of labour other than for defined indications 

Rationale: 	 These indicators have been included because induction of labour is a common obstetric 
intervention and one which is often stated by community critics to be unnecessarily high. 

Clinical indicator 1.1: Induction of labour other than for defined indications among all inductions 

Numerator: The number of women undergoing induction of labour for indications other than those 
defined (n=2,935). These defined indications are diabetes, premature rupture of membranes, 
hypertensive disorders (including chronic renal disease), intrauterine growth restriction, 
isoimmunisation, fetal distress (as documented by the clinician), fetal demise, chorioamnionitis, 
prolonged pregnancy (41 completed weeks or more), twins and antepartum haemorrhage. 

Patients having augmentation of labour are excluded in both numerator and denominator data. 

Denominator: The total number of women undergoing induction of labour for any reason (excluding 
augmentation of labour) (n=5,634). 

2,935x100Clinical indicator 1.1 = = 52.1% (95%CI 50.8%-53.4%). 
5,634 

Clinical indicator 1.2: Induction of labour other than for defined indications among all women who 
gave birth 

Numerator: 	 The number of women undergoing induction of labour for indications other than those listed 
above (excluding augmentation of labour) (n=2,935). 

Denominator: The total number of women who gave birth (including augmentation of labour) (n=19,672). 

2,935x100Clinical indicator 1.2 = =14.9% (95%CI 14.4%-15.4%). 
19,672 

Indicator 2: Rate of vaginal birth following primary caesarean section 

Rationale: 	 This indicator has been included to monitor the conduct of labour and trial of scar in those 
women who have had a previous primary (first) caesarean section. 

Clinical indicator 2.1: Rate of vaginal birth following primary caesarean section 

Numerator: The number of women who gave birth vaginally following a previous primary (first) caesarean 
section and having no intervening pregnancies greater than 20 weeks gestation (n=436). 

Denominator: The total number of women who gave birth who have had a previous primary (first) caesarean 
section and no intervening pregnancies greater than twenty weeks gestation (n=2,458). 

436x100Clinical indicator 2.1 = = 17.7% (95%CI 16.2%-19.3%). 
2,458 

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Clinical and Maternity Performance Indicators 

Indicator 3: Primary caesarean section for failure to progress 

Rationale:	 This indicator is to monitor the adequacy of trial of labour. There are two indicators, one for failure 
to progress after a period of labour with cervical dilatation of 3cm or less and the other with 
cervical dilatation of more than 3cm. As information  on cervical dilatation is not collected, the two 
indicators have been combined. 

Clinical indicator 3.0: Primary caesarean section for failure to progress among primary non-elective 
caesarean sections 

Numerator:	 The number of women undergoing primary (first) caesarean section for failure to progress 
(clinician s documented statement), which may include CPD, uterine inertia, persistent occipito 
posterior position (n=1,483). 

Denominator: The total number of women undergoing primary non-elective caesarean section (n=2,610). 
1,483 x 100Clinical indicator 3.0 = = 56.8% (95%CI 54.9%-58.7%). 

2,610 

Indicator 4: Primary caesarean section for fetal distress 

Rationale: To determine the comparative frequency of caesarean section for fetal distress. 

Clinical indicator 4.1: Primary caesarean section for fetal distress among all women who gave birth 

Clinical indicator 4.1 = = 4.5% (95% CI 4.2%-4.8%). 

Numerator: The number of women undergoing primary caesarean section for fetal distress in labour as 
evidenced by the clinician s documented diagnosis of fetal distress (n=876). 

Denominator: 

876 x 100 

The total number of women who gave birth including those with a vaginal birth (n=19,672). 

19,672 

Clinical indicator 4.2: Primary caesarean section for fetal distress among primary caesarean sections 

Numerator:	 The number of women undergoing primary caesarean section for fetal distress as defined above 
(n=876). 

Denominator: The total number of women who gave birth by primary caesarean section only  (n=3,534). 
876 x 100

Clinical indicator 4.2 = = 24.8% (95%CI 23.4%-26.2%). 
3,534 

Indicator 5: Incidence of an intact lower genital tract in primiparous patients birthing vaginally 

Rationale:	 This indicator has been included because a high incidence of an intact perineum is considered a 
desirable outcome. 

Clinical indicator 5.1: Incidence of an intact lower genital tract in primiparous women who gave 
birth vaginally 

Numerator:	 The number of primiparous patients not requiring surgical repair or suture of the lower genital tract 
(those structures below and not including the cervix) following birth (n=1,375). 

Denominator:	 The total number of primiparous women who gave birth vaginally (n=5,462). 

1,375 x 100Clinical indicator 5.1 = = 25.2% (95%CI 24.0%-26.3%). 
5,462 

page 75Pregnancy Outcome in South Australia 2008 



   

  

  

   

 

 

    

  

   

  

 

Clinical and Maternity Performance Indicators 

Indicator 6: Apgar score 

Rationale:	 This indicator has been included as a measure of the outcome of labour, with particular emphasis 
on the assessment of baby well-being. 

Clinical indicator 6.1: Apgar score of 4 or below at five minutes after birth among all babies except 
antepartum fetal deaths 

Clinical indicator 6.1 = = 0.4% (95%CI 0.3%-0.5%).

Numerator: The number of babies born with an Apgar score of 4 or below at five minutes post birth (n=78). 

Denominator: The total number of babies born (excluding fetal deaths in utero diagnosed prior to 
commencement of labour) (n=19,889). 

78 x 100 

19,889 

Indicator 7: Term babies transferred or admitted to a neonatal  intensive care unit for reasons other than 
congenital abnormality 

Rationale:	 This indicator has been included as an index of the overall management of labour in terms 
of outcome. 

Clinical indicator 7.1: Term babies transferred or admitted to a neonatal intensive care unit for reasons 
other than congenital abnormality 

Numerator:	 The number of term babies (37 weeks gestation or later) transferred/admitted to a neonatal 
intensive care unit for reasons other than congenital abnormality (n=91). 

Denominator: 	 The total number of term live babies born (n=18,227). 

91 x 100Clinical indicator 7.1 = = 0.5% (95%CI 0.4%-0.6%). 
18,227 

page 76 Pregnancy Outcome in South Australia 2008 



 
 

 

Clinical and Maternity Performance Indicators 

2. Maternity performance indicators, hospitals with at least 500 births per year 

The first two of these indicators are from the original Victorian set of maternity performance indicators, while three 
others are ACHS clinical indicators.  These six indicators are as follows: 

1. Induction of labour proportion for selected primiparae 

= Number of selected primiparae undergoing induction of labour 

Number of selected primiparae who gave birth 

2. Caesarean section rate for selected primiparae 

= Number of selected primiparae undergoing caesarean section 

Number of selected primiparae who gave birth 

The selected primipara is aged &gt;=20 and &lt;=34 years, with a singleton pregnancy, delivered at gestation &gt;=37 and 
&lt;=41 weeks, with an infant not small for gestational age (classified using birthweight percentiles rather than clinical 
suspicion of light for dates). The birthweight percentiles used are the national birthweight-gestation percentiles9 . 

These specifications are slightly different from those of the  selected primipara  of the Core Maternity Indicators 
Project10 and will be modified to those specifications in later reports. 

3. VBAC: proportion of women who gave birth vaginally following a previous primary (first) caesarean 
section and no intervening births. 

This is as defined for Clinical indicator 2 (page 74) and was 17.7% for the state in 2008 (and 17.5% for state 
hospitals) in 2008. 

4. PRIMIP no repair: proportion of women not requiring surgical repair following vaginal birth. 

This is as defined for Clinical indicator 5 (page 75) and was 25.2% for the state in 2008 (24.9% for state hospitals). 

5. TERM NICU: proportion of term babies admitted to neonatal intensive care (NICU) for reasons other than 
congenital abnormality. 

This is as defined for Clinical indicator 7 (page 76) and was 0.5% for the state (as well as for state hospitals) for 2008. 

6. SPMR: Standardized perinatal mortality ratio for all births. 

This is as defined8 in the Pregnancy and Neonatal Care Bulletin 2008. It adjusts for the difference between the 
distribution of births by birthweight between the hospital and state hospital births. As perinatal mortality is much 
higher in babies of low birthweight, this adjustment ensures that a hospital is directly comparable with other hospitals 
and state hospitals as a whole if it has a higher proportion of low birthweight babies than state hospital births. 

Observed number of deaths
SPMR = x100 

Expected number of dealths

To obtain the expected number of deaths for a hospital, the state hospital perinatal mortality rate for 2008 for each 

of the birthweight groups in Table 28a is applied to the number of births in each corresponding birthweight group 

for the hospital. This gives an expected number of deaths in each birthweight group. These expected deaths are then 

totalled to give a total number of expected deaths for the hospital.
 

SPMRs provided in this report exclude deaths attributed to congenital abnormalities (as determined by the Maternal, 

Perinatal and Infant Mortality Committee3), which are the least preventable, as well as terminations of pregnancy. 

An SPMR above 100 means that after adjustment for birthweight differences and deaths attributed to congenital 

abnormalities and terminations of pregnancy, perinatal mortality for that hospital is higher than that for state hospital 

births eg an adjusted SPMR of 120 means that it is 20% higher.
 

A 95% confidence interval (CI) which includes the value 100 in its range means that the hospital s perinatal mortality 

is not (statistically) significantly different from that for state hospital births for 2008. The SPMRs and 95%CIs for 

individual hospitals and categories of hospitals have been programmed using indirect standardization methods11.
 

page 77Pregnancy Outcome in South Australia 2008 



 
  

Clinical and Maternity Performance Indicators 

Statistics for the six maternity performance indicators for 2008 are provided in Figures 29a   29f for the nine 
hospitals, A   I, with at least 500 births in 2008. SPMRs for the preceding five years combined, 2004-2008, are 
provided in Figure 29g. Metropolitan teaching hospitals have been named with their permission and are as follows: 

A. Women s and Children s 

B. Flinders Medical Centre 

C. Lyell McEwin Hospital 

For the last five years combined the Women s and Children s Hospital SPMR of 85 (95% CI 75-98) was significantly 
lower when compared with state-wide hospital data. 

None of the elevations in the SPMR for the individual hospitals for 2008 or for the last five-year period 2004-2008 
(Fig 29g) was statistically significant. 

Figure 29a: Induction of labour proportion for selected primiparae, SA hospitals with &gt;=500 births 
per year, 2008 

5 0  

4 0  

3 0  

% 
2 0  

1 0  

0 

A B C D E F G H I 

Hospital 

Induction of labour % 

*SA hospitals = 34.0% 

Figure 29b: Caesarean section rate for selected primiparae, SA hospitals with &gt;=500 births per year, 2008 

6 0 
  

5 0 
  

4 0 
  

% 3 0 
  

2 0 
  

1 0 
  

0
 

A B C D E F G H I 
Hospital 

Caesarean section % 

*SA hospitals = 30.6% 

page 78 Pregnancy Outcome in South Australia 2008 



 
 

 

 

Clinical and Maternity Performance Indicators 

Figure 29c: VBAC: Proportion of women who had a vaginal birth following a previous primary (first) 
caesarean section &amp; no intervening births, SA hospitals with &gt;=500 births per year, 2008 

A B C D E F G H I 

Hospital 

VBAC % 

*SA hospitals = 17.5% 

Figure 29d: PRIMIP no repair: proportion of primiparous women not requiring surgical repair following 
vaginal birth, SA hospitals with &gt;=500 births per year, 2008 

A B C D E F G H I 

Hospital 

Primip no repair % 

*SA Hospitals = 24.9% 

Figure 29e: TERM NICU: proportion of term babies admitted to NICU for reasons other than congenital 
abnormality, SA hospitals with &gt;=500 births per year, 2008 

A B C D E F G H I 

Hospital 

Term NICU %
 

*SA hospitals = 0.5%
 

0 

10 

20 

30 

40 

% 

0 

10 

20 

30 

40 

% 

0 

0.2 

0.4 

0.6 

0.8 

1 

1.2 

% 

page 79Pregnancy Outcome in South Australia 2008 



 
 

  

Clinical and Maternity Performance Indicators 

Figure 29f: SPMR (Standardized Perinatal Mortality Ratio) for all births, SA hospitals with &gt;=500 births 
per year, 2008 

200 

150 

100 

50 

0 

A B C D E F G H I 

Hospital 

SPMR 

*SA hospitals 

Figure 29g: SPMR (Standardized Perinatal Mortality Ratio) for all births, SA hospitals with &gt;=500 births per 
year, 2004-2008 

200 

150 

100 

50 

0
 

A B C D E F G H I
 

Hospital 

SPMR 

*SA hospitals 

page 80 Pregnancy Outcome in South Australia 2008 



 
 

  

  
 

  

  

   
 

  

  

 

 

 

   

 

Trends in Perinatal Statistics in South Australia 

VI. Trends in Perinatal Statistics in South Australia, 1981 2008 
Perinatal statistics are presented in Tables 48 and 49 for both socio-demographic and obstetric aspects for each year 
from 1999-2008, as well as for 1981, when the perinatal data collection was commenced. 

Some features are illustrated in Fig 30.1   30.8 for the years 1985-2008. The trends noted between 1981 and 2008 
are as follows: 

1. The steady increase in the total fertility rate from 1.71 in 2000 to 1.91 live births per woman in 2008. 

2. The increase in the proportion of Asian women from 1.8% in 1981 to 7.0% and of Aboriginal women from 1.5% 
in 1981 to 3.2% in 2008. 

3. The decrease in the proportion of teenage women from 7.8% in 1981 to 4.5% in 2008. The teenage pregnancy 
rate declined in the 1980s and then rose, with the teenage abortion rate, in the 1990s until 1996. After that it 
declined, mainly due to the decline in the teenage birth rate. Recently the teenage abortion rate has also declined, 
although it rose slightly between 2007 and 2008. The teenage pregnancy rate in 2007 of 35.0 per 1,000 women 
was the lowest since 1970 and was only slightly higher at 35.4 in 2008. 

4. The increase in the age of women giving birth. The proportion of women who gave birth who were 35 years or 
older increased from 4.6% in 1981 to 21.1% in 2008, and among primiparous women from 1.2% to 12.7%. 
The mean age among women giving birth increased from 26.55 years to 30.11 years and among primiparous 
women from 24.42 years to 28.24 years. 

5. The increase in the proportion of single women from 9.6% to the peak of 14.9% in 1996, after which the 
proportion decreased. It was 11.9% in 2008. 

6. In the last decade, the proportion of births in metropolitan private hospitals increased while the proportion in 
country hospitals, especially in small country hospitals, declined. The number of births in birthing units in teaching 
hospitals increased from 125 (0.6%) in 1992 to 1,237 (6.2%) in 2008. Home births increased from 44 (0.2%) in 
1997 to 101 (0.5%) in 2008. 

7. The increase in the proportion of multiple births, related to assisted conception pregnancies, and the older age 
of women, from 2.0% in 1981 to a peak of 3.6% in 2002 and 2003. After that the proportion declined to 
3.0% in 2008. The decline is likely to be related to the increasing use of single embryo transfer in assisted 
conception practice. 

8. The induction rate increased from 22.1% in 1981 to 29.3% in 2002, after which it declined slightly. It was 28.6% 
in 2008. Fifty-two percent of inductions in 2008 were performed for other than defined indications. 

9. The fall in the proportion of normal spontaneous vaginal births (from 66.1% to 56.0%, but stable for the last 
five years), breech births (from 1.1% to 0.5%) and forceps births (from 15.2% to 4.2%), with an increase in the 
proportion delivered by ventouse, from 0.7% to 7.1%, and by caesarean section, from 16.9% in 1981 to 32.2% in 
2008. The caesarean section rate has been relatively stable for the last four years. 

10. The gradual increase in the proportion of low birthweight births from 5.8% in 1981 to a peak of 7.6% in 2005. 
This proportion has been around 7.0% in the last three years. The proportion of preterm births also increased 
from 5.5% in 1981 to a peak of 9.0% in 2005, but was 8.6% in 2008. 

11. The proportion of births with congenital abnormalities identified before discharge from hospital after birth has 
been relatively stable at 2.3%-2.7% during the last decade. 

12. The increase in the proportion of babies utilising Level II care from 6.7% in 1982 to 16.6% in 2002 and 2003, 
followed by a decline to 15.4% in 2008. 

13. The proportion of babies utilising neonatal intensive care has decreased from 3.0% in 2000 to 2.5% in 2008, 
while the proportion using paediatric intensive care remained at 0.2%-0.3%. The proportion in hospital at 28 
days has been between 2.0% and 2.5%. 

14. The considerable fall in the perinatal mortality rate, despite the increasing proportion of preterm births. The 
perinatal mortality rate for national statistics (for babies of at least 500g birthweight or 22 weeks gestation 

page 81Pregnancy Outcome in South Australia 2008 



 
 

 

 

 

Trends in Perinatal Statistics in South Australia 

if birthweight unavailable) has fallen from 11.6 in 1981 to 5.3 per 1,000 births in 2008, while the rate for 
international statistics (for births of 1,000g or 28 weeks if birthweight unavailable) has fallen from 7.2 to 3.4 per 
1,000 births during the same period. The fall in this neonatal mortality rate (for early neonatal deaths) has been 
particularly outstanding, reaching 0.6 per 1000 live births in 2007 and 2008, the lowest recorded in the state. 
The fall in perinatal mortality is reflected in the standardized perinatal mortality ratio which has been calculated 
in Table 49 for each year utilising perinatal mortality rates for 500g birthweight groups for the years 1981 1989 
combined as the standard. It was 67.3 in 2008 compared with 117.6 in 1981, with fluctuations in the last decade. 

Table 48: Socio-demographic aspects of perinatal statistics, South Australia, 1981 and 1999 2008 

Characteristic 
Year 

1981 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 

1 Total births 19,052 18,519 17,872 17,704 17,745 17,844 17,522 18,196 18,803 19,757 19,970 

2 Live births 18,905 18,404 17,765 17,584 17,623 17,710 17,409 18,067 18,663 19,624 19,819 

Women 
3 who gave 18,857 18,233 17,578 17,427 17,421 17,517 17,229 17,897 18,519 19,471 19,672 

birth 

Total 
4 fertility rate 1.75 1.75 1.71 1.71 1.73 1.75 1.74 1.82 1.82 1.91 1.91 

per woman 

5 Place of birth (%) 

Teaching 
hospital 52.2% 53.6% 54.6% 51.6% 49.6% 50.6% 49.9% 51.6% 52.1% 52.6% 53.2% 

Private 
hospital 19.7% 22.3% 21.9% 25.2% 27.9% 28.1% 27.2% 26.5% 26.7% 26.6% 26.5% 

Country 
hospital 27.8% 24.0% 23.5% 22.9% 22.2% 21.3% 22.5% 21.6% 20.8% 20.2% 20.3% 

Domiciliary* 0.3% 0.2% 0.2% 0.2% 0.3% 0.3% 0.4% 0.3% 0.5% 0.5% 0.5% 

(65) (39) (35) (37) (48) (60) (67) (63) (87) (107) (101) 

6 Race (%) 

Aboriginal 1.5% 2.4% 2.5% 2.3% 2.5% 2.7% 2.8% 2.7% 3.0% 3.0% 3.2% 

(Women who 
gave birth) (277) (447) (446) (399) (445) (468) (484) (487) (548) (578) (624) 

(Births) (280) (450) (450) (401) (452) (473) (491) (492) (559) (590) (637) 

Asian 1.8% 4.3% 4.5% 4.4% 4.8% 4.7% 4.8% 5.3% 5.1% 6.2% 7.0% 

Age 
7 Mean age 26.55 29.30 29.50 29.52 29.62 29.77 29.81 29.86 30.01 30.05 30.11 

(years) 

Teenage (%) 7.8% 5.6% 5.3% 5.4% 5.6% 5.4% 5.3% 5.2% 4.8% 4.6% 4.5% 

?35 years 
(%) 4.6% 15.0% 16.2% 16.3% 17.0% 17.6% 17.9% 18.7% 20.4% 20.2% 21.1% 

*includes unplanned home births Table 48 continued 

Pregnancy Outcome in South Australia 2008 page 82 



                                                                                                                                    

 

 

 

 

 

Trends in Perinatal Statistics in South Australia 

Table 48 continued 

8 Marital 
status (%) 

Never 
married 7.6% 12.0% 12.0% 12.3% 12.3% 11.9% 11.8% 12.5% 11.7% 11.0% 10.7% 

Widowed/ 
divorced/ 
separated 
(%) 

2.0% 1.5% 1.7% 1.6% 1.6% 1.5% 1.3% 1.3% 1.3% 1.4% 1.2% 

(Single) 9.6% 13.5% 13.7% 13.9% 13.9% 13.3% 13.0% 13.8% 13.0% 12.5% 11.9% 

9 Primiparae 

Mean age 
(years) 24.42 27.38 27.61 27.66 27.77 27.91 28.13 28.02 28.20 28.30 28.24

 Teenage 15.4% 11.3% 10.6% 10.9% 11.3% 10.9% 10.0% 10.1% 9.5% 8.9% 8.8% 

?35 years 1.2% 8.0% 9.3% 9.5% 9.9% 10.6% 11.0% 11.4% 12.6% 12.5% 12.7% 

Table 49: Obstetric aspects of perinatal statistics, South Australia, 1981 and 1999   2008 

Characteristic 
Year 

1981 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 

1 Plurality 

Multiple 
births (%) 2.0% 3.1% 3.3% 3.1% 3.6% 3.6% 3.3% 3.3% 3.0% 2.9% 3.0% 

-Twins (363) (564) (560) (550) (632) (626) (578) (570) (552) (544) (592) 

-Triplets (21) (6) (21) (3) (12) (21) (6) (21) (12) (21) (3) 

-Quadruplets (0) (0) (0) (0) (0) (0) (0) (0) (0) (0) (0) 

2 Induction of labour (%) 22.1% 27.9% 27.3% 28.3% 29.3% 29.0% 27.9% 28.3% 28.9% 29.8% 28.6% 

3 Method of birth 

Normal 
spontaneous 66.1% 62.3% 61.7% 59.5% 58.7% 57.8% 55.9% 55.8% 56.0% 56.0% 56.0% 

Elective 
caesarean 8.2% 10.4% 10.4% 11.9% 12.6% 13.3% 14.0% 14.6% 15.5% 15.3% 15.4% 

Emerg 
caesarean 8.7% 14.5% 14.8% 15.8% 16.6% 16.7% 17.6% 17.6% 17.4% 17.1% 16.8% 

Forceps 15.2% 7.1% 6.4% 6.1% 5.9% 4.8% 5.0% 4.2% 3.7% 4.1% 4.2% 

Breech 1.1% 0.5% 0.4% 0.4% 0.4% 0.4% 0.4% 0.4% 0.4% 0.4% 0.5% 

Ventouse 0.7% 5.2% 6.3% 6.3% 5.9% 6.9% 7.1% 7.3% 7.0% 7.1% 7.1% 

Total 
caesarean 16.9% 24.9% 25.2% 27.8% 29.2% 30.0% 31.5% 32.3% 32.9% 32.3% 32.2% 

Table 49 continued 

Pregnancy Outcome in South Australia 2008 page 83 



                                                                                                                                    

 

 

 

  

Trends in Perinatal Statistics in South Australia 

Table 49 continued 

Characteristic 
Year 

1981 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 

4 Birthweight &lt;2,500g 5.8% 6.6% 7.2% 6.8% 7.1% 7.0% 7.0% 7.6% 7.0% 6.9% 7.0% 

Singletons 4.9% 5.2% 5.6% 5.5% 5.4% 5.3% 5.3% 5.9% 5.5% 5.5% 5.5% 

Multiples 52.1% 49.6% 55.9% 46.3% 50.5% 53.0% 55.8% 57.7% 53.4% 53.6% 53.4% 

5 Gestational age &lt;37 weeks 5.5% 8.1% 8.6% 8.1% 8.3% 8.4% 8.7% 9.0% 8.2% 8.5% 8.6% 

Singletons 4.8% 6.7% 6.9% 6.7% 6.6% 6.7% 7.0% 7.3% 6.8% 7.1% 7.0% 

Multiples 41.1% 51.8% 57.3% 50.8% 52.2% 54.6% 58.4% 58.4% 54.4% 57.2% 59.3% 

6 Congenital abnormalities 3.4% 2.5% 2.3% 2.5% 2.4% 2.3% 2.5% 2.5% 2.3% 2.6% 2.7% 

7 Level II care na 16.6% 15.8% 15.2% 15.8% 16.6% 16.6% 16.2% 15.3% 16.1% 15.4% 

8 Level III care 3.3% 2.6% 3.0% 2.6% 2.8% 2.7% 2.9% 2.9% 2.5% 2.3% 2.5% 

9 W&amp;CH ICU care na 0.3% 0.2% 0.3% 0.2% 0.2% 0.2% 0.3% 0.2% 0.3% 0.3% 

10 
Hospitalisation 
for 28 days or 
more 

4.2% 2.1% 2.5% 2.1% 2.2% 2.2% 2.3% 2.4% 2.0% 2.1% 2.2% 

11 Neonatal deaths 96 38 57 64 54 42 52 63 38 55 51 

12 Stillbirths 147 115 106 120 122 134 113 129 140 132 151 

13 Perinatal deaths 243 153 163 184 176 176 165 192 178 188+ 202 

14 
Perinatal 
mortality rate 
per 1,000 births 

? 400g/20 weeks 12.8 8.3 9.1 10.4 9.9 9.9 9.4 10.6 9.5 9.5+ 10.1 

? 500g/22 
weeks* 

11.6 5.7 6.1 6.9 6.8 6.5 5.7 6.2 4.9 5.2+ 5.3 

? 1,000g/28 
weeks* 

7.2 3.1 3.6 3.9 4.0 3.9 3.5 3.7 3.1 2.6+ 3.4 

15 
Standardized 
perinatal 
mortality ratio 

117.6 60.2 62.0 70.6 70.3 68.1 66.9 66.5 63.0 65.1 67.3 

+ includes one perinatal death of a baby at term for which it is not known whether it was a stillbirth or a live birth 

* only neonatal deaths within the first 7 days of life are included, as recommended by the World Health Organisation for national and 
international statistics. 

page 84 Pregnancy Outcome in South Australia 2008 



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8 

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Figure 30.3: Percentage of primiparous women aged 35 years and over in SA 

Year 

Figure 30.2: Percentage of women aged 35 years and over among women giving birth in SA 

24 

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Trends in Perinatal Statistics in South Australia 

Trends in Perinatal Statistics in South Australia (SA), 1985   2008 

Figure 30.1: Percentage of teenage women among women giving birth in SA 

Year 

Pregnancy Outcome in South Australia 2008 page 85 

20
07

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3 

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Figure 30.6: Percentage of multiple births among births in SA 

4 

3 

Year 

Asian Aboriginal 

Figure 30.5: Percentage of women never married and with no de facto partner among women 
giving birth in SA 

15
 

12
 

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Trends in Perinatal Statistics in South Australia 

Figure 30.4: Percentage of Aboriginal women and Asian women among women giving birth in SA 

Year 

Pregnancy Outcome in South Australia 2008 page 86 



 
100 

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Pregnancy Outcome in South Australia 2008 page 87 

Year 

Figure 30.8: SA standardised perinatal mortality ratio (SPMR) 

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Figure 30.7: Percentage of low birthweight babies among births in SA 

Trends in Perinatal Statistics in South Australia 



 
 

 

 

 

 

 

 

 

 

Summary Statistics for 2008 

VII. Summary statistics for 2008 
These statistics refer to all live births of any gestation as well as stillbirths of at least 400g birthweight or 20 weeks 
gestation. Fifty-eight babies of less than 400g birthweight have been included. 

1. Number of births 
&gt; Reported number of births (from monthly notifications): 19,970 

&gt; Notified births with Supplementary Birth Records: 19,970 

&gt; Notified women who gave birth with SBRs: 19,672 

&gt; Crude birth rate: 12.4 live births per 1,000 population. 

&gt; Total fertility rate: 1.91 live births per woman 

2. Place of birth 
&gt; Home births: 101 home births in all (0.5%), of which 94 were planned home births (0.5% of births in the state). 


&gt; Metropolitan teaching hospitals: 10,578 (53.0%)
 

&gt; Metropolitan private hospitals: 5,258 (26.3%)
 

&gt; Country hospitals: 4,033 (20.2%)
 

3. Sex 
&gt; Males 10,164, Females 9,806. Male: Female sex ratio = 1.04:1 

4. Plurality and condition at birth 

Condition at birth 
Plurality 

Total 
Singleton Twins Triplets 

Live birth 19,240 576 3 19,819 

Stillbirth 135 16 0 151 

Total 19,375 592 3 19,970 

5. Race of women 

Race Number of women % 

Caucasian 16.955 86.2 

Aboriginal 624 3.2 

Asian 1,385 7.0 

Other 708 3.6 

Total 19,672 100.0 

page 88 Pregnancy Outcome in South Australia 2008 



      

       

       

 

 

 

 

 

 

 

 

 

 

Summary Statistics for 2008 

6. Obstetric interventions in 19,672 women who gave birth 
Induction of labour was performed for 5,634 women (28.6%) and labour was augmented for another 4,348 women 
(22.1%) who gave birth. 

Forceps were utilised for 832 women (4.2%), ventouse in 1,394 (7.1%) and episiotomy was performed for 2,235 
women who gave birth (11.4%, or 16.7% of women who gave birth vaginally). 

Caesarean section was performed in 6,334 women who gave birth (32.2%), of which 3,022 (15.4%) were elective, 
and 3,312 (16.8%) emergency operations. 

7. Low birthweight (&lt;2,500g) 
&gt; Number of singleton births of low birthweight =1,073 (5.5% of singleton births). 

&gt; Number of multiple births of low birthweight =318 (53.4% of multiple births). 

&gt; Number of all births of low birthweight =1,391 (7.0% of all births). 

8. Congenital abnormalities 
&gt; Births notified with congenital abnormalities: 547 (2.7%). 

9. Perinatal morality rates (numbers of deaths in parentheses) 

Birthweight/Gestation 
Stillbirth rate per 

1,000 births 
Neonatal death rate 
per 1,000 live births 

Perinatal mortality rate 
per 1,000 births 

1 
? 400g/20 weeks (including 
live births of any gestation) 

(151) 7.6 (51) 2.6 (202) 10.1 

2 
? 500g/22 weeks if 
birthweight unavailable 
(WHO National Statistics*) 

(81) 4.1 (25) 1.3* (106) 5.3* 

3 

? 1,000g/28 weeks if 
birthweight unavailable 
(WHO International/ 
Standard Statistics*) 

(56) 2.8 (11) 0.6* (67) 3.4* 

* Only neonatal deaths within the first 7 days of life are included. 

10. Terminations of pregnancy 
&gt; Total number of terminations notified: 5,101 

&gt; Abortion rate per 1,000 women (15-44 years): 16.0 

&gt; Total abortion rate per 1,000 women (15-44 years): 485.0 

&gt; Total first abortion rate per 1,000 women (15-44 years): 308.0 

&gt; Abortion proportion: 0.20 

page 89Pregnancy Outcome in South Australia 2008 



  

  

  

  

  

  

  

  

 

  

  

 

 
     

    

    

   

References 

References 
1. Scott J, Chan A. South Australian Perinatal Statistics Collection. Guidelines for the Supplementary Birth Record. 

Adelaide: Pregnancy Outcome Statistics Unit , South Australian Department of Health, 2006. 

2. The South Australian Birth Defects Register. 2006 Annual Report. Adelaide: Women s and Children s Hospital, 
Children, Youth and Women s Health Service, 2009. 

3. Maternal, Perinatal and Infant Mortality Committee. Maternal, Perinatal and Infant Mortality in South Australia 
2008. Adelaide: SA Health, Government of South Australia, 2009. 

4. Strategy and Operations Service, Statewide Services Division. Operational Policy, Guidelines and Standards for 
Maternal and Neonatal Services in South Australia. Adelaide: Department of Human Services, 2000. 

5. South Australian Health Commission. Report of the South Australian Birthing Services Working Group. Adelaide: 
Social Health and Policy Development Branch, South Australian Health Commission, 1994. 

6. South Australian Abortion Reporting Committee. Sixth Annual Report - For the Year 2008. Adelaide:  	SA Health, 
Government of South Australia, 2009. 

7. South Australian Health Commission Epidemiology Branch. Risk factors for adverse perinatal outcome: 
determination from a perinatal statistics collection. Adelaide: South Australian Health Commission, December 1986. 

8. Mallett R, Knox EG. Standardized perinatal mortality ratios: technique, utility and interpretation. Community Med 
1979; 1: 6-13. 

9. Roberts CL, Lancaster PAL. Australian national birthweight percentiles by gestational age. MJA 1999;170:114-8. 

10. Women s Hospitals Australasia. Supporting Excellence in Maternity Care. The Core Maternity Indicators Project. 
Turner, Australian Capital Territory: Women s Hospitals Australasia, 2007. 

11. Breslow NE, Day NE. Statistical methods in cancer research Vol II. The design and analysis of cohort studies. Lyon: 
International Agency for Research on Cancer, 1987. 

Publications 
The following is a list of publications from 1985 from the Pregnancy Outcome Unit or which utilised data from 
the Unit. 

Annual Reports 
1.	 Pregnancy Outcome in South Australia (from 1985), 


website: www.health.sa.gov.au/pehs/pregnancyoutcome.htm.
 

2.	 Maternal, Perinatal and Infant Mortality in South Australia. Annual Report of the Maternal, Perinatal &amp; Infant 
Mortality Committee (from 1985), website: www.health.sa.gov.au/pehs/pregnancyoutcome.htm. 

3.	 Committee appointed to examine and report on abortions notified in South Australia Annual Report  (from 
1985 to 2002). South Australian Abortion Reporting Committee Annual Report (from 2003). 

4.	 Pregnancy and Neonatal Care Bulletin (from 1985): for individual hospitals. 

The Unit provides birth defects data to the South Australian Birth Defects Register at the Women s and Children s 
Hospital and perinatal and birth defects data to the Australian Institute of Health and Welfare National Perinatal 
Statistics Unit in Sydney for their reports. 

page 90 Pregnancy Outcome in South Australia 2008 



 
   

  

 

 

   

   

  

 

 

 

    

    

    

    

    

    

   

    

    

     

    

    

    

References 

These reports are as follows: 

1.	 The South Australian Birth Defects Register Annual Report (from 1986). 

South Australian Birth Defects Register,  Public Health Research Unit, Women s and Children s Hospital, Children, 

Youth and Women s Health  Service, 72 King William Road, North Adelaide, South Australia 5006. 


Telephone (08) 81616518
 

Website: www.wch.sa.gov.au/services/az/other/phru/birthdefect.html
 

2.	 Australia s Mothers and Babies (from 1991) and 

3.	 Congenital anomalies in Australia (from 1981) 

AIHW National Perinatal Statistics Unit, Sydney Children s Hospital, Level 2, McNevin Dickson Building, Randwick 
Hospital Campus, Randwick NSW 2031. 

Telephone (02) 9382 1014 

Website: www.npsu.unsw.edu.au 

Other reports/papers 
1 Birth defects 

1.	 Jonas O, Stern LM, Macharper T. A South Australian Study of Pregnancy and Birth Risk Factors associated with 
Cerebral Palsy. Int J Rehab Research 1989; 12 (2): 159-166. 

2.	 Chan A, Robertson EF, Haan EA, Keane RJ, Ranieri E, Carney A. Prevalence of neural tube defects in South 
Australia, 1966   91: effectiveness and impact of prenatal diagnosis. BMJ 1993; 307: 703-6. 

3.	 Bower C, Norwood F, Knowles S, Chambers H, Haan E, Chan A. Amniotic band syndrome: a population-
based study in two Australian States. Paediatr Perinat Epidemiol 1993; 7: 395-403. 

4.	 Chan A, Robertson E, Haan E, Ranieri E, Keane R. The sensitivity of ultrasound and serum alpha-fetoprotein 
in population-based antenatal screening for neural tube defects in South Australia 1986-1991. Br J Obstet 
Gynaecol 1995; 102 :370-376. 

5.	 Chan A, Keane RJ, Hanna M, Abbott M. Terminations of pregnancy for exposure to oral retinoids in South 
Australia, 1985-1993. Aust NZ J Obstet Gynaecol. 1995; 35 : 422-426. 

6.	 Byron-Scott R, Chan A, Haan EA, Bower C, Scott H, Clark K. A population-based study of abdominal wall 
defects in South Australia and Western Australia. Proceedings, 14th Annual  Congress Australian Perinatal 
Society, Adelaide, March 1996, P82. 

7.	 Chan A, Hanna M, Abbott M, Keane RJ. Oral retinoids and pregnancy. MJA 1996;165: 164-167. 

8.	 Chan A, McCaul KA, Cundy P, Haan EA, Byron-Scott R. Perinatal risk factors for developmental dysplasia of 
the hip. Arch Dis Child 1997; 76 : F94   F100. 

9.	 Yiv BC, Saidin R, Cundy PJ, Tgetgel JD, Aguilar J, McCaul KA, Keane RJ, Chan A, Scott H. Developmental 
dysplasia of the hip in South Australia in 1991: Prevalence and risk factors. J. Paediatr Child Health 1997; 33: 
151-6. 

10. Cheffins T, Chan A, Keane RJ. The effects of rubella immunisation in South Australia. Proceedings, Rights to 
Health 29th Annual Conference, Public Health Association of Australia Inc., Melbourne, 5-8 October 1997. 

11. Byron-Scott R, Haan E, Chan A, Bower C, Scott H, Clark K. A population-based study of abdominal wall 
defects in South Australia and Western Australia. Paediatr Perinat Epidemiol. 1998; 12: 136-151. 

12. Cheffins T,  	Chan A, Keane RJ, Hann EA, Hall R. The impact of rubella immunisation on the incidence of 
rubella, congenital rubella syndrome and rubella-related terminations of pregnancy in South Australia. Br J 
Obstet Gynaecol 1998; 105: 998-1004. 

13. Chan A, McCaul K, Keane RJ, Haan EA. Effect of parity, gravidity, previous miscarriage, and age on the risk of 
Down s syndrome : population-based study. BMJ 1998; 317: 923-4. 

page 91Pregnancy Outcome in South Australia 2008 



    

    

    

     

    

    

    

    

    

    

     

    

    

     

    

    

    

    

References 

14. Byron-Scott R. et al. A validation study of congenital heart defects in South Australia. Proceedings, Australian 
Birth Defects Society. Annual Scientific Meeting. Sydney 1998. 

15. Byron-Scott R. et al. A comparison of selected birth defects in Aboriginal and non-Aboriginal babies in South 
Australia. Proceedings, Australian Birth Defects Society. Annual Scientific Meeting, Sydney 1998. 

16. Byron-Scott R. Richardson M, Hiller J, Chan A, Haan E, Knight B, Adams P. The prevalence and validation of 
congenital heart defects in South Australia, 1986-94. Proceedings of the 3rd Annual Congress of the Perinatal 
Society of Australia and New Zealand, Melbourne, 1999. P153. 

17. Chan A, Cundy PJ, Foster BK, Keane RJ, Byron-Scott R. Late diagnosis of congenital dislocation of the 
hip and presence of a screening programme. South Australian population-based study. Lancet 
1999;354:1514-17. 

18. Chan A, Cundy PJ, Foster BK, Keane RJ, Byron-Scott R. Screening for congenital dislocation of the hip (letter). 
Lancet 2000;355:232-33. 

19. Chan A, Pickering J, Haan EA, Netting M, Burford A, Johnson A, Keane RJ.  Folate before pregnancy : the 
impact of a South Australian health promotion campaign on women and health professionals. Western 
Australian Birth Defects Registry Twentieth Anniversary Scientific Symposium April 27-28, 2000. Perth, 
Western Australia. Teratology 2000;62: 365. 

20. Cheffins T, Chan A, Haan EA, Ranieri E, Ryall RG, Keane RJ, Byron-Scott R, Scott H, Gjerde EM, Nguyen 
A-M, Ford JH, Sykes S. The impact of maternal serum screening on the birth  revalence of Down s syndrome 
and the use of amniocentesis and chorionic villus sampling in South Australia. Br J Obstet Gynaecol 
2000;107:1453-9. 

21. Chan A, Pickering J, Haan EA, Netting M, Burford A, Johnson A, Keane RJ.  Folate before pregnancy :the 
impact on women and health professionals of a population-based health promotion campaign in South 
Australia. MJA 2001; 174:631-636. 

22. Chan A, Foster BK, Cundy PJ. Invited commentary. Problems in the diagnosis of neonatal hip instablity. Acta 
Paediatr 2001;90:836-9. 

23. Metz MP, Ranieri E, Gerace RL, Priest KR, Luke CG, Chan A. Newborn screening in South Australia: is it 
universal? MJA 2003;179:412-415. 

24. Chan A. Invited commentary: Parity and the risk of Down syndrome   caution in interpretation. Am J 
Epidemiol 2003;158:509-511. 

25. Gibson CS, MacLennan AH, Hague WM, Rudzki Z, Sharpe P, Chan A, Dekker GA. Fetal thrombophilic 
polymorphisms are not a risk factor for cerebral palsy. Perinatal Society of Australia and New Zealand 8th 
Annual Congress, Convention Centre, Darling Harbour, Sydney, Australia, 15th-18th March 2004, A41. 

26. Gibson CS, MacLennan AH, Rudzki Z, Hague WM, Haan EA, Sharpe P, Priest K, Chan A, Dekker GA for the 
South Australian Cerebral Palsy Research Group. The prevalence of inherited thrombophilias in a Caucasian 
Australian population. Pathology 2005;37:160-163. 

27. Byron-Scott R, Sharpe P, Hasler C, Cundy P, Hirte C, Chan A, Scott H, Baghurst PB, Haan E. A 
South Australian population-based study of congenital talipes equivarus. Paediatr Perinat Epidemiol 
2005;19:227-237. 

28. Gibson CS, MacLennan AH, Hague WM, Haan E, Priest K, Chan A, Dekker GA 	 for the South Australian 
Cerebral Palsy Research Group. Associations between inherited thrombophilias, gestational age and cerebral 
palsy. Am J Obstet Gynecol 2005;193:1437.e1-1437.e12. 

29. Sharpe PB, Chan A, Haan EA, Hiller JE. Maternal diabetes and congenital anomalies in South Australia 1986 
2000: a population-based cohort study. Birth Defects Research Part A  Clin Mol Teratol 2005:73;605-611. 

30. Gibson CS, MacLennan AH, Goldwater PN, Haan EA, Priest K, Dekker GA for the South Australian Cerebral 
Palsy Research Group. Neurotropic viruses and cerebral palsy: a population bases case-control study. BMJ 
,doi:10.1136/bmj.38668.616806.3A (published 6 January 2006). 

31. Sharpe PB, Mulpuri K, Chan A, Cundy P. Differences in risk factors between early and late diagnosed DDH. 
Arch Dis Child 2006;91:F158-162. 

page 92 Pregnancy Outcome in South Australia 2008 



    

    

    

    

    

    

    

    

    

 

    

    

    

    

   

     

   

 

    

    

    
 

References 

32. Gibson CS, MacLennan AH, Goldwater PN, Haan EA, Priest K, Dekker GA for the South Australian Cerebral 
Palsy Research Group. The association between inherited cytokine polymorphisms and cerebral palsy. Am J 
Obstet Gynecol 2006;194: 674.e1-674.e11. 

33. Gibson CS, MacLennan AH, Janssen NG, Kist WJ, Hague WM, Haan EA, Goldwater PN, Priest K, Dekker GA 
for the South Australian Cerebral Palsy Research Group. Associations between fetal inherited thrombophilia 
and adverse pregnancy outcomes. Am J Obstet Gynecol  2006; 194: 947.e1-947.e10. 

34. Gibson CS, MacLennan AH, Dekker GA, Goldwater PN, Dambrosia JM, Munroe DJ, Tsang S,  	Stewart C, 

Nelson KB. Genetic polymorphisms and spontaneous preterm birth. Obstet Gynecol 2007;109:384-391.
 

35. Muller PR, Cocciolone R, Haan EA, Wilkinson C, Scott H, Sage L, Bird R, Hutchinson R, Chan A. Trends in 

state/population-based Down syndrome screening and invasive prenatal testing with the introduction of 

first-trimester combined Down syndrome screening, South Australia, 1995-2005. Am J Obstet Gynecol 

2007;196:315.e1-315.e7.
 

36. Gibson CS, MacLennan AH, Goldwater PN, Haan EA, Priest K, Dekker GA for the South Australian Cerebral 
Palsy Research Group. Mannose-binding lectin haplotypes may be associated with cerebral palsy only after 
perinatal viral exposure. Am J Obstet Gynecol 2008;198:509.e1-509.e8. 

37. Khoo NS, van Essen P, Richardson M, Robertson T. Effectiveness of prenatal diagnosis of congenital heart 
defects in South Australia: a population analysis 1999-2003. Aust NZ J Obstet Gynaecol 2008;48:559-563. 

38. Chan AC, van Essen P, Scott H, Haan EA, Sage L, Scott J, Gill TK, Nguyen A-M T. Folate awareness and the 

prevalence of neural tube defects in South Australia, 1966-2007. MJA 2008;189: 566-569.
 

39. Djukic M, Gibson CS, MacLennan AH, Goldwater PN, Haan EA, McMichael G et al. Genetic susceptibility to 
viral exposure may increase the risk of cerebral palsy. Aust NZ J Obstet Gynaecol 2009: 49:247-253. 

40. De Souza, Halliday J, Chan A, Bower C, Morris JK. Recurrence risks for trisomies 13,18, and 21. Am J Med 

Genet Part A (In press).
 

2. Termination of pregnancy 

1.	 Hart G, Macharper T. Medical termination of pregnancy in South Australia 1970-1984. Adelaide: South 

Australian Health Commission, 1986.
 

2.	 Chan A, Taylor A. Medical Termination of Pregnancy in South Australia - The First 20 Years 1970-1989. 

Adelaide: Pregnancy Outcome Unit, South Australian Health Commission, December 1991.
 

3.	 Chan A, McColl M, Versteeg J, Gameau B, Scanlan C, Pridmore B. A South Australian Study on Contraception 
and Abortion. Public and Environmental Health Service, South Australian Health Commission and Department 
of Obstetrics and Gynaecology, The Queen Elizabeth Hospital, Adelaide, March 1994. 

4.	 Hart G, Macharper T. Clinical aspects of induced abortion in South Australia from 1970-1984. Aust. NZ J 

Obstet Gynaecol 1986; 26: 219-224.
 

5.	 Hart G, Macharper T. Induced abortion trends in South Australia. Am J Public Health 1987; 77: 200-202. 

6.	 Chan A, Keane RJ. Prevalence of induced abortion in a reproductive lifetime. Am J Epidemiol 2004;159:
 
475-480.
 

7.	 Chan A, Sage LC. Estimating Australia s abortion rates 1985-2003. MJA  2005;182:447-452. 

3. Perinatal epidemiology 

1.	 Connon AF, Macharper T. Teenage pregnancies in South Australia. Adelaide: South Australian Health 

Commission, September 1986.
 

2.	 South Australian Health Commission, Epidemiology Branch: Characteristics of pregnancies and births among 
migrant women in South Australia. Adelaide : South Australian Health Commission, October 1986. 

3.	 South Australian Health Commission, Epidemiology Branch. Risk factors for adverse perinatal outcome: 

determination from a perinatal statistics collection. Adelaide: South Australian Health Commission, 

December 1986.
 

page 93Pregnancy Outcome in South Australia 2008 



    

    

    

    

    

    

    

    

    

    

    

    

    
 

    

     

     

    

    

    

    

    

References 

4.	 South Australian Health Commission, Epidemiology Branch. Variation in perinatal risk by place of residence of 
mother in South Australia. Adelaide: South Australian Health Commission, December 1986. 

5.	 South Australian Health Commission, Epidemiology Branch. Variations in Perinatal Risk by Hospital of Birth in 
South Australia. Adelaide: South Australian Health Commission, January 1987. 

6.	 South Australian Health Commission, Epidemiology Branch. Aboriginal Births in South Australia, 1981-1986: 
An Analysis of Perinatal Outcomes, Adelaide: South Australian Health Commission, May 1988. 

7.	 South Australian Health Commission, Epidemiology Branch: Pregnancy Outcome Attributes by Postcode: 
South Australia 1981-1986. South Australian Health Commission, Adelaide: August 1988. 

8.	 Jonas O, Scott J, Chan A, Macharper T, Lister J. A validation study of the 1986 perinatal data collection form. 
Adelaide: Pregnancy Outcome Unit, South Australian Health Commission, 1991. 

9.	 South Australian Cancer Registry. Associations between perinatal characteristics and risk of childhood cancer: 
South Australian cancer cases born in 1981-1993. In: Epidemiology of Cancer in South Australia. Incidence, 
Mortality and Survival 1977 to 1994. Adelaide South Australian Health Commission, 1995. 

10. Taylor A, Twisk A-M, Chan A. Perinatal risk factors by postcode in South Australia 1989-1992. Epidemiology 
Branch, South Australian Health Commission, Adelaide: June 1995. 

11. Pregnancy Outcome Unit. Perinatal Statistics Collection. Guidelines for the Supplementary Birth Record. 
Adelaide: South Australian Health Commission, December 1997. 

12. McLean A, Scott J, Keane RJ, Sage L, Chan A. Validation of the 1994 South Australian perinatal data 
collection form. Adelaide: Pregnancy Outcome Unit, Department of Human Services, 2001. 

13. Hart G, MacHarper T, Moore D, Roder D. Aboriginal pregnancies and births in South Australia. MJA 1985; 
143: S54-56. 

14. Chan A, Roder D, Macharper, T. Obstetric Profiles of Immigrant Women from Non-English Speaking Countries 
in South Australia, 1981-83. Aust NZ J Obstet Gynaecol 1988; 28: 90-95. 

15. Jonas O, Roder D, Esterman A, Macharper T, Chan A. Pregnancy and Birth Risk Factors for Intellectual 
Disability in South Australia. Eur J Epidemiol 1989; 5: 322-327. 

16. Jonas O, Chan A, Macharper T, Roder D. Pregnancy and Perinatal Factors associated with persistently low 
Apgar scores: an analysis of the birth records of infants born in South Australia. Eur J Epidemiol 
1990; 6: 136-141. 

17. Crotty M, Ramsay AT, Smart R, Chan A. Planned Homebirths in South Australia 1976-1987 MJA 1990; 153: 
664-671. 

18. Jonas O, Chan A, Roder D, Macharper T. Pregnancy Outcomes in primigravid women aged 35 years and 
over in South Australia, 1986-1988. MJA 1991; 154: 246-249. 

19. Zhang B, Chan A. Teenage Pregnancy in South Australia, 1986-1988. Aust. NZ J Obstet Gynaecol 1991; 
31: 291-298. 

20. Jonas O, Roder D, Chan A. The Association of Maternal and Socioeconomic Characteristics in Metropolitan 
Adelaide with Medical, Obstetric and Labour Complications and Pregnancy Outcomes. Aust NZ J Obstet 
Gynaecol 1992; 32: 1-5. 

21. Chan A, Roder D, Priest K, Esterman A. A perinatal perspective on South Australia in the 1980s. MJA 1992; 
157: 515-518. 

22. Jonas O, Roder D, Chan A. The association of low socio-economic status in Metropolitan Adelaide with 
maternal demographic and obstetric characteristics and pregnancy outcome. Eur J Epidemiol 1992; 8:708. 

23. Jonas O, Roder D. Breech Presentation in South Australia, 1987-1989. Aust NZ J Obstet Gynaecol 1993; 33: 
17-21. 

24. Scott J, Chan A. Planned birthing unit deliveries in South Australia. Proceedings, 14th Annual Congress 
Australian Perinatal Society, Adelaide, March 1996, P21. 

page 94 Pregnancy Outcome in South Australia 2008 



    

    

   

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

    

     

References 

25. Dal Grande E, Chan A, Keane R. Asian, but different: Obstetric characteristics of women born in Vietnam and 
Philippines who delivered in South Australia in 1991-1994. Proceedings, 14th Annual Congress Australian 
Perinatal Society, Adelaide, March 1996, P22. 

26. Keane R, Dal Grande E, Chan A, McCaul K. Episiotomy   a decline in the cutting edge. Proceedings, 14th 
Annual Congress Australian Perinatal Society, Adelaide, March 1996, P75. 

27. Chan A, McPhee AJ. A safer leap into this dangerous world. Lancet 1996; 348 (suppl II) :12. 

28. Carter JR, Hiller JE, Ryan P, Chan A. The Association between maternal age and preterm births to primiparous 
women in South Australia, 1991-1993, Proceedings, First Annual Congress, Perinatal Society of Australia and 
New Zealand, Fremantle, Western Australia, 16-24 March 1997. 

29. Zhang B, Hiller JE, Chan A. Asthma in pregnancy in South Australia. Proceedings, First Annual Congress, 
Perinatal Society of Australia and New Zealand, Fremantle, Western Australia, 16-24 March 1997. 

30. Roder D, Nguyen A-M, Chan A. Trends in perinatal characteristics in South Australia, 1981 to 1994, by place 
of residence of mother. Aust NZ J Public Health 1997; 21: 483-8. 

31. Zhang B, Hiller JE, Chan A. Asthma in pregnancy: Association with Spontaneous Preterm Birth. Proceedings of 
the 3rd Annual Congress of the Perinatal Society of Australia and New Zealand, Melbourne, 1999, A113. 

32. McLean AP, Hiller JE, Chan A. Maternal epilepsy and fetal outcomes in South Australia. Perinatal Society 
of Australia and New Zealand 4th Annual Congress. Brisbane Convention and Exhibition Centre, Brisbane, 
Australia, 12-15 March 2000, P192. 

33. Chan A, Keane RJ, Robinson JS. The contribution of maternal smoking to preterm birth, small for gestational 
age and low birthweight among Aboriginal and non-Aboriginal births in South Australia. MJA 2001;174: 
389-93. 

34. van der Klis KAM, Westenberg L, Chan A, Dekker G, Keane RJ. Teenage pregnancy: trends,characteristics and 
outcomes in South Australia and Australia. Aust N Z J Public Health 2002; 26: 125-31. 

35. Westenberg L, van der Klis KAM, Chan A, Dekker G, Keane RJ. Aboriginal teenage pregnancies compared 
with non-Aboriginal in South Australia 1995-1999. Aust N Z J Obstet Gynaecol 2002;42: 187-191. 

36. Wang JX, Knottnerus A-M, Schuit G, Norman RJ, Chan A, Dekker GA. Surgically obtained sperm and risk of 
gestational hypertension and pre-eclampsia. Lancet 2002;359: 673-4. 

37. Jacobs DJ, Vreeburg SA, Dekker GA, Heard AR, Priest KR, Chan A. Risk factors for hypertension during 
pregnancy in South Australia. Aust NZ J Obstet Gynaecol 2003; 3: 421-428. 

38. Heard AR, Dekker GA, Chan A, Jacobs DJ, Vreeburg SA, Priest KR. Hypertension during pregnancy in South 
Australia, Part 1: Pregnancy outcomes. Aust NZ J Obstet Gynaecol 2004; 44: 404-409. 

39. Vreeburg SA, Jacobs DJ, Dekker GA, Heard AR, Priest KR, Chan A. Hypertension during pregnancy in South 
Australia, Part 2: Risk factors for adverse maternal and/or perinatal outcome   results of multivariable analysis. 
Aust NZ J Obstet Gynaecol 2004;44: 410-418. 

40. Leahy K, Elliot E, Kennare R, Chan A. Characteristics and pregnancy outcomes of first time mothers aged 
35 years and over compared to younger first time mothers in South Australia 1991-2002. Before and 
Beyond Birth. Abstract Book. Perinatal Society of Australia and New Zealand 9th Annual Congress. Adelaide 
Convention Centre, Adelaide, South Australia, 13-16 March 2005, A144. 

41. Kennare R, Heard A, Chan A. Substance use during pregnancy: risk factors and obstetric and perinatal 
outcomes in South Australia. Aust NZ J Obstet Gynaecol 2005;45:220-225. 

42. Freak-Poli R, Chan A, Tucker G, Street J. Previous abortion and risk of spontaneous preterm birth. Perinatal 
Society of Australia and New Zealand 10th Annual Congress. Perth Convention Exhibition Centre, Perth, 
Western Australia, 3-6 April 2006, FC17.1, p 165. 

43. Scott J, Chan A. South Australian Perinatal Statistics Collection. Guidelines for the Supplementary Birth 
Record. Adelaide: Pregnancy Outcome Statistics Unit, South Australian Department of Health, 2006. 

44. Budde MP, De Lange TE, Dekker GA, Chan  	A, Nguyen AM. Risk factors for placental abruption in a 
socio-economically disadvantaged region. J Matern Fetal Neonat Med 2007 Sep; 20(9):687-93. 

page 95Pregnancy Outcome in South Australia 2008 



    

     

 

    

    

    

    

    

    

    

    

    

    

 

    

    

   

   

    

    

References 

45. Freak-Poli R, Chan A, Tucker G, Street J. Previous abortion and risk of pre-term birth: a population study. J 

Matern-Fetal Neonat Med 2009;22(1):1-7.
 

46. Kennare RM, Keirse MJNC, Tucker GR, Chan AC. Planned home and hospital births in South Australia 

1991-2006: differences in outcomes. MJA 2010, 192: 76-80.
 

4. Perinatal mortality 

1.	 Roder D, Chan A, Esterman A. Birthweight   specific trends in perinatal mortality by hospital category in 

South Australia, 1985   1990. MJA 1993; 158: 664-667.
 

2.	 Connon AF, Chan A on behalf of the Postneonatal Subcommittee, maternal, perinatal and Inmfant 
Mortality Committee. Accidental deaths of babies in the postneonatal period in South Australia (letter). MJA 
1994;161:397. 

3.	 Roder D, Chan A, Priest K. Perinatal mortality trends among South Australian Aboriginal births 1981-92. J 

Paediatr Child Health 1995; 31: 446-450.
 

4.	 Haslam R, McPhee A, Chan A, Keane R. Neonatal mortality   a system of classification and trends in South 

Australia. Proceedings of the 3rd Annual Congress of the Perinatal Society of Australia and New Zealand, 

Melbourne, 1999. P86.
 

5.	 Robson S, Chan A, Keane RJ, Luke CG. Subsequent birth outcomes after an unexplained stillbirth: preliminary 
population-based retrospective cohort study. Aust NZ J Obstet Gynaecol 2001;41: 29-35. 

6.	 Flenady V, Chan A, Haslam R, King J, Tudehope D, McCowan L. Cause specific perinatal mortality in Australia 
and New Zealand using a new clinical classification system (ANZACPM and ANZNDC). Perinatal Society of 
Australia and New Zealand 7th Annual Congress, Hotel Grand Chancellor, Hobart, Tasmania, March 9th-12th 
2003, A87. 

7.	 Dodd JM, Robinson JS, Crowther CA, Chan A. Stillbirth and neonatal outcomes in South Australia, 1991 
2000. Am J Obstet Gynecol 2003;189: 1731-1736.
 

8.	 Chan A, King JF, Flenady V, Haslam RH, Tudehope DI. Classification of perinatal deaths: Development of the 
Australian and New Zealand classifications. J Paediatr Child Health 2004;40: 340-347. 

9.	 Flenady V, King J, Chan A, McCowan L, Tudehope D, Haslam R, Charles A, Roberts C for the Perinatal 
Mortality Audit Guidelines Working Party of the PSANZ Perinatal Mortality Special Interest Group. 
Development of Clinical Practice Guideline for Perinatal Mortality Audit incorporating psychological and social 
aspects of perinatal bereavement. Before and Beyond Birth. Abstract Book. Perinatal Society of Australia and 
New Zealand 9th Annual Congress, Adelaide Convention Centre, Adelaide, South Australia, 13-16 March 
2005, P58. 

10. De Lange TE, Budde MP, Heard AR, Tucker G, Kennare R, Dekker GA. Avoidable risk factors in perinatal 

deaths: a perinatal audit in South Australia. Aust NZ J Obs Gynaecol 2008;48:50-57.
 

5. Caesarean section 

1.	 Jonas O, Chan A, Macharper T. Caesarean Section in South Australia, 1986. Aust NZ J Obstet Gynaecol 1989; 
29: 99-106. 

2.	 Chan A. Epidemiology of the rising Caesarean section rate. Proceedings, 14th Annual Congress Australian 

Perinatal Society, Adelaide, March 1996, A70.
 

3.	 Chan A, Keane RJ, Scott J. Elective Caesarean section and child deprivation (letter). Lancet 1996; 347: 1196. 

4.	 Kennare, R. Why is the caesarean section rate rising? MIDIRS Midwifery Digest 2003; 13 (4): 503-508. 

5.	 Kennare R, Heard A, Chan A. Is caesarean section in the first birth a problem for women in the next birth? 
Before and Beyond Birth. Abstract Book. Perinatal Society of Australia and New Zealand 9th Annual Congress. 
Ade;laide Convention Centre, Adelaide, South Australia, March 13-16 2005, A 127. 

6.	 Kennare R, Tucker G, Heard A, Chan A. Risks of adverse outcomes in the next birth after caesarean delivery. 
Obstet Gynecol 2007;109:270-276. 

page 96 Pregnancy Outcome in South Australia 2008 



  

 

 

 

 

 

  

   
 

    
 

    

  

 

 

 

 

 

 

  

  

  

 

  

Appendix 

Appendix 1: Definitions 
Women who gave birth (previously called confinements): women who gave birth to a live birth of any gestation 

or a stillbirth of at least 400g birthweight or 20 weeks gestation 


Primigravida: A woman pregnant for the first time.
 

Multigravida: A woman who has been pregnant more than once.
 

Parity: the total number of previous pregnancies resulting in live births or stillbirths.
 

Primipara: pregnant woman who has had no previous pregnancy resulting in a live birth or stillbirth.
 

Race:
 

1.	 Caucasian:  individuals of European descent. 

2.	 Aboriginal:  this includes part-Aboriginals as well as full blood Aboriginals. An Aboriginal is a person of 

Aboriginal descent who identifies as an Aboriginal and is accepted as such by the community in which he 

or she lives.
 

3.	 Asian: (exclude Asia Minor) - In this category, include women originating from all Asian countries, 

including the Indian subcontinent (India, Bangladesh, Pakistan, Nepal, Sri Lanka), who were formerly 

listed as  Other  race.
 

4.	 Torres Strait Islander (TSI): A Torres Strait Islander is a person of Torres Strait Islander descent who identifies 
as a Torres Strait Islander and is accepted as such by the community in which he or she lives. 

5.	 Aboriginal &amp; TSI: persons of both Aboriginal and Torres Strait Islander descent. 

6. Other: Races other than (1) - (5). Include women from the Middle East and Africa. 

Guidelines for use regarding Indigenous Status - categories (2), (4) and (5).
 

There are three components to the definition:
 

&gt; descent
 

&gt; self identification
 

&gt; community acceptance
 

It is not possible to collect the three components of the definition in a single question. The Australian Bureau of 

Statistics (ABS) proposes that the focus of a single question should be the descent, the first component of the 
definition. The ABS therefore proposes the use of the following alternative questions, depending on whether the 
person is present or not. 

Where the person is present :  Are you of Aboriginal or Torres Strait Islander origin? ; 

OR 

where the person is not present and someone who knows the person well responds for him/her:  Is the person of 
Aboriginal or Torres Strait Islander origin?  

If the response is  Yes , then clarify whether the person is of Aboriginal origin (2), Torres Strait Islander origin (4) or 
both Aboriginal and Torres Strait Islander origin (5). 

Self reporting of descent is not equivalent to self reporting of identity but because of the absence of a second 
 identity  question some respondents will interpret the  origin  question to mean both descent and identification. 
What identification in the context of the variable Indigenous Status should measure is an individual s self assessed 
historical and cultural affiliation. 

Body Mass Index (BMI): weight ( in kg)  height2 (in metres). 

This is used as a standard for recording obesity statistics and also as a measure of underweight. However the 
categories do not take into account factors such as frame size, muscularity, varying proportions of components 
such as fat, bone, cartilage and water, and may be misleading in athletes, children and some ethnic groups. The 
categories for describing weight using BMI are: 

page 97Pregnancy Outcome in South Australia 2008 



  

  

  

  

  

  

  

 

  

 

 

Appendix 

BMI category Name 

&lt;18.5 Underweight
 

18.5-24.9 Normal
 

25-29.9 Overweight
 

30-34.9 Obese
 

35-39.9 Severely obese
 

40 or greater Morbidly obese.
 

Induction of labour: An intervention undertaken to stimulate the onset of labour by pharmacological or 

other means.
 

Caesarean section: Birth of a child by an abdominal operation.
 

Elective caesarean section:  One which takes place as a planned procedure before the spontaneous onset of labour.
 

Emergency caesarean section: One which is undertaken for a complication:
 

(a)  before the onset of labour or 

(b) during labour, whether that labour is of spontaneous onset or following induction of labour. 

Gestational age: The duration of pregnancy in completed weeks from the first day of the last normal 

menstrual period.
 

Preterm: less than 37 completed weeks gestation.
 

Birthweight: The first weight of a fetus or newborn obtained after birth.  This is preferably measured within the first 

hour of life before significant post-natal weight loss has occurred.
 

Low birthweight: Birthweight of less than 2,500g.
 

Very low birthweight: Birthweight of less than 1,500g.
 

Congenital abnormality: Any defect probably of prenatal origin; thus structural, chromosomal and biochemical 

defects are included. An exclusion list of isolated minor abnormalities is provided by the Unit. Abnormalities are 

classified as major if they are either lethal or significantly affect the individual s function or appearance. 

Apgar score: A numerical scoring system applied after birth (usually at 1 minute and again at 5 minutes) to evaluate 
the condition of the baby, as specified below: 

Sign 
Score 

0 1 2 

Heart rate Absent Slow (below 100) Over 100 

Respiratory effort Absent Slow, irregular Good, crying 

Muscle tone Flaccid 
Some flexion of 

extremities 
Active motion 

Reflex irritability No response Grimace Vigorous cry 

Colour Blue, pale 
Body pink, extremities 

blue 
Completely pink 

Live birth: The complete expulsion or extraction from its mother of a product of conception, irrespective of the 
duration of pregnancy, which after such separation breathes or shows any other evidence of life, such as beating of 
the heart, pulsation of the umbilical cord or definite movement of voluntary muscles, whether or not the umbilical 
cord has been cut or the placenta is attached. 

page 98 Pregnancy Outcome in South Australia 2008 



    

      

                

 

         

 

      

      

  

Appendix 

Crude birth rate: 
Number of live births in any year 

Average population in that year 
= x 1,000 

Age-specific fertility rate:

Number of live births to women in an age group in a year x 1,000 
Estimated resident population of women of that age group in the same year 

General fertility rate: 
Total number of live births in a year 

Estimated resident population of women aged 15-44 years in the same year 
x 1,000 

Total fertility rate (TFR): the sum of age-specific fertility rates (live births at each age of women per female 
population of that age). It represents the number of children a woman would bear during her lifetime if she 
experienced current age-specific fertility rates at each age of her reproductive life. 

Fetal death: Death prior to the complete expulsion or extraction from a woman of a product of conception, 
irrespective of the duration of pregnancy; the death is indicated by the fact that after such separation the fetus does 
not breathe or show any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or 
definite movement of voluntary muscles. 

Early fetal death: Death in a fetus of less than 400g birthweight, and of less than 20 weeks gestation. 
A miscarriage is a spontaneous early fetal death. 

Late fetal death or stillbirth:  Death in a fetus of at least 400g birthweight, or of at least 20 weeks gestation. 

Late fetal death rate or stillbirth rate: 

Number of late fetal deaths or stillbirths in any year=  = x 1,000 
Number of live births and stillbirths in that year 

Neonatal death: Death of a liveborn infant within 28 days of birth. 

Neonatal death rate: 

Number of neonatal deaths in any year=  = x 1,000 
Number of live births in that year 

Perinatal death: Includes late fetal death (stillbirth) and neonatal death. 

Perinatal mortality rate (PMR): 

= Number of stillbirths and neonatal dealths = x 1,000 
Number of stillbirths and live births 

For South Australian statistics, the rate refers to live births of any gestation and stillbirths of at least 400g birthweight 
or 20 weeks gestation. 

For national statistics, the rate refers to all births of at least 500g birthweight, or when birthweight is unavailable, 
of at least 22 weeks gestation (as recommended by the World Health Organisation (WHO)) and neonatal deaths 
occurring within seven days of birth. 

For international comparison, the rate refers to all births of at least 1,000 g birthweight or, when birthweight 
is unavailable, of at least 28 weeks gestation and neonatal deaths occurring within seven days of birth (as 
recommended by WHO). 

Maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, 
irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy 
or its management but not from accidental or incidental causes1. 

page 99Pregnancy Outcome in South Australia 2008 



  

  
 

         

Appendix 

Maternal deaths are divided into two groups: 

1. Direct obstetric deaths: those resulting from obstetric complications of the pregnant state (pregnancy, labour and 
puerperium) from interventions, omissions, incorrect treatment, or from a chain of events resulting from any of 
the above. 

2. Indirect obstetric deaths: those resulting from previous existing disease or disease that developed during 
pregnancy and which was not due to direct obstetric causes, but which was aggravated by physiologic effects 
of pregnancy. 

As an extension of the WHO definition, accidental and incidental deaths occurring in pregnant women are also 
reviewed by the Maternal, Perinatal and Infant Mortality Committee so as to avoid missing indirect deaths which may 
be difficult to distinguish from incidental deaths. Examples of incidental deaths are deaths from drowning and road 
accidents, where the pregnancy is unlikely to have contributed significantly to the death, although it may be possible 
to postulate a remote association. 

Termination of pregnancy:  Termination performed by a medical practitioner in a prescribed hospital in South 
Australia, on specified grounds under the Criminal Law Consolidation Act and notified under the Criminal Law 
Consolidation (Medical Termination of Pregnancy) Regulations 1996. Terminations of pregnancy at gestations of 20 
weeks or later or where the fetus weighs at least 400g, performed by induction of labour resulting in a birth  are 
included in the South Australian perinatal data collection. These are usually for congenital abnormalities or medical 
reasons. 

Abortion rate: 

Number of induced abortions in a group of women in a year = x 1,000 
Estimated resident population of same group in the same year 

The abortion rate per 1,000 women in the reproductive age group 15-44 years has been calculated in this report 
using as the numerator all abortions; the denominator used has been the estimated resident population for women 
aged 15-44 years in that year. 

Abortion proportion: 
Abortions 

= 
Abortion + live births 

Abortions
This is often called the abortion ratio, which is strictly: 

Live births 

Total abortion rate = the sum of the five-year age-specific abortion rates multiplied by 5. 

This represents the number of abortions 1,000 women would have during their lifetime if they experienced the rates 
of the year shown. 

1 World Health Organisation. International Statistical Classification of Diseases and Related Health Problems. Tenth Revision. Volume 2. Geneva: WHO, 
1993, p 134. 

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Appendix 

Appendix 2: 2008 Supplementary Birth Record Form 

17 Type of antenatal care 
1. ? No antenatal care 
2. ? Hospital clinic
3. ? Obstetrician in private practice 
4. ? General practitioner 
5. ? Birth centre 
6. ? Home birth midwife 
7. ? Obstetrician/midwife 

(shared care) in private practice 
8. ? GP/midwife (shared care) 
9. ? Other (specify)............................................ 

10. ? Not stated 
18 Tobacco smoking status at first visit 

1. Smoker 
2. Quit in pregnancy before first visit 
3. Non smoker 
4. Unknown smoking status 

19 Average number of tobacco cigarettes
smoked per day in 2nd half of pregnancy 
? None 
? Number per day = ............................................ 
? &lt;1 (occasional) 
? Unknown number 

20 Medical conditions present in this 
pregnancy 

1. ? None 
2. ? Anaemia 
3. ? Urinary tract

infection 
4. ? Hypertension

(pre-existing) 
5. ? Diabetes 

(pre-existing)
6. ? Epilepsy 
7. ? Asthma 
8. ? Other (specify)............................................ 

21 Obstetric complications 
1. ? None 
2. ? Threatened 

miscarriage
3. ? APH - Abruption 
4. ? APH - Placenta 

praevia
5. ? APH - Other &amp; 

unknown cause 
6. ? Pregnancy hypertension (all types) 
7. ? Suspected IUGR
8. ? Gestational diabetes 
9. ? Other (specify, including impaired 

glucose tolerance) 
................................................................... 

22 Date of admission prior to delivery 

day month year 
23 Procedures performed in this pregnancy 
Tick if Yes Tick if Unknown 

1. ? MSAFP (NTD etc) ? 
2. ? Triple/Quadruple screen ? 

(Down s etc) 
3. ? Ultrasound examination ? 
4. ? Chorion villus sampling ? 
5. ? Amniocentesis ? 
6. ? Cordocentesis ? 
7. ? Other surgical procedures (specify) 

................................................................... 
LABOUR AND DELIVERY 

24 Onset of labour 
1. Spontaneous
2. No labour (LSCS)
3. Induction (excluding augmentation) 
Give reason/s for induction 
(If postdates, state T+ ..............  days) 

.................................................................... 

.................................................................... 
25 If induction, or augmentation after

spontaneous onset, specify method/s 
1. ? ARM 
2. ? Oxytocics
3. ? Prostaglandins 
4. ? Other (specify)............................................ 

26 Presentation prior to delivery 
1. Vertex 
2. Breech 
3. Face 
4. Brow 
5. Other 
6. Unknown 

4 Hour of birth 
(24 hour clock) 

5 Sex 
1. Male  
2. Female  
3. Indeterminate 

6 Birthweight (grams) 
7 Gestation at birth 

(best clinical estimate in weeks) 

CONDITION AT  BIRTH 

8 Apgar Score 1 minute

 5 minute 
9 Time to establish regular 

breathing (to nearest minute) 
10 Resuscitation at delivery

1. ? None 
2. ? Aspiration
3. ? Oxygen
4. ? IPPV - bag &amp; mask
5. ? IPPV - intubation 
6. ? Narcotic antagonist 
7. ? Sodium bicarbonate 
8. ? Ext. cardiac massage 
9. ? Other (specify) 

................................................................... 
11 Condition occurring during birth 

1. ? None 
2. ? Fracture 
3. ? Dislocation 
4. ? Nerve injury
5. ? Other (specify) 

................................................................... 
12 Congenital abnormalities

1. ? Nil apparent
2. ? Yes (specify) 

.................................................................... 

.................................................................... 

.................................................................... 

.................................................................... 

.................................................................... 

.................................................................... 
13 Treatment given 

1. ? None of the treatments below 
2. ? Oxygen therapy &gt; 4 hours 
3. ? Phototherapy for jaundice 
4. ? Gavage feeding more than once 
5. ? Any intravenous therapy 

14 Nursery care required 
1. ? Level 1 only
2. ? Special nursery (Level 2) 

Number of days .......................
3. ? Neonatal Intensive Care Unit (NICU)

- FMC/WCH (Level 3) 

Number of days .......................
4. ? Paediatric Intensive Care Unit (PICU) 

- WCH 

Number of days ....................... 
15 Was transfer to NICU/PICU for a 

congenital abnormality? 
? Yes 
? No 

OUTCOME OF BABY 
16 Outcome of baby 

1. Fetal death 
2. Discharged
3. In hospital at 28 days
4. Neonatal death 

17 Baby transferred to 

.................................................................... 
on 

day month year 

18 Date of final discharge (or death) 

day month year 

2008 SUPPLEMENTARY BIRTH RECORD 

Mother s name............................................................................................................................. 
Surname Given Names 

Child s surname (if different)........................................................................................................ 

Mother s address......................................................................................................................... 

..................................................................................................... Postcode 

Personal information above this line is con?dential SLA 

MOTHER S INFORMATION 

1 Mother s date of birth 

day month year
2 Race 

1. Caucasian    
2. Aboriginal    
3. Asian 
4. Torres Strait Islander (TSI)
5. Aboriginal &amp; TSI    
6. Other 

3 Country of birth 

.................................................................... 
4 Type of patient 

1. Hospital/Public    
2. Private 

5 Marital status 
1. Never married    
2. Married/De facto 
3. Widowed            
4. Divorced 
5. Separated 

OCCUPATION 

6 Baby s father 

.................................................................... 

Baby s mother 

.................................................................... 
PREVIOUS PREGNANCY  OUTCOMES 

7 Number of previous pregnancies 

8 Number of previous pregnancies resulting
in births &gt;20 weeks (parity) 

9 Number of previous outcomes
 Singleton Multiple 

Livebirths, not neonatal deaths 

Livebirths, neonatal deaths 

Stillbirths 

Miscarriages 

Ectopic pregnancies 

Terminations of pregnancy 

10 Outcome of last pregnancy 

.................................................................... 
11 Date of delivery/termination of last 

pregnancy

 month  year 
12 Method of delivery in last birth 

0. No previous birth
1. Vaginal
2. Caesarean 
9. Not known 

13 Number of previous caesareans 
THIS PREGNANCY 

14 Date of last menstrual period

 day month  year 
15 Intended place of birth 

1. Hospital 
2. Birth centre 
3. Home 
4. Other (specify) .................................................. 
5. Not booked 

16a Number of antenatal visits 
16b First antenatal visit 

Gestation (weeks) 

Height (cm) 

Weight (kg) 

BMI 

Please return top copy to:
Pregnancy Outcome Unit, PO Box 6,

Rundle Mall, Adelaide SA  5000 

27 Method of delivery
1. Normal spontaneous
2. Forceps
3. Assisted breech (no forceps) 
4. LSCS (elective)
5. LSCS (emergency) 

If LSCS state reason/s: 
................................................................... 

6. Ventouse 
7. Breech extraction      
8. Breech spontaneous
9. Unknown 

10. Assisted breech (with forceps for head) 
28 Complications of labour, delivery and

puerperium 
1. ? None 
2. ? PPH (Primary) 

?600 - 999ml 
?1000ml or more 

3. ? Fetal distress 
4. ? Retained placenta 
5. ? Prolonged labour

(&gt;18 hrs) 
6. ? Cord prolapse
7. ? Wound infection 
8. ? Failure to progress (specify) 

................................................................... 
9. ? Other (specify) 

................................................................... 
29 Perineal status after delivery

Tick tear, repair &amp; episiotomy if all
1. ? Intact 
2. ? 1st degree tear/vaginal graze    
3. ? 2nd degree tear 
4. ? 3rd degree tear
5. ? 4th degree tear
6. ? Repair of tear
7. ? Episiotomy
8. ? Other (specify)........................................... 
9. ? Not stated 

30 CTG performed during labour
1. None               
2. External    
3. Scalp clip 

31 Fetal scalp pH taken during labour
1. No 
2. Yes 

32 Analgesia for labour
1. ? None 
2. ? Nitrous oxide and oxygen 
3. ? Narcotic (parenteral)
4. ? Epidural (lumbar/caudal) 
5. ? Spinal
6. ? Other (specify)............................................ 
7. ? Combined spinal-epidural 

33 Anaesthesia for delivery 
1. ? None 
2. ? Local anaesthesia to perineum 
3. ? Pudendal 
4. ? Epidural (lumbar/caudal) 
5. ? Spinal
6. ? General anaesthesia 
7. ? Other (specify)............................................ 
8. ? Combined spinal-epidural 

34 Mother s outcome for birth hospital/ 
home birth 

1. ? Discharged 
2. ? Transferred   
3. ? Died 
Transferred to ........................................................ 
on 

day month year 
35 MOTHER S FINAL DISCHARGE/DEATH 
Date 

day month year 

BABY DETAILS 

1 Case record number 

2 Place of birth 
1. Hospital    
2. BBA 
3. Domicilary   
4. Birthing unit/centre 

3 Date of delivery 

day month year 

FOR COMPLETION BY MIDWIVES AND NEONATAL NURSES 

Hospital/Place of birth......................................................... 

Mother s Case Record Number.......................................... 

Plurality (1=single, 2=twin, 3=triplet, 4=quad) 

For multiple births, please complete a separate baby form for each baby. 

. 

Pregnancy Outcome in South Australia 2008 page 101 

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Appendix 

Appendix 3: Congenital Abnormality Form 

S.A. PREGNANCY OUTCOME STATISTICS UNIT, 

PO Box 6, Rundle Mall, Adelaide SA  5000
 

SBR No.CONGENITAL ABNORMALITY FORM 
ACC NO. 

BABY S SURNAME..................................................................................... 
4 

FAMILY HISTORY OF CONGENITAL ABNORMALITY Yes  No Not known 
BABY S FIRST NAME .................................................................................
 

1. Parents (specify).................................................................
 
SEX ....................IF MULTIPLE BIRTH, BIRTH ORDER.............................
 

2. Siblings of this baby (including known stillbirths
DATE OF BIRTH.............. / ............/ .......... UR NO. .................................... and 2nd trimester terminations of pregnancy) 

HOSPITAL ................................................................................................... (specify) .................................................................................. 

ADDRESS OF MOTHER............................................................................. 3. Other relatives (specify)......................................................
 

.....................................................................................................................
 ...................................................................................... .........
 

RESIDENCE OF MOTHER DURING THE FIRST 16 WEEKS OF PREGNANCY 

................................................................................................
 

EXPOSURE TO TERATOGENS 
DURING THE FIRST 16 WEEKS OF PREGNANCY 
This information can be provided by the doctor undertaking antenatal care 

Yes  If yes, details 

1. Infection (including viral) ..........................................................
 

2. Xrays ..........................................................
 

3. Environmental chemicals ..........................................................
 

4. Prescribed drugs ..........................................................
 

5. Over-the-counter drugs ..........................................................
 

6. Alcohol ..........................................................
 

7. Other addictive substances ..........................................................
 

8. Any other substances .......................................................... 
CONGENITAL ABNORMALITIES / BIRTH DEFECTS PRESENT 
(Please list all defects &amp; specify where relevant right/left, anterior/posterior) Comments ................................................................................................
 

Of?ce use only 
..................................................................................................................
 

1..............................................................................................
 HAS THE FATHER OF THIS CHILD A HISTORY OF EXPOSURE TO ANY 
POTENTIAL TERATOGENS? Yes No Not known

2..............................................................................................
 
(specify) ...................................................................................................
 

3..............................................................................................
 ADDITIONAL INFORMATION (eg drinking water supply/local epidemics) 

4..............................................................................................
 ..................................................................................................................
 

PRENATAL DIAGNOSIS 5..............................................................................................
 
Please tick all tests performed  Please tick if 

6..............................................................................................
 during this pregnancy  abnormal result 

1. MSAFP (NTD etc) 
7..............................................................................................
 2. Triple/Quadruple screen (Down s, etc) 

3. Ultrasound (morphology)
8..............................................................................................
 4. Chorion villus sampling 

5. Amniocentesis 
9..............................................................................................
 6. Cordocentesis 

8. Other (specify) .............................................................
10............................................................................................
 
9. Not known 

SPECIFIC SYNDROME/S (if known) ....................................
 Comments ...................................................................................................
 

................................................................................................
 .....................................................................................................................
 

NAME OF NOTIFYING DOCTOR ................................................................................ Signed....................................................................Date.......................................
 

NAME &amp; ADDRESS OF OBSTETRICIAN/MIDWIFE (if not the same) .......................................................................................................................................................
 

Pregnancy Outcome in South Australia 2008 page 102 



page 103Pregnancy Outcome in South Australia 2008 



page 104 Pregnancy Outcome in South Australia 2008 




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