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P R E G N A N C Y
O U T C O M E

I N S O U T H A U S T R A L I A  2 0 0 1

P R E G N A N C Y O U T C O M E U N I T

EPIDEMIOLOGY BRANCH   DEPARTMENT OF HUMAN SERVICES

ISSN 0819-3835



 
(i) 
 
 
 
 
 
 

PREGNANCY OUTCOME 
 

IN 
 

SOUTH AUSTRALIA 
 
 
 
 

2001 
 
 
 
 
 

Annabelle Chan   Joan Scott   Anh-Minh Nguyen   Rosemary Keane 
 
 
 
 
 
 
 
 
 

Pregnancy Outcome Unit 
Epidemiology Branch 

Department of Human Services 
Adelaide 

 
 

December 2002 
 
 

ISSN 0819-3835 



 
(ii)



 
(iii) 

 
PREGNANCY OUTCOME STATISTICS UNIT Postal Address: 
Epidemiology Branch PO Box 6, Rundle Mall 
Department of Human Services ADELAIDE   5000 
162 Grenfell Street SOUTH AUSTRALIA 
ADELAIDE   5000 Telephone:  (08) 8226 6382 

 SOUTH AUSTRALIA Fax: (08) 8226 6291 
 
 

STAFF: 
 
Annabelle Chan Senior medical consultant 
Joan Scott Senior midwife 
Leonie Sage Midwife (part-time) 
Maureen Fisher Clerical Officer 
Judith Thompson Clerical Officer (part-time) 
Rosemary Keane Senior midwife (till July 2002) 
Paula Green Midwife (part-time) 
Robyn Kennare Senior midwife, Maternal, Perinatal &amp; Infant Mortality Committee 
                                              (from August 2002) 

 
 

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: 
 
-  doctors who notified congenital abnormalities and terminations of pregnancy, 
 
-  the pathology departments of teaching hospitals for autopsy information, 
 
-  the Department of Cytogenetics and Molecular Genetics, Women's and Children's 

Hospital, and Genetic Consulting and Testing Pty Ltd for cytogenetics reports, 
 
-  the Births, Deaths and Marriages Registration Division for perinatal death certificates, 
 
- the Coroner's Office for burial orders and autopsy reports, 
 
-  the South Australian Branch of the Australian Bureau of Statistics for assistance 

and for provision of statistics on births outside hospital, 
 
- 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,  
 

- Ann-Marie Twisk for her assistance with the perinatal data collection, 
 

- Maureen Fisher and Judith Thompson for typing this Report, and Sandra Sowerby and Maureen 
Fisher for the graphics. 



 
(iv) 

 
  CONTENTS Page 

 
SUMMARY  (viii) 
 
I. INTRODUCTION  1 
II. PERINATAL EPIDEMIOLOGY  1 
 1 Place of residence of mother 2 
 2 Place of birth  3 
 3 Maternal race  9 
 4 Maternal age  10 
 5 Country of birth 11 
 6 Marital status  12 
 7 Occupation of father and mother 14 
 8 Previous pregnancy outcomes 14 
 9A Antenatal care  15 
 9B Type of antenatal care 16 
 10 Smoking 17 
 11 Medical conditions 18 
 12 Obstetric complications 18 
 13 Procedures performed in current pregnancy 19 
 14A Onset of labour 19 
 14B Reasons for induction of labour 20 
 15A Presentation and method of delivery 21 
 15B Reason for Caesarean section 24 
 16 Complications of labour and delivery 25 
 17 Fetal monitoring during labour 25 
 18 Analgesia for labour and anaesthesia for delivery 26 
 19 Postnatal length of stay of mother 26 
 20 Sex of baby 28 
 21 Birthweight and gestation 28 
 22 Birth Injuries 30 
 23 Treatment given in neonatal period 30 
 24 Level of care utilised 30 
 25 Length of stay of babies 31 
 26 Congenital abnormalities 32 
 27 Multiple births 33 
 28 Perinatal mortality 34 
 29 Home births 35 
 30 Birthing Unit births 37 
 
III TERMINATIONS OF PREGNANCY 39 
IV OBSTETRIC PROFILES BY HOSPITAL CATEGORY 46 
 V  CLINICAL INDICATORS FOR SA 2001 54 
VI  TRENDS IN PERINATAL STATISTICS IN SOUTH AUSTRALIA, 1981-2001 57 
VII SUMMARY STATISTICS for 2001 62 
 References 64 
 Publications 65 
 Appendices  Appendix 1 2001 Supplementary birth record 72 
  Appendix 2 Congenital abnormality form 73 
  Appendix 3 Definitions 74 



 
 (v) 

 TABLES Page 
 
 1 Births and Crude birth rate by CURB Regions, SA, 2001 2 
 2 Total births notified in 2001, by place of birth and plurality 3 
 3A Hospital births by category of hospital, SA, 2001 6 
 3B Hospital births in South Australia in 2001 by race and hospital 7 
 4A Confinements by race of mother, SA, 2001 9 
 4B Confinements by race and birthplace category, SA, 2001 9 
 4C Perinatal mortality by race 10 
 4D Maternal age by race 10 
 5A Confinements by country of birth of mother, major groups, 
    SA, 2001 11 
 5B Confinements by specified country of birth of mother, SA, 2001 12 
 6A Marital status by age of mother 13 
 6B Type of patient by marital status of mother 13 
 7 Occupation of father and mother 14 
 8A Parity by race 15 
 8B Previous pregnancy outcomes 15 
 9A Antenatal visits by race 16 
 9B Type of antenatal care 16 
 10A Tobacco smoking status at first visit 17 
 10B Average no of tobacco cigarettes smoked per day in 2nd half 
  of pregnancy 17 
 11 Medical conditions in current pregnancy 18 
 12 Frequency of some obstetric complications 18 
 13 Procedures performed in current pregnancy 19 
 14A Onset of labour 19 
 14B Method of induction of labour 20 
 14C Augmentation of labour after spontaneous onset 21 
 15A Method of delivery 22 
 15B Method of delivery by presentation 23 
 15C Method of delivery in breech presentation, by plurality 23 
 16 Frequency of some complications of labour and delivery 25 
 17A CTG performed during labour 25 
 17B Fetal scalp pH taken during labour 25 
 18A Analgesia for labour 26 
 18B Anaesthesia for delivery 26 

 19A Postnatal length of stay of mother 27 
 19B Average postnatal length of stay of mother by type of patient and 
    type of delivery 27 
 20 Sex of baby 28 

 21A Birthweight distribution of all births 28 
 21B Perinatal mortality by birthweight, SA, 2001 29 
 22 Birth injuries 30 
 23 Neonatal treatment given 30 
 24 Level of nursery care utilised by birthweight 31 
 25 Length of stay of liveborn babies in hospital 31 
 26 Selected congenital abnormalities notified to the perinatal 
    statistics collection, 1991-2001, SA 32 
 27A Birthweight by plurality 33 
 27B Gestation at delivery, by plurality 33 
 27C Perinatal outcome by plurality 34 
 
 
 



 
 (vi) 

 
 

 28 Perinatal mortality, SA, 2001 34 
 29 Planned home confinements by age of mother, 2001 35 
 30 Method of delivery in planned home confinements, 2001 35 
 31 Birthweight distribution of planned home births, 2001 36 
 32 Perinatal outcome in planned home births, 2001 36 
 33 Planned birthing unit confinements by age of mother, 2001 37 
 34 Method of delivery in planned birthing unit confinements, 2001 37 
 35 Birthweight distribution of planned birthing unit births, 2001 38 
 36 Perinatal outcome in planned birthing unit births, 2001 38 
 37 Abortion rate per 1000 women aged 15-44 years, SA, 1970-2001 39 
 38 Terminations of pregnancy by age, South Australia, 2001 40 
 39 Abortion and birth rates and abortion proportions by age, SA, 2001 40 
 40 Terminations by marital status 42 
 41 Terminations by place of residence 42 
 42 Terminations by hospital category 42 
 43 Terminations by category of doctor 43 
 44 Reason for termination for suspected or identified abnormality of fetus 43 
 45 Complications of terminations 44 
 46A Women with previous terminations by age 44 
 46B Calculation of Total Abortion Rate (TAR) for 2001 for South Australia 45 
 46C Calculation of Total First Abortion Rate (TFAR) for 2001 for South Australia 45 
 47 Obstetric profiles by hospital category 2001 48 

48 Sociodemographic aspects of perinatal statistics, SA, 1981 and 1992-2001 58 
 49 Obstetric aspects of perinatal statistics, SA, 1981 and 1992-2001 59 



 
(vii) 

 
 FIGURES  Page 
 
 1A South Australian hospitals with obstetric beds in 2001 4 
 1B Central Regions - inset  5 
 2 Distribution of hospital births by hospital category, SA, 2001 6 
 3 Maternal age by race, SA confinements 2001  11 
 4 Reasons for Induction of labour, SA 2001  20 
 5A Method of delivery in all confinements 2001  22 
 5B Reason for LSCS, SA 2001  24 
 5C Reason for Elective LSCS, SA 2001  24 
 5D Reason for Emergency LSCS, SA 2001  24 
 6 Perinatal mortality rate by birthweight, SA births 2001 29 
 7 Abortion rate in South Australia, 1970-2001  39 
 8A Abortions and births by age, SA 2001  41 
 8B Teenage pregnancy, abortion and birth rates, South Australia, 
  1970 2001  41 
 9 % Aboriginal mothers by hospital category  49 
 10 % Mothers with &lt;7 antenatal visits by hospital category 49 
 11 % Teenage mothers by hospital category  49 
 12 % Mothers 35 years or more by hospital category  49 
 13 % Single mothers by hospital category  50 
 14 % Mothers with 4 or more prior livebirths by hospital category 50 
 15 % Mothers with 1 or more prior perinatal deaths by hospital 50 
      category 
 16 % Mothers with obstetric complications by hospital category 50 
 17 % Mothers with complications during labour or delivery by  
       hospital category  51 
 18 % Mothers with induction of labour by hospital category 51 
 19 % Mothers having epidural analgesia by hospital category 51 
 20 % Breech deliveries by hospital category  51 
 21 % Emergency LSCS by hospital category  52 
 22 % Elective LSCS by hospital category  52 
 23 % Total LSCS by hospital category  52 
 24 % Births with birthweight below 2500g by hospital category 52 
 25 % Births with gestation &lt;37 weeks by hospital category 53 
 26 % Births with prolonged hospitalisation by hospital category 53 
 27 % Livebirths requiring neonatal intensive care by hospital 
      category  53 
 28 % Births with birth defects by hospital category  53 
 29 Trends in perinatal statistics in SA, 1986-2001 
 29.1 % Teenage mothers among women giving birth in SA 60 

 29.2 % Mothers aged 35 years and over among women giving 
      birth in SA 60 
 29.3 % Primigravid women aged 30 years and over in SA 60 
 29.4 % Confinements of Aboriginal women and Asian women in SA 60 
 29.5 % Mothers never married and with no de facto partner 
      among women giving birth in SA 61 
 29.6 % Multiple births among SA births 61 
 29.7 % Low birthweight babies among SA births 61 
 29.8 SA standardised perinatal mortality ratio 61 



 
(viii) 

 
SUMMARY 
 
 1. The number of births notified in South Australia in 2001 was 17704, which was 167 

less than the previous year.  The number of women who gave birth was 17427. The 
crude birth rate fell to 11.6 per 1000 population and was generally higher in country 
regions than the Central regions.  However, the lowest rate was in Yorke and Lower 
North, while the Central Northern Region had one of the highest rates. 

 
2. Compared with 2000, the numbers of births decreased in metropolitan teaching 

hospitals (from 55% to 52% of births in the State) and country hospitals (23% of 
births) but increased in all metropolitan private hospitals (from 22% to 25% of 
births). Five percent of  women (934) gave birth in birthing units in teaching 
hospitals and another 5% (904) who intended to give birth in birthing units required 
transfer to labour wards before delivery. Thirty-six planned homebirths were 
notified, similar to the number in the previous three years, but our ascertainment of 
planned homebirths is incomplete   about 78% in 2001. 

  
3. 5571 terminations of pregnancy were notified, eight more than in 2000.  The abortion 

rate was 17.6 per 1000 women aged 15-44 years and has been relatively stable for  
the last four years. 
 

4. Teenage women accounted  for 5% of confinements and 21% of terminations.  The 
teenage pregnancy rate declined in the 1970s and 1980s, but increased in the early 
1990s, with an increase in the teenage abortion rate. However, since 1996 it has 
declined mainly  due to the decline in the teenage birth rate.  Teenage abortions have 
exceeded teenage births each year since 1995, and in 2001 56% of known teenage 
pregnancies were terminated compared with 24% of known pregnancies for all ages. 

 
5. Older women aged 35 years or more have been contributing an increasing proportion 

to confinements, from 5% in 1981 to 16% in 2001.  Thirty-four percent of women 
giving birth in their first pregnancy were aged 30 years or more, compared with 9% 
in 1981. For the first time, there were more women giving birth in the five-year age 
group 30-34 years than in the 25-29 years age group. 

 6. Asian women contributed 4% of confinements, an increasing proportion from 2% in 
1981.  They were generally older (20% being aged 35 years or more) and gave birth 
mainly in teaching hospitals. 

 
 7. Aboriginal women contributed 2% of confinements in the State.  Nineteen percent of 

Aboriginal women (compared with 5% of non-Aboriginal women) were teenagers 
and 39% (compared with 7% of non-Aboriginal women) had less than seven 
antenatal visits during pregnancy.  Smoking in pregnancy was more prevalent 
among Aboriginal mothers and their proportion of low birthweight babies was more 
than twice that of non-Aboriginal mothers.  Their perinatal mortality rate was three 
and a half times that for non-Aboriginal mothers in 2001 (37.4 compared with 9.8 
per 1000 births). 



 
(ix) 

 
8. Although many women had more than one type of antenatal care, the most common 

types used were hospital clinics (43%), obstetricians in private practice (31%) and 
general practitioners (30%).  Thirty percent of women were private patients, a higher  
proportion than the previous year (27%).  The median length of stay of mothers after 
a birth was 3 days for vaginal deliveries and 5 days for Caesarean section.  It was 2 
days longer among private patients. 

 
9. At least ninety-six percent of women who gave birth had an ultrasound examination; 

28% had labour induced while another 22% had spontaneous labour augmented; 
epidurals were used for pain relief during labour for 33% of women, and 15% (a 
declining proportion) had an episiotomy.  The main reasons for induction of labour 
were prolonged pregnancy (26%), hypertension (19%), premature rupture of 
membranes (7%), intrauterine growth restriction (5%) and diabetes or gestational 
diabetes (4%).  However, the proportion of inductions performed which were not for 
the defined indications has increased from 35% in 1998 to 40% in 2001.   

 
10. For the first time, the proportion of spontaneous normal vaginal deliveries (59%) has 

fallen below 60% and the proportion of women delivered by ventouse has just 
exceeded that by forceps (both 6%, compared with 1% and 15% respectively in 
1981). In 2001 the proportion of women delivered by Caesarean section has risen to 
28%, with 12% of women having elective caesareans. Fourteen percent of women 
who gave birth had had a previous Caesarean section and only 23% of women had a  
vaginal delivery following a previous first Caesarean without intervening births, 
compared with 28% the previous year.  The main reasons given for Caesarean 
section were failure to progress in labour or cephalopelvic disproportion (28%), 
previous Caesarean section (26%), fetal distress (16%) and malpresentation (12%).   

 
11. The perinatal mortality rate and the neonatal mortality rate for all births in 2001 were 

10.4 per 1000 births and 3.6 per 1000 livebirths respectively.  For international 
comparisons, the World Health Organization recommends including only births of at 
least 1000g birthweight (or 28 weeks gestation if birthweight unavailable ) and 
neonatal deaths within the first 7 days of life (instead of 28 days) in calculating the 
perinatal mortality rate.  This rate for international comparisons for South Australia for 
2001 was 3.9 per 1000 births.  This rate has declined by 46% from 7.2 per 1000 births 
in 1981.  The decline has been even greater for neonatal deaths (a decline of 60% from 
2.5 per 1000 livebirths in 1981 to 1.0 per 1000 livebirths in 2001). 



 
(x) 

 



1 

I.  INTRODUCTION 

This Report summarizes the statistics for 2001 from the following two collections in 
the Pregnancy Outcome Unit: 
 

 1. The Perinatal Statistics Collection 
 

This collection utilises notifications of births in South Australia made by 
midwives and neonatal nurses on the Supplementary Birth Record (SBR - 
Appendix 1). 
 
Information on congenital abnormalities detected at birth or in the neonatal 
period is provided by doctors using the Congenital Abnormality Form 
(Appendix 2). These data are provided under legislation, the South Australian 
Health Commission (Pregnancy Outcome Statistics) Regulations 1999. 
 
Perinatal death certificates and Burial Orders in coronial cases are obtained from 
the Births, Deaths and Marriages Registration Division, chromosome analysis 
reports from cytogenetics departments and autopsy reports from pathology 
departments and the Coroner's Office.  All these are linked with the SBRs. 

 
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 utilised in this collection. 
 
Some definitions used by the Pregnancy Outcome Unit are provided in 
Appendix 3.  Guidelines* with some of these definitions are issued to all 
obstetric units to promote the uniform completion of forms. 

II. PERINATAL EPIDEMIOLOGY 

The births in 2001 in South Australia described in this Report include all livebirths and stillbirths 
(including terminations of pregnancy) of at least 400g birthweight or 20 weeks gestation.  Forty-two 
births of less than 400g birthweight have been included, all of which were perinatal deaths.  These 
consisted of fifteen livebirths born at 20-24 weeks gestation and 27 stillbirths.  Twenty were 
terminations of pregnancy. Nine of the babies were from twin pregnancies, and one of these babies 
which was an intrauterine death was retained in utero until its twin was delivered at 38 weeks 
gestation. 

SBRs were received for all 17704 births reported by hospital and home birth midwives in their 
monthly notification lists.  These comprised 17584 livebirths and 120 stillbirths.  The number of 
women confined was 17427. 

Findings relating to Aboriginal mothers and babies in the text of this Report have been italicised for 
easy identification. 

* Pregnancy Outcome Unit, Guidelines for the Supplementary Birth Record,  Adelaide: South Australian Health 
Commission,1997. 



2 

 
 

1. Place of residence of mother 
 

South Australia is divided into 9 CURB* Regions, comprising 5 country Regions and 4 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 place of residence of mother by CURB Regions is provided in Table 1 together with the 
estimated resident population and Crude Birth Rate.  Only livebirths are used in calculating the 
Crude Birth Rate (see Appendix 3).  The Crude Birth Rate in 2001 for South Australia was 11.6 per 
1000 population.  It was lowest in the Yorke and Lower North and the Central Western, Eastern and 
Southern Regions, and highest in Eyre, the South East and the Central Northern Regions. 

 
 
 
 

TABLE 1 

BIRTHS AND CRUDE BIRTH RATE BY CURB REGIONS, SA, 2001 

TOTAL BIRTHS LIVEBIRTHS 

ESTIMATED 
RESIDENT 

POPULATION, 
June 30, 2001+ 

CURB REGION 
(Mother's Residence) 

NO % NO NO 

CRUDE BIRTH 
RATE per 1000 

population 

Central Northern 5086 28.7 5054 387230 13.1 

Central Western 2268 12.8 2254 214751 10.5 

Central Eastern 2805 15.8 2794 262548 10.6 

Central Southern 3797 21.5 3772 360275 10.5 

Yorke &amp; Lower North 453 2.6 449 44499 10.1 

Murraylands 846 4.8 837 68614 12.2 

South East 826 4.7 823 62694 13.1 

Northern 1014 5.7 1002 80254 12.5 

Eyre 494 2.8 488 33989 14.4 

Interstate 115 0.6 111 na na 

TOTAL 17704 100.0 17584 1514854 11.6 

 
+ Australian Bureau of Statistics. REGIONAL POPULATION GROWTH. Canberra: Australian Bureau of 

Statistics (ABS), 2002 (Catalogue No 3228.0). 
 
n.a.  not applicable 

 
 
 
 
 
 
 * CURB - Committee on Uniform Regional Boundaries. 



3 

2. Place of Birth 

Of the 17704 births in 2001, 36 (0.2%) were planned home births.  One mother was not booked at 
any hospital and delivered a stillbirth at home.  The remaining 17667 births took place in hospitals or 
(in 50 cases) before arrival at hospitals into which the mothers had been booked.  These births which 
occurred before arrival at hospitals (also called BBAs) 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 2001 are provided in Figures 
1A and 1B. 

 
TABLE 2 

TOTAL BIRTHS NOTIFIED IN 2001, BY PLACE OF BIRTH AND PLURALITY 

(Based on Supplementary Birth Records) 

HOME BIRTHS HOSPITAL BIRTHS CONDITION AT 
BIRTH SINGLETON SINGLETON TWIN TRIPLET 

TOTAL 

Livebirth 36 17005 540 3 17584 

Stillbirth 1* 109 10 0 120 

TOTAL BIRTHS 37 17114 550 3 17704 

 

*  Unplanned home birth, not booked at any hospital 
 

Of the 17667 hospital births, 77% occurred in metropolitan hospitals (teaching and private) and 23% 
in country hospitals.  This distribution is summarized in Table 3A and Figure 2 and the numbers of 
births and confinements 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.  Nearly 52% of births in South Australia in 2001 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.  
Level II teaching hospitals have neonatal special care units and comprise Lyell McEwin Health 
Service and Modbury Hospital.  The Queen Elizabeth Hospital now provides only Level I services. 
These levels are defined in the Report of Maternal and Neonatal Services in South Australia.1 

Compared with 2000, the numbers of births decreased at metropolitan teaching hospitals and country 
hospitals.  In metropolitan teaching hospitals, births decreased mainly at Flinders Medical Centre, 
The Queen Elizabeth and Modbury Hospitals. Births increased at all eight metropolitan private 
hospitals. 

In the country, births increased at Mt Gambier, Port Pirie, Port Lincoln and Murray Bridge Hospitals, 
while decreases occurred at Mt Barker, Naracoorte, Tanunda, Southern Districts and Waikerie 
Hospitals. 



&gt; 2000 births per annum

1000-1999 births per annum

500-999 births per annum

100-499 births per annum

&lt; 100 births per annum

Metropolitan Adelaide

CURB Regions - Boundaries

12080400 140 Km

4

V
IC

.
N

.S
.W

.
Q

LD

N.T.

Millicent

SOUTH EAST

MURRAY
 LANDS

W
.A

.

Naracoorte

Kangaroo Island

Pt Lincoln

Murray Bridge

Riverland
Regional
(Berri)

Whyalla

Clare

Pt Pirie
Pt Augusta

Mt Gambier

SEE INSET
Figure 1B

CENTRAL REGIONS

EYRE

NORTHERN

YORKE &amp;
LOWER
NORTH

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

Figure 1A

SOUTH AUSTRALIAN HOSPITALS WITH OBSTETRIC BEDS IN 2001*

NYPRHS
(Wallaroo)



0 403020

kilometres

10

&gt; 2000 births per annum

1000-1999 births per annum

500-999 births per annum

100-499 births per annum

&lt; 100 births per annum

CENTRAL EASTERN

CENTRAL NORTHERN

    CENTRAL WESTERN
(includes Kangaroo Island)

      SCDH
(Victor Harbor)

Kapunda

Tanunda

Gawler Health Service

Ashford

Mt Barker

    SDWMH
(McLaren Vale)

Modbury

Lyell
McEwin

Central
Districts

Stirling

W&amp;CH

NECH

BWMH

FMC

Flinders
Private

Western

TQEH

Calvary

CENTRAL SOUTHERN

Metropolitan Adelaide
(Hospital abbreviations
as in Table 3B)

5

Figure 1B

CENTRAL REGIONS
(as at June 2001)



6 

 

TABLE 3A 
HOSPITAL BIRTHS BY CATEGORY OF HOSPITAL, SA, 2001 

CATEGORY OF HOSPITAL NO. OF BIRTHS % HOSPITAL BIRTHS 

Metropolitan teaching 9143 51.7 

  Level III (6168) (34.9) 

  Other teaching (2975) (16.8) 

Metropolitan private 4465 25.3 

  500+ births per annum (3685) (20.9) 

  &lt;500 births per annum (780) (4.4) 

Country 4059 23.0 

Major country (791) (4.5) 

  100-399 births per annum (2450) (13.9) 

  50-99 births per annum (563) (3.2) 

  &lt;50 births per annum (255) (1.4) 

TOTAL 17667 100.0 

 
 

0 10 20 30 40 50 60

Figure 2:  DISTRIBUTION OF HOSPITAL BIRTHS BY HOSPITAL CATEGORY
SOUTH AUSTRALIA 2001

(n=17667)

Percentage of births
Hospital abbreviations as in Table 3B

W&amp;CH 22.6% FMC 12.3% LMHS
8.8%

TQEH
4.8%

MOD
3.2%

51.7%

a b c d e f g

wv x y z

25.3%

23.0%

a Ashford 7.7%
b Calv ary 3.6%
c North Eastern Community 3.4%
d Flinders Priv ate 3.1%
e Burnside War Memorial 3.0%
f  Western 2.2%
g Other 2.2%

t  Mt Gambier 2.8%
u  Whyalla 1.7%
v  Gawler 1.8%
w  Mount Barker 1.9%
x Other hospitals with 100-399 births pa 10.1%
y  Hospitals with 50-99 births pa 3.2%
z  Hospitals with &lt;50 births pa 1.4%
(pa=per annum)

t u

Teaching
hospitals

Metropolitan Private
Hospitals

Country Hospitals



7 

 
TABLE 3B 

HOSPITAL BIRTHS IN SOUTH AUSTRALIA IN 2001 BY RACE AND HOSPITAL 
(as indicated by returned SBRs for hospital births) 

HOSPITAL CAUCASIAN ABORIGINAL ASIAN OTHER TOTAL BIRTHS 
TOTAL 

CONFINEMENTS 

METROPOLITAN TEACHING 
Women s &amp; Children s Hospital (W&amp;CH) 3508 100 279 101 3988 3866 
Flinders Medical Centre (FMC) 2054 29 65 32 2180 2143 
Lyell McEwin Health Service (LMHS)* 1397 43 100 16 1556 1531 
The Queen Elizabeth Hospital (TQEH)* 613 35 170 32 850 849 
Modbury Hospital (MOD)* 497 15 41 15 568 568 
RAH 1 0 0 0 1 1 
TOTAL 8070 222 655 196 9143 8958 
METROPOLITAN PRIVATE 
500+ Births p.a. 
Ashford Community * 1331 2 28 4 1365 1336 
Calvary* 621 1 18 1 641 627 
North Eastern Community (NECH) 591 1 6 2 600 598 
Flinders Private 535 1 13 3 552 544 
Burnside War Memorial (BWMH)* 513 0 13 1 527 518 
&lt; 500 Births p.a. 
Western 380 3 3 1 387 382 
Central Districts 282 1 4 0 287 284 
Stirling  105 0 1 0 106 106 
TOTAL 4358 9 86 12 4465 4395 
COUNTRY 
Major Country 
Mt. Gambier 473 5 4 5 487 480 
Whyalla 278 19 6 1 304 302 
SUBTOTAL 751 24 10 6 791 782 
100-399 Births p.a. 
Gawler Health Service** 315 1 2 0 318 318 
Millicent 126 0 0 0 126 125 
Mt. Barker 334 1 4 2 341 335 
Murray Bridge Soldiers' Memorial 250 15 4 2 271 271 
Naracoorte 142 1 0 3 146 146 
Northern Yorke Peninsula Regional 
Health Service (NYPRHS, Wallaroo) 98 1 0 1 100 100 

Pt. Augusta 167 77 3 15 262 260 
Pt. Lincoln 229 24 2 2 257 257 
Pt. Pirie 207 9 2 0 218 218 
Riverland Regional (Berri) 168 6 1 4 179 177 
South Coast District (SCDH, Victor 
Harbor) 101 0 2 3 106 106 

Tanunda 126 0 0 0 126 126 
SUBTOTAL 2263 135 20 32 2450 2439 
 
* Level II hospitals. 
** Although this is a metropolitan hospital, it is close to the country, and, like most country hospitals, is a recognised hospital. 



8 
 

HOSPITAL CAUCASIAN ABORIGINAL ASIAN OTHER TOTAL BIRTH 
TOTAL 

CONFINEMENTS 

50-99 Births p.a. 

Clare 82 0 1 0 83 83 

Crystal Brook 63 1 0 0 64 64 

Kangaroo Island 52 0 1 1 54 54 

Kapunda 54 0 0 0 54 54 

Loxton 91 2 0 0 93 91 

Renmark 76 2 3 0 81 81 

Southern Districts War Memorial (SDWMH, 
McLaren Vale)** 

83 0 1 0 84 84 

Waikerie 48 0 0 2 50 50 

SUBTOTAL 549 5 6 3 563 561 

1-49 Births p.a. 

Balaklava 10 0 1 0 11 11 

Booleroo Centre 16 0 0 0 16 16 

Burra Burra 10 0 0 0 10 10 

Central Yorke Peninsula (Maitland) 7 2 0 0 9 9 

Cleve 22 0 0 1 23 23 

Cowell 3 0 0 0 3 3 

Cummins 14 0 0 1 15 15 

Jamestown 33 0 0 0 33 33 

Kimba 6 0 0 0 6 6 

Leigh Creek 1 0 0 0 1 1 

Mannum 25 1 0 0 26 26 

Mid West Health (Wudinna) 9 0 0 0 9 9 

Mid West Health (Streaky Bay) 16 0 0 0 16 16 

Orroroo 4 0 0 0 4 4 

Peterborough 6 0 0 0 6 6 

Port Broughton 1 0 0 0 1 1 

Quorn 15 1 0 0 16 16 

Roxby Downs 1 0 0 0 1 1 

Southern Yorke Peninsula (Yorketown) 32 1 0 0 33 33 

Tumby Bay 15 0 0 0 15 15 

Yalata 0 1 0 0 1 1 

SUBTOTAL 246 6 1 2 255 255 

       

TOTAL (COUNTRY) 3809 170 37 43 4059 4037 

       

GRAND TOTAL 16237 401 778 251 17667 17390 

 
**  Although this is a metropolitan hospital, it is close to the country, and like most country hospitals, is a recognised hospital. 



9 

3. Maternal Race 

The distribution of South Australian confinements by race of mother is provided in Table 4A and 
also by category of birthplace in Table 4B.  In this table and all others where distribution by race is 
shown,  Aboriginal  includes Aboriginal (377 women), Torres Strait Islander (4 women) and those 
who are Aboriginal and Torres Strait Islander (18 women).  Aboriginal mothers accounted for 2.3% 
of confinements and delivered mainly in country hospitals and metropolitan teaching hospitals, 
while Asian mothers, accounting for 4.4%, delivered mainly in metropolitan teaching hospitals. 

 
TABLE 4A 

CONFINEMENTS BY RACE OF MOTHER, SA, 2001 

RACE OF MOTHER NO OF CONFINEMENTS % CONFINEMENTS 

Caucasian 16007 91.9 

Aboriginal 399 2.3 

Asian 773 4.4 

Other 248 1.4 

TOTAL 17427 100.0 

 
 
 
 
 

TABLE 4B 

CONFINEMENTS BY RACE AND BIRTHPLACE CATEGORY, SA, 2001 

RACE OF MOTHER 
CAUCASIAN ABORIGINAL ASIAN OTHER TOTAL BIRTHPLACE 
NO % NO % NO % NO % NO % 

Metropolitan 
teaching hospital 7894 49.3 220 55.1 650 84.1 194 78.2 8958 51.4 

Metropolitan 
private hospital 4288 26.8 9 2.3 86 11.1 12 4.8 4395 25.2 

Country hospital 3788 23.7 170 42.6 37 4.8 42 16.9 4037 23.2 

Home 37 0.2 0 0.0 0.0 0.0 0 0.0 37 0.2 

TOTAL 16007 (91.9) 399 (2.3) 773 (4.4) 248 (1.4) 17427 100.0 

 
 
 



10 

 
 

The perinatal mortality rate for births to Aboriginal mothers was 37.4 per 1000 births in 2001 
compared with 9.8 per 1000 births for births to non-Aboriginal mothers (Table 4C). 
 
 

TABLE 4C 

PERINATAL MORTALITY BY RACE (all births) 

TOTAL 
BIRTHS STILLBIRTH 

NEONATAL 
DEATH 

ALIVE AT 
28 DAYS PERINATAL DEATH 

RACE 
NO NO NO NO NO RATE per 1000 births 

Caucasian 16274 106 58 16110 164 10.1 

Aboriginal 401 11 4 386 15 37.4 

Asian 778 3 2 773 5 6.4 

Other 251 0 0 251 0 0.0 

TOTAL 17704 120 64 17520 184 10.4 
 

4. Maternal age 

The largest proportion of confinements (32.0%) was contributed by women in the 30-34 years age 
group (Table 4D).  Confinements of teenagers comprised 5.4% and those of older women (?35 
years) 16.5%.  Aboriginal mothers were generally younger, 19.3% being teenagers (Figure 3).  
Among Asian women, on the other hand, there were fewer teenagers (1.6%) and a larger proportion 
(20.1%) of older women. 
 
 

TABLE 4D 

MATERNAL AGE BY RACE (all confinements) 

CAUCASIAN ABORIGINAL ASIAN OTHER TOTAL AGE 
(years) NO % NO % NO % NO % NO % 

&lt;15 2 0.0 1 0.3 0 0.0 0 0.0 3 0.0 

15-19 831 5.2 76 19.0 12 1.6 13 5.2 932 5.4 

20-24 2432 15.2 124 31.1 122 15.8 55 22.2 2733 15.7 

25-29 4852 30.3 113 28.3 269 34.8 87 35.1 5321 30.5 

30-34 5235 32.7 62 15.5 215 27.8 59 23.8 5571 32.0 

35-39 2204 13.8 20 5.0 124 16.0 29 11.7 2377 13.6 

40-44 433 2.7 3 0.8 28 3.6 5 2.0 469 2.7 

45+ 18 0.1 0 0.0 3 0.4 0 0.0 21 0.1 

TOTAL 16007 (91.9) 399 (2.3) 773 (4.4) 248 (1.4) 17427 100.0 
 



11 

Caucasian Aboriginal Asian Other Total
0

20

40

60

80

100

13-19 20-24 25-29 30-34 35+

Figure 3:  MATERNAL AGE BY RACE,  SA  CONFINEMENTS 2001
(n=17427)

n=16007 n=399 n=773 n=248 n=17427

Age (years)
 

 

5. Country of birth 

The distribution of women by country of birth is provided in Table 5A and by specified countries of 
birth with 40 or more confinements in Table 5B.  Of the 14.6 % of women born outside Australia, 
the largest proportion was born in the United Kingdom and Ireland (4.7%).  Other countries 
contributing relatively large proportions of migrant women were Vietnam (1.7% of confinements), 
New Zealand (1.1%), the Philippines (0.7%), Cambodia, Yugoslavia and China (0.4% each), and 
India, Malaysia, Germany, and South Africa (0.3% each). 

 
TABLE 5A 

CONFINEMENTS BY COUNTRY OF BIRTH OF MOTHER, 
MAJOR GROUPS,* SA, 2001 

 COUNTRY OF BIRTH NO % 

1 Oceania and Antarctica 15110 86.7 

2 Europe and the USSR 1206 6.9 

3 The Middle East and North Africa 100 0.6 

4 Southeast Asia 605 3.5 

5 Northeast Asia 121 0.7 

6 Southern Asia 90 0.5 

7 Northern America 54 0.3 

8 South America, Central America and the Caribbean 41 0.2 

9 Africa (excluding North Africa) 97 0.6 

10 Unknown 3 0.0 

 TOTAL 17427 100.0 
 

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



12 
 
 
 

TABLE 5B 

CONFINEMENTS BY SPECIFIED COUNTRY OF BIRTH OF MOTHER, SA, 2001 

SPECIFIED COUNTRY OF BIRTH* NO % of confinements 
% of confinements of 

migrant women 
(n=2548) 

1100 Australia 14876 85.4 0.0 

4102 Cambodia 62 0.4 2.4 

5101 China 73 0.4 2.9 

2305 Germany 60 0.3 2.4 

6104 India 51 0.3 2.0 

4105 Malaysia 52 0.3 2.0 

1301 New Zealand 187 1.1 7.3 

4107 Philippines 115 0.7 4.5 

9920 South Africa  56 0.3 2.2 

2101-2107 The United Kingdom and Ireland 811 4.7 31.8 

4110 Vietnam 296 1.7 11.6 

2212 Yugoslavia 65 0.4 2.6 

 All other countries 720 4.1 28.3 

 Unknown 3 0.0 0.0 

TOTAL  17427 100.0 100.0 

 
*  ASCCSS, Australian Bureau of Statistics 
 
 
 
6. Marital Status 

 
While 86.1% of women who delivered in 2001 were married or in a de facto relationship, 12.3% 
were never married and 1.6% were widowed, separated or divorced (Table 6A).  A quarter of never 
married women were teenagers, and another third were in their early twenties.  A much larger 
proportion of single women were hospital/public patients compared to the proportion for married 
women and women in de facto relationships (92.5% v 66.2%, Table 6B). 



13 

 
 

TABLE 6A 

MARITAL STATUS BY AGE OF MOTHER 

MARITAL STATUS 

Never married Married / de facto 
Widowed/ 
separated/ 
divorced 

Total 
AGE OF 
MOTHER 
(years) 

NO % NO % NO % NO % 

&lt;20 546 25.5 389 2.6 0 0.0 935 5.4 

20-24 708 33.1 1995 13.3 30 10.8 2733 15.7 

25-29 483 22.6 4753 31.7 85 30.7 5321 30.5 

30-34 266 12.4 5227 34.8 78 28.2 5571 32.0 

35-39 122 5.7 2186 14.6 69 24.9 2377 13.6 

40-44 17 0.8 438 2.9 14 5.1 469 2.7 

45+ 0 0.0 20 0.1 1 0.4 21 0.1 

TOTAL 2142 (12.3) 15008 (86.1) 277 (1.6) 17427 100.0 
 
 
 
 
 
 
 
 

TABLE 6B 

TYPE OF PATIENT BY MARITAL STATUS OF MOTHER 

MARITAL STATUS 

Never married Married/De facto 

Widowed/ 
separated/ 
divorced 

Total TYPE OF PATIENT 

NO % NO % NO % NO % 

Hospital/Public 1982 92.5 9928 66.2 259 93.5 12169 69.8 

Private 160 7.5 5080 33.8 18 6.5 5258 30.2 

TOTAL 2142 (12.3) 15008 (86.1) 277 (1.6) 17427 100.0 
 

 



14 

 
 
7. Occupation of father and mother 

 
 This distribution based on the Australian Statistical Classification of Occupations (ASCO) of the 

Australian Bureau of Statistics is provided in Table 7.  Unclassified occupations have been given 
a separate category (Category 9).  A much larger proportion of mothers than fathers (30.4% v 
0.3%) was included in the occupation of 'home duties', and also in the groups clerks, 
salespersons and personal service workers.  More fathers were managers and administrators, 
professionals, tradespersons, plant and machine operators, and labourers, but occupation was 
unknown for 9.6% of fathers. 

 
 

TABLE 7 

OCCUPATION OF FATHER AND MOTHER 

 FATHER MOTHER 

 
OCCUPATION 

NO % NO % 

1 Managers and administrators 2993 17.2 1199 6.9 

2 Professionals 1984 11.4 1702 9.8 

3 Para professionals 838 4.8 990 5.7 

4 Tradespersons 3143 18.0 590 3.4 

5 Clerks 475 2.7 2302 13.2 

6 Salespersons and personal service workers 966 5.5 2556 14.7 

7 Plant and machine operators and drivers 1104 6.3 124 0.7 

8 Labourers and related workers 2393 13.7 650 3.7 

9 Students 328 1.9 521 3.0 

 Pensioners 124 0.7 61 0.4 

 Home Duties 57 0.3 5297 30.4 

 Unemployed 1085 6.2 961 5.5 

 Other 259 1.5 178 1.0 

 Unknown 1678 9.6 296 1.7 

 TOTAL 17427 100.0 17427 100.0 

 
 
8. Previous pregnancy outcomes 

 
Forty one percent of women had no previous birth and 30.6% were pregnant for the first time.  
Among Aboriginal women, these proportions were lower, with 30.3% giving birth for the first time.   
The proportion of women of parity 4 or greater was higher among Aboriginal women (16.0%) than 
among Caucasian women (2.9%) or Asian women (1.7%) (Table 8A). 



15 
 

TABLE 8A 

PARITY BY RACE 

 RACE OF MOTHER 

 CAUCASIAN ABORIGINAL ASIAN OTHER 
TOTAL 

 

PARITY 

NO % NO % NO % NO % NO % 

0 -  PRIMIGRAVIDA 4916 30.7 93 23.3 258 33.4 68 27.4 5335 30.6 

 - MULTIGRAVIDA 1680 10.5 28 7.0 68 8.8 14 5.6 1790 10.3 

1  5686 35.5 96 24.1 300 38.8 85 34.3 6167 35.4 

2  2469 15.4 66 16.5 99 12.8 45 18.1 2679 15.4 

3  788 4.9 52 13.0 35 4.5 22 8.9 897 5.1 

4  271 1.7 29 7.3 12 1.6 8 3.2 320 1.8 

?5  197 1.2 35 8.8 1 0.1 6 2.4 239 1.4 

 TOTAL 16007 (91.9) 399 (2.3) 773 (4.4) 248 (1.4) 17427 100.0 

 
 

Among women with previous pregnancies (multigravid women), the proportions who have had 
previous adverse pregnancy outcomes are shown in Table 8B. 

 
 

TABLE 8B 
PREVIOUS PREGNANCY OUTCOMES (multigravidae only, n= 12092) 

PREVIOUS PREGNANCY OUTCOME NO % 

Miscarriage 3872 32.0 

Termination of pregnancy 2200 18.2 

Stillbirth 175 1.4 

Neonatal death (NND) 89 0.7 

Ectopic pregnancy 266 2.2 

 
 

9A. Antenatal care 
 

Women who delivered a baby are grouped in Table 9A according to the number of reported antenatal 
visits: no visits, only 1 - 6 visits, 7 or more visits.  If we exclude women for whom the number of 
antenatal visits was unknown, 39.0% of Aboriginal women compared with 7.2% of Caucasian 
women were reported as having less than 7 visits.  Among Asian women this proportion was 9.7%.  
A low frequency of antenatal visits may be taken, particularly in term births, as an indication of 
inadequate antenatal care.  However, for 12.3% of women (21.6% of Aboriginal women), the number 
of antenatal visits made was not known.  It is hoped that this proportion will be reduced by the use of 
the Pregnancy Hand-held Record,2 which will also facilitate continuity of care. 




16 

 
TABLE 9A 

ANTENATAL VISITS BY RACE (all confinements) 

RACE OF MOTHER 

CAUCASIAN ABORIGINAL ASIAN OTHER 
TOTAL ANTENATAL 

VISITS 
NO % NO % NO % NO % NO % 

None 41 0.3 17 4.3 1 0.1 2 0.8 61 0.4 
1-6 968 6.1 105 26.3 64 8.3 37 14.9 1174 6.7 

?7 13073 81.7 191 47.9 604 78.1 173 69.8 14041 80.6 

Unknown 1925 12.0 86 21.6 104 13.5 36 14.5 2151 12.3 

TOTAL 16007 (91.9) 399 (2.3) 773 (4.4) 248 (1.4) 17427 100.0 
 
 
 

9B. Type of antenatal care 
 

Table 9B shows that the main types of antenatal care used were hospital clinics (42.6%), 
obstetricians in private practice (30.8%), general practitioners (29.8%) and birth centres (9.2%).  
There were 65 women (0.4%) who had no antenatal care at all.  Individual women may have used 
more than one type of antenatal care. 

 
 

TABLE 9B 
TYPE OF ANTENATAL CARE (n = 17427) 

TYPE OF CARE NO % 

No antenatal care 65 0.4 

Hospital clinic 7425 42.6 

Obstetrician in private practice  5366 30.8 

General practitioner (GP) 5194 29.8 

Birth centre 1605 9.2 

Home birth midwife 38 0.2 

Obstetrician/midwife (shared care) in private practice 287 1.6 

GP/midwife (shared care) 599 3.4 

Other 101 0.6 

Not stated 42 0.2 

 
 



17 

10. Smoking 
 

In 1998 two new items were added to the Supplementary Birth Record to ascertain the smoking 
status of pregnant women, an important factor in pregnancy outcome.  The first item requested 
information on the woman s tobacco smoking status at her first antenatal visit (Table 10A), and the 
second on the average number of tobacco cigarettes smoked daily in the second half of her 
pregnancy (Table 10B).  Table 10A shows that 21.9% of women were reported to be smokers at their 
first antenatal visit, and 3.8% had quit smoking before their first visit.  Smoking status was unknown 
for 1.8% of women.  In the second half of pregnancy 19.9% of women were reported to be smokers 
and 1.4% smoked more than 20 cigarettes per day, but the number of cigarettes smoked was not 
known for 2.7% of women. 

A higher proportion of Aboriginal women was reported to be smokers at their first antenatal visit 
(58.4%) and in the second half of pregnancy (50.1%).  A higher proportion (5.0%) was also smoking 
more than 20 cigarettes per day, but the number of cigarettes smoked was not known for 10.8% of 
Aboriginal women. 

 
 

TABLE 10A 

TOBACCO SMOKING STATUS AT FIRST VISIT 

SMOKING STATUS NO 
% OF 

CONFINEMENTS 
(n = 17427) 

Smoker 3822 21.9 

Quit in pregnancy before first visit 670 3.8 

Non-smoker 12619 72.4 

Unknown smoking status 316 1.8 
 
 
 
 

TABLE 10B 

AVERAGE NO. OF TOBACCO CIGARETTES SMOKED PER DAY IN 2nd HALF 
OF PREGNANCY 

AVERAGE NO PER DAY NO % OF CONFINEMENTS (n = 17427) 

None 13483 77.4 

Occasional (&lt;1) 120 0.7 

1-10 2037 11.7 

11-20 1067 6.1 

21-30 208 1.2 

31-40 27 0.2 

41+ 15 0.1 

Unknown 470 2.7 

 



18 

 
11. Medical conditions 

 
A medical condition was recorded in the current pregnancy for 4685 women (26.9%).  The 
frequencies of specified medical conditions are provided in Table 11. 

 
TABLE 11 

MEDICAL CONDITIONS IN CURRENT PREGNANCY 

 MEDICAL CONDITION NO % OF CONFINEMENTS (n = 17427) 

1 None 12742 73.1 
2 Anaemia 1313 7.5 
3 Urinary tract infection 416 2.4 
4 Hypertension (pre-existing) 244 1.4 
5 Diabetes (pre-existing) 74 0.4 
6 Epilepsy 89 0.5 
7 Asthma 1174 6.7 
8 Other 2261 13.0 

 
 
12. Obstetric Complications 

 
An obstetric complication was recorded in 5403 confinements (31.0%).  The reported frequencies of 
the more common complications are presented in Table 12.  There were three maternal deaths (cf 
definition in Appendix 3) notified to the Maternal, Perinatal and Infant Mortality Committee.3  One 
was a direct death due to haemorrhage from a placenta percreta, and the other two were indirect 
deaths, one in early pregnancy from cardiac failure and the other from a frontal lobe tumour, with 
symptoms appearing late in pregnancy. 

 
TABLE 12 

FREQUENCY OF SOME OBSTETRIC COMPLICATIONS (all confinements) 

OBSTETRIC COMPLICATION NO % OF CONFINEMENTS (n = 17427) 

No complication 12024 69.0 
Threatened miscarriage 355 2.0 
Antepartum haemorrhage (APH) - Abruption 123 0.7 
APH - Placenta praevia 107 0.6 
APH   Other &amp; unknown causes 402 2.3 
Pregnancy hypertension 1417 8.1 
Intrauterine growth restriction (suspected) 532 3.1 
Gestational diabetes 562 3.2 

Other complications (including 124 women with 
impaired glucose tolerance) 2884 16.5 

 



19 

 
13. Procedures performed in current pregnancy 

 
Procedures performed are listed as reported in Table 13.  At least one ultrasound examination was 
performed for 95.7% of women, amniocentesis for 7.2% and chorion villus sampling for 0.9%. 

For quite a large proportion of women it was not known whether a specific procedure had been 
performed, eg 9.9% for maternal serum alpha feto-protein (MSAFP) screening.  The figures for 
MSAFP and Down syndrome screening are believed to be underestimates, when compared with 
statistics from the Chemical Pathology Department of the Women s and Children s Hospital. It is 
hoped that the use of the Pregnancy Hand-held Record will reduce the number of  unknown  entries. 

 
 

TABLE 13 

PROCEDURES PERFORMED IN CURRENT PREGNANCY 

YES NO UNKNOWN 
PROCEDURE 

NO % NO % NO % 

MSAFP (Neural tube defect screen etc) 
(Maternal serum alpha feto-protein) 8321 47.7 7381 42.4 1725 9.9 

Triple/Quadruple screen (Down etc) 8492 48.7 7265 41.7 1670 9.6 
Ultrasound 16682 95.7 391 2.2 354 2.0 
Chorion villus sampling 149 0.9 16953 97.3 325 1.9 
Amniocentesis 1255 7.2 15872 91.1 300 1.7 
Cordocentesis 12 0.1 17104 98.1 311 1.8 
Other surgical procedure 89 0.5 17338 99.5 0 0.0 

 
 

14A. Onset of labour 
 
Labour occurred spontaneously in 57.6% of confinements (Table 14A).  It was induced in 28.3%, 
and the methods of induction used were artificial rupture of membranes (ARM) in 62.1% of 
inductions, prostaglandins in 64.2% and oxytocics in 44.3% (Table 14B).  More than one method 
was used in many cases. 

 
 

TABLE 14A 

ONSET OF LABOUR (all confinements) 

ONSET OF LABOUR NO % 

Spontaneous 10035 57.6 

No labour - LSCS* 2463 14.1 

Induction 4929 28.3 

TOTAL 17427 100.0 
 

*    Lower segment Caesarean section 



20 
 
 
 

TABLE 14B 

METHOD OF INDUCTION OF LABOUR (all confinements) 

METHOD OF INDUCTION NO % OF CONFINEMENTS(n =17427) 
% OF INDUCTIONS 

(n =4929) 

No induction 12498 71.7 - 

ARM 3060 17.6 62.1 

Oxytocics 2185 12.5 44.3 

Prostaglandins 3166 18.2 64.2 

 
 

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 listed in the Australian Council for Healthcare Standards  Clinical Indicators   A Users  
Manual : Obstetrics and Gynaecology Indicators Version 2  (cf  p 54). 

Fig 4 demonstrates that 25.6% of women were induced for prolonged pregnancy (41 or more 
completed weeks), 19.1% for hypertension, 6.8% for premature rupture of membranes (PROM), 
5.4% for intrauterine growth restriction (IUGR) and 4.1% for diabetes (including gestational diabetes 
and glucose intolerance).  
 

Other
Prolonged pregnancy

Chorioamnionitis
Fetal death

Fetal distress
Isoimmunisation

IUGR
Hypertensive disorders

PROM
Diabetes*

0 10 20 30 40 50
percentage

*includes diabetes mellitus, gestational diabetes and glucose intolerance

Figure 4: REASONS FOR INDUCTION OF LABOUR, SA 2001
(n-4929)

 



21 

 
 

Labour was augmented for 3781 (37.7%) of the 10035 women who went into spontaneous labour.  
Methods used in augmentation were artificial rupture of membranes (ARM) (72.4%), oxytocics 
(40.4%) and prostaglandins (2.2%).  It should be noted that prostaglandins are not recommended by 
the manufacturers as a method of augmenting labour.  The proportion of women delivered who had 
labour augmented was 21.7%. 

 
 
 
 
 

TABLE 14C 

AUGMENTATION OF LABOUR AFTER SPONTANEOUS ONSET 

 
METHOD OF AUGMENTATION NO 

% OF 
CONFINEMENTS 

(n=17427) 

% OF 
AUGMENTATIONS 

(n=3781) 

 Any augmentation 3781 21.7 100.0 

1 ARM 2739 15.7 72.4 

2 Oxytocics 1529 8.8 40.4 

3 Prostaglandins 85 0.5 2.2 
 
 
 
 
 

 
15A. Presentation and method of delivery 

 
Of the women who delivered, 59.5% had normal spontaneous vaginal deliveries (Table 15A and 
Figure 5A).  Caesarean section (LSCS) was performed for 27.8% of women, with 11.9% of 
deliveries being elective sections; forceps were utilised for 6.1%, ventouse for 6.3% and breech 
delivery for the remaining 0.4%.  The method of delivery given for confinements in multiple births is 
that for the first birth.  The method of delivery by presentation for all births is provided in Table 15B.  
Breech presentation occurred in 4.8% of births and Caesarean section was the method of delivery for 
88.9% of breech presentations.  Caesarean section was utilised for 90.1% of breech presentations in 
singletons (Table 15C).  

 

 



22 

 
TABLE 15A 

METHOD OF DELIVERY (all confinements) 

METHOD OF DELIVERY NO % 

Normal spontaneous vaginal 10362 59.5 

Forceps 1061 6.1 

Assisted breech 36 0.2 

LSCS (elective) 2082 11.9 

LSCS (emergency) 2754 15.8 

Ventouse 1095 6.3 

Breech extraction 5 0.0 

Breech spontaneous 32 0.2 

TOTAL 17427 100.0 

 
 
 

Normal spont vaginal (59.5%)

Ventouse (6.3%)

LSCS (27.8%)

Breech delivery (0.4%)
Forceps (6.1%)

Figure 5A: METHOD OF DELIVERY IN ALL
CONFINEMENTS 2001

n = 17427

 
 
 



23 

 
 

TABLE 15B 

METHOD OF DELIVERY BY PRESENTATION 

(all births, n=17704) 

 PRESENTATION 

 VERTEX BREECH OTHER UNKNOWN 
TOTAL 

 

METHOD OF 
DELIVERY 

NO % NO % NO % NO % NO % 

1 Normal 
  spontaneous 10388 62.5 0 0.0 25 12.4 3 9.1 10416 58.8 

2 Forceps 1057 6.4 0 0.0 16 7.9 0 0.0 1073 6.1 

3 Assisted 
  breech 0 0.0 48 5.7 0 0.0 0 0.0 48 0.3 

4 Elective LSCS 1658 10.0 441 52.0 40 19.8 19 57.6 2158 12.2 

5 Emergency 
  LSCS 2418 14.6 313 36.9 113 55.9 11 33.3 2855 16.1 

6 Ventouse 1100 6.6 0 0.0 6 3.0 0 0.0 1106 6.3 

7 Breech 
  extraction 0 0.0 11 1.3 2 1.0 0 0.0 13 0.1 

8 Breech 
  spontaneous 0 0.0 35 4.1 0 0.0 0 0.0 35 0.2 

 TOTAL 16621 (93.9) 848 (4.8) 202 (1.1) 33 (0.2) 17704 100.0 

 
 
 

TABLE 15C 

METHOD OF DELIVERY IN BREECH PRESENTATION, 

BY PLURALITY (n = 848) 

ASSISTED  LSCS  LSCS BREECH BREECH 
PLURALITY 

BREECH ELEC EMERG EXTRACT SPONT 
TOTAL 

Singleton 35 381 247 4 30 697 

Twins 13 60 64 7 5 149 

Triplets 0 0 2 0 0 2 

       

TOTAL 48 (5.7%) 441 (52.0%) 313 (36.9%) 11 (1.3%) 35 (4.1%) 848 (100.0%) 

 



24 

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 
failure to progress/cephalopelvic disproportion (CPD) (27.6%), previous Caesarean section (25.6%), 
fetal distress (15.9%) and malpresentation (12.3%).  The main reasons for elective sections were 
previous section (52.7%), malpresentation (16.5%) and CPD (9.5%), and the main reasons given for 
emergency sections were failure to progress or CPD (40.3%), fetal distress (26.9%) and 
malpresentation (9.4%).  14.5% of women had had a previous Caesarean section. 

 
 

Other
IUGR

Multiple pregnancy
APH

Pregnancy hypertension/hypertension
Malpresentation

Fetal distress
Previous LSCS

CPD/Failure to progress

0 10 20 30 40 50 60

Figure 5C: REASON FOR ELECTIVE LSCS, 2001 (n=2082)

Other
IUGR

Multiple pregnancy
APH

Pregnancy hypertension/hypertension
Malpresentation

Fetal distress
Previous LSCS

CPD

0 10 20 30 40 50 60

Figure 5D: REASON FOR EMERGENCY LSCS, 2001 (n=2754)

Other
IUGR

Multiple pregnancy
APH

Pregnancy hypertension/hypertension
Malpresentation

Fetal distress
Previous LSCS

CPD/Failure to progress

0 10 20 30 40 50 60

Percentage

Percentage

Percentage

Figure 5B: REASON FOR LSCS, 2001 (n=4836)



25 

 
16. Complications of labour and delivery 

 
A complication of labour or delivery was recorded in 5814 confinements (33.4%).  The reported 
frequency of some complications is presented in Table 16.  Episiotomy was performed for 2691 
women (15.4%). 

 
TABLE 16 

FREQUENCY OF SOME COMPLICATIONS OF LABOUR AND DELIVERY 

(all confinements) 

COMPLICATION OF LABOUR  NO OF 
CONFINEMENTS 

% OF CONFINEMENTS
(n=17427) 

None 11613 66.6 

Post partum haemorrhage - primary 1113 6.4 

Fetal distress 1988 11.4 

Retained placenta 243 1.4 

Prolonged labour 185 1.1 

Cord prolapse 16 0.1 

Wound infection 43 0.2 

Third degree tear (174) or fourth degree tear (14)  188 1.1 

Failure to progress 1862 10.7 

Other 3525 20.2 

 
 
17. Fetal monitoring during labour 

 
Cardiotocography (CTG) was performed during labour for 59.2% of women.  The majority of these 
(51.3% of women) were external CTGs (Table 17A) while 7.9% had a scalp clip.  A fetal scalp pH 
was taken during labour in 501 confinements (2.9%, Table 17B). 

 
TABLE 17A 

CTG PERFORMED DURING LABOUR 
(all confinements) 

 CTG DURING 
LABOUR 

NO OF CONFINEMENTS % OF CONFINEMENTS 

1 None 7111 40.8 

2 External 8940 51.3 

3 Scalp clip 1376 7.9 

 
 

TABLE 17B 
FETAL SCALP pH TAKEN DURING LABOUR 

(all confinements) 

 FETAL SCALP pH TAKEN NO OF 
CONFINEMENTS 

% OF CONFINEMENTS 

1 No 16926 97.1 

2 Yes 501 2.9 

 
 



26 

 
 
18. Analgesia for labour and anaesthesia for delivery 

 
These distributions are provided in Tables 18A and 18B.  Epidurals were used for analgesia in labour 
for 32.6% and for anaesthesia in delivery for 28.8% of women.  The proportion of women who had 
an epidural for either was 34.5% (6011 women).  The proportion of women who had a spinal 
anaesthetic increased between 1991 and 2001 from 0.2% to 0.9% for analgesia and from 0.5% to 
17.6% for anaesthesia.  31.3% of the women who delivered received none of the specified methods 
for analgesia during labour. 

 
TABLE 18A 

ANALGESIA FOR LABOUR 

 ANALGESIA NO % OF CONFINEMENTS

1 None 5461 31.3 

2 Nitrous oxide and oxygen 6491 37.2 

3 Narcotic (parenteral) 5051 29.0 

4 Epidural (lumbar/caudal) 5676 32.6 

5 Spinal 155 0.9 

6 Other 62 0.4 
 
 
 

TABLE 18B 

ANAESTHESIA FOR DELIVERY 

 ANAESTHESIA NO % OF CONFINEMENTS 

1 None 7020 40.3 

2 Local anaesthesia 2084 12.0 

3 Pudendal 200 1.1 

4 Epidural (lumbar/caudal) 5013 28.8 

5 Spinal 3067 17.6 

6 General anaesthesia 561 3.2 

7 Other 94 0.5 

 
 
  19. Postnatal length of stay of mother 
 

The distribution of length of stay of mothers who delivered in hospitals is presented in Table 19A for 
public and private patients.  The median duration for all women was three days for vaginal deliveries 
and 5 days for Caesarean deliveries (Table 19B).  The median duration of stay was two days shorter 
for public patients for both vaginal and Caesarean deliveries (three and five days respectively, for 
public patients compared with five and seven days for private patients). 



27 

 
 
 
 

TABLE 19A 

POSTNATAL LENGTH OF STAY OF MOTHER 

PUBLIC PRIVATE TOTAL 
DAYS 

NO % NO % NO % 

&lt;1 322 2.6 14 0.3 336 1.9 

  1 1292 10.6 63 1.2 1355 7.8 

  2 2608 21.4 121 2.3 2729 15.7 

  3 3121 25.7 382 7.3 3503 20.1 

  4 2207 18.2 888 17.0 3095 17.8 

  5 1484 12.2 1845 35.3 3329 19.1 

  6 631 5.2 748 14.3 1379 7.9 

  7 or more 494 4.1 1170 22.4 1664 9.6 

TOTAL 12159 100.0 5231 100.0 17390 100.0 

 
 
 
 
 
 
 
 
 
 

TABLE 19B 

AVERAGE POSTNATAL LENGTH OF STAY OF MOTHER BY TYPE OF PATIENT &amp; TYPE OF DELIVERY 

 PUBLIC PRIVATE TOTAL 

 Vaginal LSCS Total Vaginal LSCS Total Vaginal LSCS Total 

 (n=9206) (n=2953) (n=12159) (n=3348) (n=1883) (n=5231) (n=12554) (n=4836) (n=17390) 

Mean ( SD) 2.81 4.85 3.30 4.56 6.47 5.25 3.27 5.48 3.89 

no. of days ( 1.84) ( 1.77) ( 2.02) ( 1.36) ( 1.46) ( 1.67) ( 1.89) ( 1.84) ( 2.12) 

Median  
no. of days 3 5 3 5 7 5 3 5 4 

 



28 
 
 

20. Sex of baby 
 
The sex distribution of babies is provided in Table 20; the male:female sex ratio was 1.02:1. 

 
TABLE 20 

SEX OF BABY 

SEX NO % 

Male 8930 50.4 

Female 8774 49.6 

TOTAL 17704 100.0 
 

 
21. Birthweight and gestation 
 

The birthweight distribution of all births is presented in Table 21A. There were two births of 
unknown birthweight, one of which was a stillbirth. Both were term births and one was a home birth. 
The percentage of low birthweight babies (&lt;2500g) was 6.8%, and that of very low birthweight 
babies (&lt;1500g) was 1.6%.  The mean birthweight was 3355g (SD 623.9g), with birthweights 
ranging from 170g to 5604g.  Among babies of Aboriginal mothers, the proportion of low 
birthweight babies was 17.5%. 

 
TABLE 21A 

BIRTHWEIGHT DISTRIBUTION OF ALL BIRTHS 

BIRTHWEIGHT (g) NO OF BIRTHS PERCENTAGE OF BIRTHS

&lt;500* 64 0.4 

500-749 61 0.3 

750-999 49 0.3 

1000-1499 111 0.6 

1500-1999 209 1.2 

2000-2499 705 4.0 

2500-2999 2673 15.1 

3000-3499 6284 35.5 

3500-3999 5437 30.7 

4000-4499 1781 10.1 

4500+ 328 1.9 

Unknown 2 0.0 

TOTAL 17704 100.0 

 
*  includes 42 births of &lt;400g birthweight described on page 1. 
 
 
The improvement in perinatal mortality with increasing birthweight is demonstrated in Table 21B 
and Figure 6.  The perinatal mortality rate for babies of normal birthweight (2500g or more) was 2.6 
per 1000 births. In 2001, 1199 babies were of low birthweight and 1436 (8.1%) were preterm (&lt;37 
weeks gestation). 



29 

 
TABLE 21B 

PERINATAL MORTALITY BY BIRTHWEIGHT, SA, 2001 

(all births) 

STILLBIRTHS 
NEONATAL 

DEATHS 
PERINATAL 

DEATHS 

BIRTHWEIGHT (g) 
TOTAL 

BIRTHS 
LIVE-

BIRTHS 
NO 

RATE 
per 1000 

births 
NO 

RATE 
per 1000 

live-
births 

NO 
RATE 

per 1000 
births 

&lt;500* 64 23 41 640.6 22 956.5 63 984.4 

500-749 61 40 21 344.3 11 275.0 32 524.6 

750-999 49 42 7 142.9 7 166.7 14 285.7 

1000-1499 111 107 4 36.0 7 65.4 11 99.1 

1500-1999 209 199 10 47.8 4 20.1 14 67.0 

2000-2499 705 699 6 8.5 1 1.4 7 9.9 

2500-2999 2673 2665 8 3.0 4 1.5 12 4.5 

3000-3499 6284 6273 11 1.8 7 1.1 18 2.9 

3500-3999 5437 5429 8 1.5 1 0.2 9 1.7 

4000-4499 1781 1778 3 1.7 0 0.0 3 1.7 

4500+ 328 328 0 0.0 0 0.0 0 0.0 

Unknown* 2 1 1 500.0 0 0.0 1 500.0 

TOTAL 17704 17584 120 6.8 64 3.6 184 10.4 

 
* Includes 42 births of &lt;400g birthweight, all of which were perinatal deaths. 

    The births of unknown birthweight were both term births. 
 

&lt;500 500- 750- 1000- 1500- 2000- 2500- 3000- 3500- 4000+
0.1

1

10

100

1000

Birthweight (g)

Figure 6: PERINATAL MORTALITY RATE BY BIRTHWEIGHT

SA Births 2001

 



30 
 

22. Birth Injuries 
 

Birth injuries were reported in 143 livebirths (0.8%).  The most common injury reported was 
cephalhaematoma; fracture, nerve injury and dislocation occurred less frequently (Table 22). 

 
TABLE 22 

BIRTH INJURIES* 

(in 17584 livebirths) 

BIRTH INJURY NO OF BIRTHS % OF BIRTHS 

None 17441 99.2 

Fracture 24 0.1 

Dislocation 2 0.0 

Nerve Injury 16 0.1 

Cephalhaematoma 86 0.5 

Other 18 0.1 

 
* More than one injury may occur in each birth. 

 
 
23. Treatment given in neonatal period 

 
The proportion of livebirths who received specified treatments in the neonatal period are provided in 
Table 23: 84.1% of neonates did not receive any of the treatments. 

 
TABLE 23 

NEONATAL TREATMENT GIVEN 

(all livebirths) 

NEONATAL TREATMENT NO % OF LIVEBIRTHS 

None of the treatments listed below 14785 84.1 

Oxygen therapy for more than 4 hours 1173 6.7 

Phototherapy for jaundice 1192 6.8 

Gavage feeding more than once 1371 7.8 

Any intravenous therapy 1492 8.5 

 
 
24. Level of care utilised 

 
Table 24 shows that 84.6% of neonates utilised Level I care only.  Level II care was used by 15.2% 
of neonates, Level III care at the Women s and Children s Hospital or Flinders Medical Centre by 
2.6% 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. 



31 
 
 

TABLE 24 

LEVEL OF NURSERY CARE UTILISED BY BIRTHWEIGHT 

(all livebirths) 

BIRTHWEIGHT (g) 

&lt;&lt;&lt;&lt;1500 
(n=212) 

1500-2499 
(n=898) 

2500+ 
(n=16473) Unknown 

TOTAL 
(n=17584) LEVEL OF CARE 

UTILISED 

NO % NO % NO % NO % NO % 

Level I only 30 14.2 194 21.6 14654 89.0 1 100.0 14879 84.6 

Level II 163 76.9 700 78.0 1805 11.0 0 0.0 2668 15.2 

Level III (W&amp;CH &amp; FMC) 173 81.6 136 15.1 150 0.9 0 0.0 459 2.6 

Level III (W&amp;CH paediatric) 3 1.4 11 1.2 34 0.2 0 0.0 48 0.3 

 
 
 
 25. Length of stay of babies 
 

The distribution of length of stay of liveborn babies in hospital is presented in Table 25 for preterm 
(&lt;37 weeks gestation) and term births (?37 weeks gestation).  The mean duration of stay was 5.4 
days (SD 9.7) and the median duration 4 days.  The mean duration was 4.0 days (SD 3.4) for term 
births and 22.4 days (SD 27.8) for preterm births, while the median durations were 4 and 13 days 
respectively. 

 
 

TABLE 25 

LENGTH OF STAY OF LIVEBORN BABIES IN HOSPITAL 

PRETERM BIRTHS TERM BIRTHS TOTAL LENGTH OF 
STAY (DAYS) NO % NO % NO % 

&lt;1 40 3.0 288 1.8 328 1.9 

  1 13 1.0 1239 7.7 1252 7.1 

  2 28 2.1 2594 16.0 2622 14.9 

  3 48 3.6 3272 20.2 3320 18.9 

  4 57 4.2 2902 17.9 2959 16.9 

  5 90 6.7 3064 18.9 3154 18.0 

  6 80 5.9 1235 7.6 1315 7.5 

  7-13 320 23.8 1479 9.1 1799 10.3 

  14-20 188 14.0 67 0.4 255 1.5 

  21-27 157 11.7 37 0.2 194 1.1 

  28 or more 326 24.2 24 0.2 350 2.0 

TOTAL 1347 100.0 16201 100.0 17548 100.0 

 
 
 



32 

 
 

26. Congenital abnormalities 
 

Among the 17704 births in 2001 there were 451births (2.5%) notified with congenital abnormalities; 
426 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 
ICD-9** 4-digit classification.  Table 26 includes births with the more readily identifiable defects 
used for international monitoring (sentinel defects) notified to the perinatal statistics collection in 
1991-2001.  Terminations of pregnancy are not included unless they meet the criterion for inclusion, 
ie at least 400g birthweight/20 weeks gestation.  Notifications of births with birth defects identified 
after discharge from the hospital of birth but within the first 5 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.4 

 
 

TABLE 26 
SELECTED CONGENITAL ABNORMALITIES 

NOTIFIED TO THE PERINATAL STATISTICS COLLECTION, 1991-2001, SOUTH AUSTRALIA 
CONGENITAL ABNORMALITY  

BPA CODE 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 

NO OF BIRTHS =  19749 20152 19969 19801 19620 19111 18674 18734 18519 17871 17704 

74000-74029 Anencephalus 1 0 1 1 3 1 0 1 2 3 1 

74100-74199 Spina bifida 5 1 5 1 7 5 3 9 4 5 9 

74200-74209 Encephalocele 2 1 2 1 1 1 1 0 1 0 0 

74230-74239 Hydrocephalus 1 4 5 4 5 0 3 5 7 4 4 

74900-74909 Cleft palate 13 14 8 11 12 14 14 16 8 10 14 

74910-74929 Cleft lip and palate 
  (Total cleft lip) 8 20 21 12 24 18 19 20 17 16 15 

75030-75038 Tracheo-oesophageal 
  fistula, oesophageal atresia and  
  stenosis 

10 8 12 8 8 8 5 7 6 2 10 

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

11 8 9 3 4 9 4 13 5 9 3 

75260-75261 Hypospadias and 
  epispadias 44 51 52 53 47 53 43 46 43 40 40 

75300-75301 Renal agenesis and 
  dysgenesis 13 3 5 6 7 4 6 12 4 5 7 

75520-75549 Limb reduction 
  defects 16 16 8 9 14 9 5 9 9 11 6 

75660-75669 Anomalies of 
  diaphragm  6 7 7 3 3 5 5 3 4 7 6 

75670-75679 Anomalies of  
  abdominal wall 4 8 14 3 8 7 7 12 8 8 13 

75800-75809 Down syndrome 14 21 18 16 20 11 24 25 25 19 21 

 
*   British Paediatric Association Classification of Diseases, British Paediatric Association, London 1979. 
 
** International Classification of Diseases.  Manual of the International Statistical Classification of Diseases, 
    Injuries and Causes of Death, 1975 Revision, World Health Organisation, Geneva 1977. 



33 

 
27. Multiple births 

 
There were 275 twin and 1 triplet confinements compared with 17151 singleton ones.  Thus there 
was one twin confinement in every 63 and 1 triplet confinement in every 17427 confinements.  The 
total number of multiple births was 553 (3.1% of total births). 

A comparison of multiple births with singleton ones shows that multiple births were of lower 
birthweight (with 46.3% being of low birthweight compared with 5.5% for singletons, Table 27A), 
and gestation (with 50.8% being preterm births compared with 6.7% for singletons, Table 27B).  The 
proportion in hospital at 28 days was 17.7% for multiple births compared with 1.6% for singletons, 
and the perinatal death rate for multiple births was also elevated (41.6 compared with 9.4 per 1000 
births for singletons, Table 27C). 

 
TABLE 27A 

BIRTHWEIGHT BY PLURALITY 

(all births) 

SINGLETON BIRTHS MULTIPLE BIRTHS 
BIRTHWEIGHT (g) 

NO % NO % 

&lt;500 53 0.3 11 2.0 

500-749 45 0.3 16 2.9 

750-999 33 0.2 16 2.9 

1000-1499 87 0.5 24 4.3 

1500-1999 156 0.9 53 9.6 

2000-2499 569 3.3 136 24.6 

2500-2999 2468 14.4 205 37.1 

3000-3499 6205 36.2 79 14.3 

3500-3999 5425 31.6 12 2.2 

4000-4499 1780 10.4 1 0.2 

4500+ 328 1.9 0 0.0 

Unknown 2 0.0 0 0.0 

TOTAL 17151 100.0 553 100.0 

 
 

TABLE 27B 

GESTATION AT DELIVERY, BY PLURALITY 

(all births) 

SINGLETON BIRTHS MULTIPLE BIRTHS TOTAL GESTATION 
(weeks) NO % NO % NO % 

&lt;24 59 0.3 12 2.2 71 0.4 

24-27 69 0.4 22 4.0 91 0.5 

28-31 120 0.7 27 4.9 147 0.8 

32-36 907 5.3 220 39.8 1127 6.4 

37-41 15806 92.2 272 49.2 16078 90.8 

42+ 190 1.1 0 0.0 190 1.1 

TOTAL 17151 100.0 553 100.0 17704 100.0 

 



34 

 
 

TABLE 27C 

PERINATAL OUTCOME BY PLURALITY 

(all births) 

SINGLETON BIRTHS MULTIPLE BIRTHS TOTAL 
PERINATAL OUTCOME 

NO % NO % NO % 

Stillbirth 110 0.6 10 1.8 120 0.7 

Discharged within 28 days 16721 97.5 432 78.1 17153 96.9 

In hospital at 28 days 269 1.6 98 17.7 367 2.1 

Neonatal death 51 0.3 13 2.4 64 0.4 

TOTAL 17151 100.0 553 100.0 17704 100.0 
 
 

28. Perinatal mortality 
 
As demonstrated earlier, high crude perinatal mortality rates were associated with births to 
Aboriginal mothers (Table 4C), low birthweight births (Table 21B) and multiple births (Table 27C).  
The perinatal mortality rate for all births (of at least 400g birthweight/20 weeks gestation) in 2001 
was 10.4 per 1000 births and the neonatal mortality rate 3.6 per1000 livebirths.  The perinatal 
mortality rates for other specified minimum birthweights or gestational ages (where birthweight was 
unavailable) are provided in Table 28.  The perinatal mortality rate recommended by the World 
Health Organisation (WHO) for use in international comparisons refers only to births of at least 
1000g birthweight (or, if birthweight is unavailable, 28 weeks gestation) and to neonatal deaths 
within the first 7 days of life.  This rate was 3.9 per 1000 births in 2001, with a neonatal mortality 
rate of 1.0 per 1000 livebirths. 

 
TABLE 28 

PERINATAL MORTALITY, SA, 2001 

(all births of specified birthweight/gestation) 

TOTAL 
BIRTHS 

LIVE-
BIRTHS STILLBIRTHS 

NEONATAL 

DEATHS 
PERINATAL DEATHS 

SPECIFIED 
BIRTHWEIGHT 
GESTATION 

NO NO NO 
RATE 

PER 1000 
BIRTHS 

NO 

RATE 
PER 1000 

LIVE- 
BIRTHS 

NO 
RATE 

PER 1000 
BIRTHS 

?400g/20 weeks* 17704 17584 120 6.8 64 3.6 184 10.4 

?500g/22 weeks 
(WHO National Statistics) 17640 17561 79 4.5 42 2.4 121 6.9 

     33** 1.9 112** 6.3 

?1000g/28 weeks  
(WHO International 
Statistics) 

17530 17479 51 2.9 24 1.4 75 4.3 

     18** 1.0 69** 3.9 
 

* includes 42 births of birthweight &lt;400g 
** only neonatal deaths within the first 7 days of life are included 



35 

29. Home Births 
 
Supplementary Birth Records were received from home birth midwives for 36 planned home births 
which occurred at home in 2001.  There was an unplanned homebirth which was not booked at any 
hospital, and has not been included with the planned home births.  This baby was stillborn. 

Ascertainment of planned home births occurring at home in South Australia for the year 2001 is 
estimated to be 78.3% (36 out of 46 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 hospital).  In addition, 12 
women who planned to deliver at home were transferred to hospital care before delivery.  Statistics 
for all 48 planned home confinements in 2001 are provided in Tables 29-32. 

 

TABLE 29 

PLANNED HOME CONFINEMENTS BY AGE OF MOTHER, 2001 

DELIVERED AT 
HOME 

DELIVERED IN 
HOSPITAL TOTAL AGE IN YEARS 

NO % NO % NO % 

&lt;20 2 5.6 1 8.3 3 6.3 

20-24 2 5.6 1 8.3 3 6.3 

25-29 12 33.3 3 25.0 15 31.2 

30-34 7 19.4 2 16.7 9 18.7 

35-39 11 30.6 5 41.7 16 33.3 

40-44 2 5.6 0 0.0 2 4.2 

TOTAL 36 100.0 12 100.0 48 100.0 
 
 
 
 
 
 

TABLE 30 

METHOD OF DELIVERY IN PLANNED HOME CONFINEMENTS, 2001 

DELIVERED AT 
HOME 

DELIVERED IN 
HOSPITAL TOTAL METHOD OF DELIVERY 

NO % NO % NO % 

Normal spontaneous vaginal 36 100.0 8 66.7 44 91.7 

LSCS elective 0 0.0 1 8.3 1 2.1 

LSCS emergency 0 0.0 2 16.7 2 4.2 

Ventouse 0 0.0 1 8.3 1 2.1 

TOTAL 36 100.0 12 100.0 48 100.0 

 
 



36 

 
 

TABLE 31 

BIRTHWEIGHT DISTRIBUTION OF PLANNED HOME BIRTHS, 2001 

DELIVERED AT 
HOME 

DELIVERED IN 
HOSPITAL TOTAL BIRTHWEIGHT (g) 

NO % NO % NO % 

&lt;2000 0 0.0 0 0.0 0 0.0 

2000-2499 0 0.0 3 25.0 3 6.3 

2500-2999 0 0.0 1 8.3 1 2.1 

3000-3499 9 25.0 3 25.0 12 25.0 

3500-3999 14 38.9 3 25.0 17 35.4 

4000-4499 8 22.2 2 16.7 10 20.8 

4500+ 4 11.1 0 0.0 4 8.3 

Unknown 1 2.8 0 0.0 1 2.1 

TOTAL 36 100.0 12 100.0 48 100.0 

 
 
 
 
 

TABLE 32 

PERINATAL OUTCOME IN PLANNED HOME BIRTHS, 2001 

DELIVERED 
AT HOME 

DELIVERED IN 
HOSPITAL TOTAL OUTCOME 

NO % NO % NO % 

Stillbirth 0 0.0 0 0.0 0 0.0 

Discharged within 28 days 35 97.2 12 100.0 47 97.9 

Prolonged hospitalisation  
  (in hospital at 28 days) 1 2.8 0 0.0 1 2.1 

Neonatal death 0 0.0 0 0.0 0 0.0 

TOTAL 36 100.0 12 100.0 48 100.0 

 



37 

 

30. Birthing Unit births 

Statistics presented for births in birthing units in South Australia (Tables 33-36) relate to the birthing 
units at The Queen Elizabeth Hospital, 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 deliveries.  These statistics relate to all 1838 planned birthing unit confinements.  
Of these, 934 confinements occurred in the birthing units while 904 women (49.2%) were transferred 
to labour wards before delivery.  Of the women transferred to labour wards, 23.2% had Caesarean 
sections, 5.1% had low birthweight babies and seven had perinatal deaths.  These statistics have also 
been included in the statistics for the respective hospitals. 

 
TABLE 33 

PLANNED BIRTHING UNIT CONFINEMENTS BY AGE OF MOTHER, 2001 

DELIVERED IN 
BIRTHING UNIT 

DELIVERED IN 
LABOUR WARD TOTAL AGE IN YEARS 

NO % NO % NO % 

&lt;20 77 8.2 75 8.3 152 8.2 

20-24 191 20.5 198 21.9 389 21.2 

25-29 316 33.8 292 32.3 608 33.1 

30-34 230 24.6 231 25.5 461 25.1 

35-39 104 11.1 92 10.2 196 10.7 

40-44 16 1.7 15 1.7 31 1.7 

45+ 0 0.0 1 0.1 1 0.0 

TOTAL 934 100.0 904 100.0 1838 100.0 

 
 
 
 

TABLE 34 

METHOD OF DELIVERY IN PLANNED BIRTHING UNIT CONFINEMENTS, 2001 

DELIVERED IN 
BIRTHING UNIT 

DELIVERED IN 
LABOUR WARD TOTAL METHOD OF DELIVERY 

NO % NO % NO % 

Normal spontaneous vaginal 932 99.8 546 60.4 1478 80.4 

Forceps 0 0.0 55 6.1 55 3.0 

Breech/Assisted breech 0 0.0 2 0.2 2 0.1 

LSCS elective 0 0.0 25 2.8 25 1.4 

LSCS emergency 0 0.0 185 20.5 185 10.1 

Ventouse 2 0.2 89 9.8 91 5.0 

Breech Extraction 0 0.0 1 0.1 1 0.0 

Breech spontaneous 0 0.0 1 0.1 1 0.0 

TOTAL 934 100.0 904 100.0 1838 100.0 

 
 
 
 
 



38 

TABLE 35 

BIRTHWEIGHT DISTRIBUTION OF PLANNED BIRTHING UNIT BIRTHS, 2001 

DELIVERED IN 
BIRTHING UNIT 

DELIVERED IN 
LABOUR WARD TOTAL BIRTHWEIGHT (g) 

NO % NO % NO % 

&lt;1500 0 0.0 10 1.1 10 0.5 

1500-1999 1 0.1 7 0.8 8 0.4 

2000-2499 3 0.3 29 3.2 32 1.7 

2500-2999 90 9.6 128 14.1 218 11.8 

3000-3499 352 37.7 296 32.6 648 35.2 

3500-3999 340 36.4 310 34.1 650 35.3 

4000-4499 133 14.2 110 12.1 243 13.2 

4500+ 15 1.6 18 2.0 33 1.8 

TOTAL 934 100.0 908 100.0 1842 100.0 

 
 
 
 
 

 
TABLE 36 

PERINATAL OUTCOME IN PLANNED BIRTHING UNIT BIRTHS, 2001 

DELIVERED IN 
BIRTHING UNIT 

DELIVERED IN 
LABOUR WARD TOTAL OUTCOME 

NO % NO % NO % 

Stillbirth 0 0.0 5 0.6 5 0.3 

Discharged within 28 days 933 99.9 888 97.8 1821 98.8 

Prolonged hospitalisation  
  (in hospital at 28 days) 1 0.1 13 1.4 14 0.8 

Neonatal death 0 0.0 2 0.2 2 0.1 

TOTAL 934 100.0 908 100.0 1842 100.0 

 



39 

III. TERMINATIONS OF PREGNANCY 
There were 5571 terminations of pregnancy notified in South Australia in 2001.  The abortion rate 
per 1000 women aged 15-44 years was 17.6.  This rate demonstrated a rapid rise in the early years 
from 1970 to a peak of 13.9 in 1980.  There was a period of relative stability in the 1980s (between 
12.9 and 13.9 per 1000 women) before the rise commencing in 1991 (Table 37 and Fig 7).  However, 
the rate appears to be levelling out in the last few years. 

TABLE 37   ABORTION RATE PER 1000 WOMEN 
AGED 15-44 YEARS, SA, 1970-2001 

YEAR NO RATE PER 1000 WOMEN  AGED 15-44 YEARS 
1970 1440 6.0 
1971 2409 9.6 
1972 2692 10.6 
1973 2847 11.1 
1974 2867 10.9 
1975 3000 11.1 
1976 3289 11.9 
1977 3494 12.4 
1978 3895 13.6 
1979 3880 13.3 
1980 4081 13.9 
1981 4096 13.7 
1982 4061 13.4 
1983 4036 13.1 
1984 4091 13.1 
1985 4079 12.9 
1986 4327 13.5 
1987 4229 13.1 
1988 4263 13.0 
1989 4342 13.1 
1990 4463 13.4 
1991 4696 14.1 
1992 4717 14.2 
1993 4959 15.0 
1994 5140 15.7 
1995 5475 16.8 
1996 5546 17.2 
1997 5608 17.5 
1998 5485 17.2 
1999 5660 17.8 
2000 5563 17.6 
2001 5571 17.6 

0

4

8

12

16

20

YEAR

RATE PER 1000 WOMEN AGED 15-44 YEARS

FIGURE 7: ABORTION RATE IN SA 1970-2001

 
 



40 

The age distribution of women who had terminations is shown in Table 38.  Among the age groups 
(Table 39) the highest abortion rate (33.6 per 1000) was for women aged 20-24 years. Some of these 
rates are different from those in the 2001 Report of the Committee appointed to examine and report 
on abortions notified in South Australia5 due to the revision of the ABS population estimates after 
the 2001 Census. The abortion proportion (abortion as a proportion of abortions and births) was 0.24; 
it was highest among teenagers (0.56), and was also high among women aged 20-24 years (0.36) and 
older women aged 40 years or more (0.32).  This means that about 56% of known teenage 
pregnancies were terminated.  This proportion was highest for younger teenagers (0.91 for those 
aged 13-14 years). 

TABLE 38 
TERMINATIONS OF PREGNANCY BY AGE, SOUTH AUSTRALIA, 2001 

AGE (years) No % 
13 6 0.1 
14 24 0.4 
15 85 1.5 
16 160 2.9 
17 277 5.0 
18 307 5.5 
19 337 6.0 

20-24 1560 28.0 
25-29 1180 21.2 
30-34 876 15.7 
35-39 525 9.4 
40-44 212 3.8 

45+ 22 0.4 

TOTAL 5571 100.0 

 
The distribution of abortions and births by age in South Australia in 2001 (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 births occurred among those 30-34 years. However the highest birth rate of 
109.3 per 1000 women was in the age group 25-29 years. Teenagers accounted for 21.5% of the 
abortions and 5.4% of the confinements in South Australia in 2001.  The teenage pregnancy rate (per 
1000 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 with the increase in the teenage abortion rate.  Since then it 
has declined with a decline in the teenage birth rate (Figure 8B). The teenage pregnancy rate was 
42.3 per 1000 women in 2001. 

 
TABLE 39 

ABORTION AND BIRTH RATES AND ABORTION PROPORTIONS BY AGE, SA 2001 

AGE (years) NO OF TERMINATIONS 

ESTIMATED 
RESIDENT FEMALE 

POPULATION 
JUNE 30 2001* 

ABORTION 
RATE PER 1000 

WOMEN 

NO OF 
BIRTHS 

BIRTH RATE 
 PER 1000 
WOMEN 

ABORTION 
PROPORTION 

13-14 30 na na 3 na 0.91 
15-19 1166 50606 23.6** 942 18.7 0.55 
20-24 1560 46364 33.6 2755 59.4 0.36 
25-29 1180 49258 24.0 5386 109.3 0.18 
30-34 876 54051 16.2 5686 105.2 0.13 
35-39 525 57121 9.2 2432 42.6 0.18 
40-44 212 58361 4.0** 479 8.6 0.31 
45+ 22 na na 21 na 0.51 

TOTAL 5571 315761 17.6** 17704 56.1** 0.24 
* Australian Bureau of Statistics. Australian Demographic Statistics. Canberra: ABS, 19th September 2002 (Catalogue No 3101.0). 
** the abortion and birth rates for women aged 15-19 years include terminations and births for younger ages, and the 

rates for women aged 40-44 years include terminations and births for older ages, while the total rates include all 
terminations and births.



41 
 

Abortions Births Abortions &amp; Births
0

20

40

60

80

100

Age (years)

13-19 20-24 25-29 30-34 35-39 40+

n=5571       n = 17704 n=23275

Figure 8A: ABORTIONS AND BIRTHS
 BY AGE SOUTH AUSTRALIA 2001

 
 

0

10

20

30

40

50

60

YEAR

Abortion Rate*

Birth Rate*

Pregnancy 
Rate**Abortions and births to women aged less than 15  years

are included in the numerator

Rate per 1000 women aged 15-19 years

Figure 8B: TEENAGE PREGNANCY, ABORTION AND BIRTH RATES
 SOUTH AUSTRALIA 1970-2001



42 

Terminations were performed in the majority of cases (47.8%) for never married women; and in 
13.9% of cases for women who were divorced or separated (Table 40): however in 3.4% of cases the 
marital status was not known. 

 
TABLE 40 

TERMINATIONS BY MARITAL STATUS 

MARITAL STATUS N0 % 

Never married 2663 47.8 

Married 1359 24.4 

De facto 576 10.3 

Widowed 6 0.1 

Divorced/Separated 775 13.9 

Not known 192 3.4 

TOTAL 5571 100.0 

 
While 81.2% of terminations was performed for metropolitan residents (Table 41), a larger 
proportion (96.0%) was performed in metropolitan hospitals (Table 42), which include the 
Pregnancy Advisory Centre at which 3086 (55.4%) of the terminations in the State were performed. 

 
TABLE 41 

TERMINATIONS BY PLACE OF RESIDENCE 

RESIDENCE OF WOMEN N0 % 

Metropolitan  4521 81.2 

Country 1050 18.8 

TOTAL 5571 100.0 

 
 
 

TABLE 42 

TERMINATIONS BY HOSPITAL CATEGORY 

HOSPITAL WHERE 
TERMINATION PERFORMED N0 % 

Metropolitan teaching 4916 88.2 

Metropolitan private 431 7.7 

Country 224 4.0 

TOTAL 5571 100.0 

 



43 

 
The proportion of terminations performed by obstetricians was 32.7%, 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 65.2% in 2001 (Table 43)).  The number of terminations 
performed for suspected or identified abnormalities of the fetus was 109 (2.0% of terminations), of 
which 101 (92.7%) were for specified fetal including chromosomal abnormalities (Table 44). 

 
 

TABLE 43 

TERMINATIONS BY CATEGORY OF DOCTOR 

CATEGORY OF DOCTOR PERFORMING 
TERMINATION NO % 

Obstetrician 1824 32.7 

Trainee obstetrician 49 0.9 

Medical practitioner in family advisory clinic 3630 65.2 

General practitioner 68 1.2 

TOTAL 5571 100.0 

 
 
 
 

TABLE 44 

REASON FOR TERMINATION FOR SUSPECTED OR IDENTIFIED ABNORMALITY OF FETUS 

REASON FOR TERMINATION NO % 

Possibility of hereditary disease or congenital abnormality 1 0.9 

Identified chromosomal abnormality 40 36.7 

Other identified fetal abnormality 61 56.0 

Possibility of damage from drugs 5 4.6 

Possibility of damage from maternal infection (other than Rubella) 2 1.8 

TOTAL 109 100.0 

 
 

The majority of terminations (92.5%) was performed within the first 14 weeks of pregnancy and 
most frequently (in 90.7% of cases) by vacuum aspiration.  Twenty-six complications were reported 
for 24 women (0.4%).  The types of complications are listed in Table 45. 



44 

 
 
 

TABLE 45 

COMPLICATIONS OF TERMINATIONS 

COMPLICATIONS NO % OF COMPLICATIONS 
% OF 

TERMINATIONS 
(n=5571) 

Sepsis 2 7.7 0.0 

Haemorrhage  - intra-operative 8 30.8 0.1 

                        - post-operative 3 11.5 0.1 

Perforation of or trauma to body 
  of uterus 

3 11.5 0.1 

Anaesthetic complication 0 0.0 0.0 

Other 10 38.5 0.2 

TOTAL 26 100.0 0.5 

 
Of the 5571 women who had terminations, 2160 (38.8%) had had a previous termination (Table 
46A).  Among the teenagers 19.1% had had a previous termination.  The total abortion rate (TAR) 
for 2001 was 553.0 per 1000 women aged 15-44 years (Table 46B).  This represents the number of 
abortions 1000 women would have during their lifetime if they experienced the abortion rates of the 
different age groups for 2001.  As a woman may have more than 1 abortion in her lifetime, to 
estimate how prevalent abortion is at these age-specific abortion rates for 2001, a total first abortion 
rate (TFAR, Table 46C) may be calculated after exclusion of women with repeat terminations.  This 
TFAR for 2001 was 339.0 per 1000 women aged 15-44 years.  This suggests that about 1 in 3 
women would have an abortion in their lifetime if they experienced the abortion rates of the different 
age groups for 2001. 

 
 

TABLE 46A 

WOMEN WITH PREVIOUS TERMINATIONS BY AGE 

AGE (years) NO % % OF AGE GROUP 

&lt; 15 1 0.0 3.3 

15 - 19 228 10.6 19.6 

20 - 24 614 28.4 39.4 

25 - 29 582 26.9 49.3 

30 - 34 413 19.1 47.1 

35 - 39 237 11.0 45.1 

40+ 85 3.9 36.3 

TOTAL 2160 100.0 38.8 

 
 

Further details of abortions in South Australia in 2001 may be obtained from the Thirty-second 
Annual Report of the Committee Appointed to Examine and Report on Abortions notified in South 
Australia.5 



45 

 
 
 
 

TABLE 46B 

CALCULATION OF TOTAL ABORTION RATE (TAR) FOR 2001 FOR SOUTH AUSTRALIA* 

Age (years) No of women who had terminations 
Estimated female resident 

population June 2001 
Abortion rate per 1000 

women 

15-19 1196 50606 23.6 

20-24 1560 46364 33.6 

25-29 1180 49258 24.0 

30-34 876 54051 16.2 

35-39 525 57121 9.2 

40-44 234 58361 4.0 

TOTAL 5571 315761 110.6+ 

 
 *  In these calculations, abortions to women under 15 years are included in the age group 15-19 yrs and 
               abortions to women aged 45 years or more are included in the age group 40-44 years, as is traditional. 
 + sum of abortion rates for 5 year age groups. 
 
 Total abortion rate = sum of abortion rates for 5 year age groups x 5 = 553.0 per 1000 women aged 15-44 years. 
 
 

TABLE 46C 

CALCULATION OF TOTAL FIRST ABORTION RATE (TFAR) FOR 2001 FOR SOUTH AUSTRALIA 

Age 
(years) 

No of women 
who had 

terminations 
(A) 

No of women 
who had 
previous 

terminations 
(B) 

No of women 
who had first 
termination 

(A)   (B) 

Estimated 
female resident 
population June 

2001 

First abortion rate 
per 1000 women 

15-19 1196 229 967 50606 19.1 

20-24 1560 614 946 46364 20.4 

25-29 1180 582 598 49258 12.1 

30-34 876 413 463 54051 8.6 

35-39 525 237 288 57121 5.0 

40-44 234 85 149 58361 2.6 

TOTAL 5571 2160 3411 315761 67.8+ 

 
 + sum of abortion rates for 5 year age groups. 

 
Total First Abortion Rate (TFAR) = 67.8 x 5 = 339.0  per 1000 women aged 15-44 yrs.  Exclusion of women who have 
had a previous termination also from the estimated female resident population denominator would result in a TFAR  of 
342.5 per 1000 women aged 15-44 years.   



46 

IV. OBSTETRIC PROFILES BY HOSPITAL CATEGORY 

Obstetric profiles for 6 hospital categories for 2001 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 Queen Elizabeth Hospital, Lyell McEwin 
Health Service and Modbury Hospital, 

3. Metropolitan private hospitals with 500 or more births per year, 

4. Metropolitan private hospitals with less than 500 births per year, 

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

6. Other country hospitals (mainly smaller). 

A list of maternal and baby factors identified either as risk factors for poor perinatal outcome in 
earlier analyses,6 or of general interest, is provided with  means  for all State hospital births as well 
as proportions for the 6 hospital categories. 

The  mean  is the proportion for all State hospital confinements (for maternal factors) or births (for 
baby factors), 

 

     e.g. % Aboriginal mothers     =
No of confinements of Aboriginal mothers in State hospitals

Total confinements in State hospitals
 100  

 
Where indicated (+) in Table 47, it is the mean (number of confinements or births) for the 29 
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 Health Service 

4. The Queen Elizabeth Hospital 

5. Modbury Hospital 

6. Ashford Community Hospital Inc 

7. Calvary Hospital Adelaide Inc 

8. North Eastern Community Hospital Inc 

9. Burnside War Memorial Hospital Inc 

10. Flinders Private Hospital 

11. Western Hospital Inc 

12. Central Districts Private Hospital 

13. Stirling &amp; Districts Hospital 

14. Mount Gambier &amp; District Health Service Inc 



47 

 
15. The Whyalla Hospital &amp; Health Services Inc 

16. Gawler Health Service 

17. Millicent &amp; District Hospital &amp; Health Services Inc 

18. Mount Barker District Soldiers  Memorial Hospital Inc 

19. Murray Bridge Soldiers  Memorial Hospital Inc 

20. Naracoorte Health Service Inc 

21. Northern Yorke Peninsula Regional Health Service (Wallaroo) 

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

23. Port Lincoln Health Service Inc 

24. Port Pirie Regional Health Service Inc 

25. Riverland Regional Health Service (Berri) 

26. South Coast District Hospital (Victor Harbor) 

27. Tanunda War Memorial Hospital 

28. Country hospitals with 50-99 births per year 

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

The 10th percentile is the proportion below which 10% of the 29 hospital proportions, ie the 3 lowest 
hospital proportions, would be found if the 29 proportions were ranked from highest to lowest.  The 
90th percentile is the proportion above which 10% of the 29 hospital proportions, ie the 3 highest 
proportions, would be found if the 29 proportions were ranked from highest to lowest.  As the two 
Level III hospitals which account for 34.9% of hospital births have proportions of some factors (such 
as prolonged hospitalisation and use of neonatal intensive care) which are much greater than for the 
other 27 hospitals, occasionally the mean for all hospitals will be seen to be higher than the 90th 
percentile. 

The table and figures provide obstetric profiles for the 6 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 ratios,7 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. 

It is possible for each hospital to compare its statistics for each factor with those for State hospitals 
and for categories of hospitals.  It is also possible to note 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). 



48 

 
TABLE 47 

OBSTETRIC PROFILES BY HOSPITAL CATEGORY 2001 
Births 400+ g/20+ weeks gestation 

 ALL STATE 
HOSPITALS 

METROPOLITAN 
HOSPITALS 

COUNTRY 
HOSPITALS 

 Mean 10th percentile 
90th 

percentile 
Level 3 

teaching 
Other 

teaching 

Private 
500+ 

births 
p.a. 

Private 
&lt;500 
births 

p.a. 

Major Other 

Maternal factors 

Confinements (n=17390) 600+ 125 1336 6009 2949 3623 772 782 3255 

% Aboriginal mothers 2.3 0.0 5.5 2.1 3.2 0.1 0.5 3.1 4.5 

% Antenatal visits &lt;7* 8.1 0.7 14.3 14.1 9.5 0.7 0.3 4.9 8.3 

% Teenage mothers 5.4 0.6 11.9 5.4 9.6 0.5 0.8 9.1 7.1 

% Mothers ?35 years 16.4 9.2 23.6 16.2 11.6 25.1 20.0 10.4 12.1 

% Single mothers 13.9 2.7 22.3 19.3 21.2 2.7 2.7 12.3 12.8 

%  4+ Prior livebirths 3.2 0.8 6.0 2.9 5.4 0.9 1.4 5.6 4.2 

%  1+ Prior Perinatal deaths 1.4 0.7 2.0 1.6 1.4 1.2 0.8 1.4 1.5 

% Obstetric complications 31.1 15.7 38.1 39.7 33.7 23.8 20.7 31.5 23.1 

% Labour complications 33.4 20.3 40.9 42.7 34.4 28.8 23.8 24.8 24.9 

% Induction 28.3 18.4 33.1 28.0 29.6 30.4 33.7 28.0 24.3 

% Emergency LSCS 15.8 9.6 20.3 19.1 11.6 18.3 13.3 12.4 12.3 

% Elective LSCS 12.0 8.0 19.5 8.6 9.3 19.6 15.9 11.0 11.5 

% Total LSCS 27.8 18.4 37.7 27.7 20.9 37.9 29.3 23.4 23.8 

% Ultrasound examination* 97.8 95.2 99.3 98.1 97.8 97.8 98.0 97.8 97.0 

% Amniocentesis* 7.3 2.1 11.9 7.2 5.7 12.1 10.4 4.2 4.0 

% Episiotomy 15.5 8.7 26.1 12.0 15.5 21.5 26.3 13.3 13.1 

% Repair of perineal tear 24.2 14.4 33.1 26.4 23.3 23.4 20.5 27.1 22.2 

% Epidural analgesia 32.6 12.3 48.0 35.0 27.0 47.8 49.0 21.6 15.3 

% Spinal analgesia 0.9 0.4 3.4 0.4 0.7 1.2 1.6 0.5 1.5 

% Private patients 30.1 0.6 100.0 8.2 2.0 100.0 100.0 10.1 6.4 

% Primiparous women 40.9 31.2 45.5 43.8 35.9 46.3 42.4 38.9 34.1 

% Previous LSCS 14.5 10.6 18.1 13.3 13.4 17.0 16.2 12.4 15.2 

% PPH 6.4 2.4 6.9 10.5 6.2 2.7 3.5 4.6 4.2 

Baby Factors  

Births (n=17667) 609+ 126 1365 6168 2975 3685 780 791 3268 

% Birthweight &lt;2500g 6.8 1.4 8.4 11.5 6.6 3.6 3.0 5.1 3.0 

% Gestational age &lt;37 weeks 
    at birth 8.1 1.2 9.5 13.6 7.2 5.6 3.0 6.5 3.1 

% Prolonged hospitalisation 
    (&gt;27 days) 2.1 0.0 1.6 4.6 0.8 1.0 0.1 0.3 0.6 

% Neonatal intensive  care 
(Level 3 + W&amp;CH  paediatric 
intensive care) 

2.8 0.4 2.3 5.9 1.2 1.3 1.0 0.6 1.1 

% Birth defect 2.5 1.1 3.3 3.0 2.6 2.2 2.8 2.8 1.9 

 
* adjusted for missing values. 
+ mean number of confinements or births for the 29 hospitals or groups of hospitals. 
 



49 
 

 

1 2 3 4 5 6 . .
0

2

4

6

Hospital Category

Figure 9: Percentage of Aboriginal mothers by hospital
category

90th Percentile

Mean

10th Percentile

1 2 3 4 5 6 . .
0
2
4
6
8

10
12
14
16
18
20
22
24

Figure 10: Percentage of mothers with &lt;7
antenatal v isits by hospital category

Hospital Category

1 2 3 4 5 6 . .
0

3

6

9

12

15

90th Percentile

Mean

10th Percentile

1 2 3 4 5 6 . .
0

5

10

15

20

25

30

Figure 11: Percentage of teenage mothers by
hospital category

Figure 12: Percentge of mothers 35 years or more
by hospital category

10th Percentile

Mean

90th Percentile

Hospital Category Hospital Category

90th Percentile

Mean

10th Percentile



50 

1 2 3 4 5 6 . .
0

5

10

15

20

25

Hospital Category

90th percentile

Mean

1 2 3 4 5 6 . .
0

2

4

6

8
90th percentile

Mean

Hospital Category

Figure 13: Percentage of single mothers by
hospital category

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

Hospital Category Hospital Category

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

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

10th Percentile
10th Percentile

1 2 3 4 5 6 . .
0

1

2

3

4

5

1 2 3 4 5 6 . .
0

10

20

30

40

50

90th percentile

Mean

10th Percentile

90th percentile

Mean

10th Percentile



51 

1 2 3 4 5 6 . .
0

5

10

15

20

25

30

35

40

45

50

 Figure 19: Percentage of mothers hav ing epidural
 analgesia  by hospital category

Hospital Category
1 2 3 4 5 6 . .

0

5

10

15

20

25

30

35

Mean

Hospital Category

Figure 18: Percentage of mothers w ith induction of labour
by  hospital category

Mean

90th Percenti le

1 2 3 4 5 6 . .
0
5

10
15
20
25
30
35
40
45
50
55

 Figure 17: Percentage of mothers w ith complications
 during labour or delivery by hospital category

Hospital Category
1 2 3 4 5 6 . .

0

0.5

1

1.5

2

90th Percenti le

Mean

10th Percentile

Hospital Category

Figure 20: Percentage of breech deliv eries by  hospital
category

10th Percenti le

Mean

90th Percentile

90th Percenti le

10th Percentile

10th Percenti le



52 

1 2 3 4 5 6 . .
0
2
4
6
8

10
12
14
16
18
20
22

Figure 21: Percentage of emergency LSCS by
hospital category

Hospital Category

90th Percentile

Mean

10th Percentile

1 2 3 4 5 6 . .
0
2
4
6
8

10
12
14
16
18
20
22

Figure 22: Percentage of elective LSCS by hospital
category

Hospital Category

90th Percentile

Mean

10th Percentile

1 2 3 4 5 6 . .
0
5

10
15
20
25
30
35
40

Figure 23: Percentage of total LSCS by hospital category

Hospital Category

Mean

10th Percentile

1 2 3 4 5 6 . .
0

2

4

6

8

10

12

14

16

Figure 24: Percentage of births with birthweight
below 2500g by hospital category

90th Percentile

Hospital Category

Mean

10th Percentile

90th Percentile



53 

1 2 3 4 5 6 . .
0

4

8

12

16

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

Hospital Category

90th Percentile

Mean

10th Percentile

1 2 3 4 5 6 . .
0

2

4

6

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

Hospital Category

90th Percentile

Mean

10th Percentile

1 2 3 4 5 6 . .
0

1

2

3

4

5

6

7

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

Hospital Category

90th Percentile

Mean

10th Percentile

1 2 3 4 5 6 . .
0

1

2

3

4

5

Figure 28: Percentage of births w ith birth
defects by hospital category

Hospital Category

90th Percentile

Mean

10th Percentile



54 

  

V.    CLINICAL INDICATORS* FOR SA 2001 
 

1.      INDICATOR TOPIC: 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. 
 
1.1   Numerator:    The number of women undergoing induction of labour for indications other than those 
                                 defined which 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 and prolonged pregnancy (41 completed weeks or more).  Patients 
                                 having augmentation of labour are excluded in both numerator and denominator data. 
(n=1986) 
 
        Denominator: The total number of women undergoing induction of labour for any reason (excluding 
                                 augmentation of labour). (n = 4929) 
 

        Clinical indicator  1.1 = 
4929

1986x100  = 40.3% 

 
1.2   Numerator:    The number of women undergoing induction of labour for indications other than those 
                                 listed above (excluding augmentation of labour). (n=1986) 
 
        Denominator: The total number of women delivering (including augmentation of labour). (n=17427) 
 

        Clinical indicator  1.2 = 
17427

1986x100  = 11.4% 

 
 

2. INDICATOR TOPIC: RATE OF VAGINAL DELIVERY 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. 
 
2.1   Numerator:    The number of women delivering vaginally following a previous primary (first) caesarean 
                                 section and having no intervening pregnancies greater than 20 weeks gestation. (n=394) 
 
        Denominator: The total number of women delivering who have had a previous primary (first) caesarean 
                                 section and no intervening pregnancies greater than twenty weeks gestation. (n=1720) 
 

        Clinical indicator  2.1 = 
1720

394x100  = 22.9% 

 
* Australian Council for Healthcare Standards.  Clinical Indicators   A Users  Manual: 
   Obstetrics and Gynaecology Indicators Version 2 



55 

  

 
 
3.      INDICATOR TOPIC: 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, but as cervical dilatation 
                                 is not collected, the two indicators have been combined. 
 
3.0   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 occipitoposterior position. (n=1157) 
 
        Denominator: The total number of women undergoing primary non-elective caesarean section. 
                                 (n=2214) 
 

        Clinical indicator  3.1 = 
2214

1157x100  = 52.3% 

 
 
 
4.      INDICATOR TOPIC: PRIMARY CAESAREAN SECTION FOR FETAL DISTRESS 
 
 
        Rationale:        To determine comparative frequency of caesarean section for fetal distress. 
 
4.1   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=828) 
 
        Denominator:  The total number of women delivering including those delivering vaginally. 
                                  (n=17427) 
 

        Clinical indicator  4.1 = 
17427

828x100  = 4.8% 

 
4.2   Numerator:      The number of women undergoing primary caesarean section for fetal distress as 
                                  defined above. (n=828) 
 
        Denominator:  The total number of women delivering by primary caesarean section only. (n = 2938) 
 

        Clinical indicator  4.2 = 
2938

100 x 828  = 28.2% 

 



56 

  

5. INDICATOR TOPIC: INCIDENCE OF AN INTACT LOWER GENITAL TRACT IN 
        PRIMIPAROUS PATIENTS DELIVERING VAGINALLY 
 
        Rationale:       This indicator has been included because a high incidence of an intact perineum is  
                                 considered a desirable outcome. 
 
5.1   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 delivery. 
                                 (n=1483) 
 
        Denominator: The total number of primiparous women delivering vaginally. (n=4958) 
 

        Clinical indicator  5.1 = 
4958

100 x 1483  = 29.9% 

 
 
6.       INDICATOR TOPIC: 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. 
 
6.1   Numerator:    The number of babies born with an Apgar score of 4 or below at five minutes post 
                                 delivery. (n=78) 
 
        Denominator: The total number of babies born (excluding fetal deaths in utero diagnosed prior to 
                                 commencement of labour). (n=17641) 
 

        Clinical indicator  6.1 = 
17641

100 x 78  = 0.4% 

 
 
7.       INDICATOR TOPIC: 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. 
 
7.1   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=88) 
 
        Denominator: The total number of term live babies born. (n=16237) 
 

        Clinical indicator  7.1 = 
16237

100 x 88  = 0.5% 

 
 



57 

  

VI. TRENDS IN PERINATAL STATISTICS IN SOUTH AUSTRALIA, 1981-2001 

Perinatal statistics are presented in Tables 48 and 49 for both sociodemographic and obstetric aspects for each 
year from 1992-2001, as well as for 1981, when the perinatal data collection was commenced.  The trends noted 
between 1981and 2001 are as follows, and some features are illustrated in Fig 29.1   29.8: 

1. The fall in the crude birth rate, from 14.3 to 11.6 per 1000 population. The annual number of births has 
declined since 1992, but especially since 1995. 

2. The increase in the proportion of confinements of Asian mothers from 1.8% to 4.4% and of Aboriginal 
mothers from 1.5% to 2.3% in 2001. These proportions have been stable in the last three years. 

3. The decrease in the proportion of teenage confinements from 7.8% to 5.4%, but relatively stable since 
1993..  The teenage pregnancy rate declined in the 1970s and 1980s and then rose, with the teenage 
abortion rate, in the 1990s till 1996, after which it has declined mainly due to the decline in the teenage 
birth rate. 

4. The increase in the proportion of confinements of older women (35 years and over) from 4.6% to 16.5%. 

5. The increase in mean age among primigravid women, from 23.77 years to 27.00 years.  The proportion of 
primigravidae aged 30 years and over increased from 8.9% to 34.3%. 

6. The increase in the proportion of confinements of never married women, from 7.6% to the peak of 13.2% 
in 1996, after which it has decreased, but relatively stable in recent years. 

7. The increase in the proportion of multiple births, related to assisted conception pregnancies, and the older 
age of mothers, from 2.0% to 3.1% (the peak was 3.4% in 1996). This proportion has also been stable in 
recent years. 

8. The number and proportion of home births have declined since 1981, but have been stable in the last four 
years. Births in private hospitals declined in the last decade, but increased between 2000 and 2001.  The 
number of births annually in birthing units in teaching hospitals has increased steadily from 125 (0.6%) in 
1992 to 934 (5.3%) in 2001, with nearly as many more women planning to deliver in birthing units but 
transferred to labour ward before delivery. 

9. The induction rate increased from 22.1% to 28.3% and 40% were performed for other than defined 
indications. 

10. The fall in the proportion of normal spontaneous vaginal deliveries (from 66.1% to 59.5%), breech 
deliveries (from 1.1% to 0.4%) and forceps deliveries (from 15.2% to 6.1%), with a rise in the proportion 
delivered by ventouse from 0.7% to 6.3% and by Caesarean section, from 16.9% to 27.8%. 

11. The increase in the proportions of low birthweight (from 5.8% to 6.8%) and preterm babies (from 5.5% to 
8.1%).  However, both have been stable in recent years and the proportion of low birthweight babies among 
multiple births decreased to 46.3% in 2001. 

12. The proportion of births with congenital abnormalities has fluctuated between 2.3% and 2.5% over the last 
decade. 

13. The increase in the proportion of babies utilising Level II care from 6.7% in 1982 to 15.2% in 2001 after 
peaking at 16.6% in 1999.  The proportion of babies in hospital at 28 days decreased to 2.1% in 2001.. 

14. The considerable fall in the perinatal mortality rate, despite the increasing proportion of preterm births.  
This fall is reflected in the standardized perinatal mortality ratio which has been calculated for each year 
utilising perinatal mortality rates for 500g birthweight groups for the years 1981-1989 combined as the 
standard.  It was 70.6 in 2001 compared with 117.6 in 1981.  The fall in neonatal mortality has been 
particularly outstanding. 

 



58 

  

 
 
 
 

TABLE 48 

SOCIODEMOGRAPHIC ASPECTS OF PERINATAL STATISTICS, SA, 1981 and 1992 - 2001 

  YEAR 

  1981 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 

1 Total births 19052 20152 19969 19801 19620 19111 18674 18734 18519 17871 17704 

2 Livebirths 18905 20004 19846 19673 19472 18979 18535 18613 18404 17765 17584 

3 Confinements 18857 19868 19681 19519 19310 18784 18394 18421 18233 17577 17427 

4 Crude birth rate 
per 1000 
population 

14.3 13.7 13.6 13.4 13.2 12.9 12.5 12.5 12.3 11.9 11.6 

5 Place of birth (%) 

  Teaching hospital 52.2% 49.0% 48.9% 48.9% 49.6% 50.7% 50.9% 53.4% 53.6% 54.6% 51.6% 

  Private hospital 19.7% 27.0% 26.4% 27.3% 26.3% 24.9% 24.2% 22.6% 22.3% 21.9% 25.2% 

  Country hospital 27.8% 23.7% 24.5% 23.6% 24.1% 24.4% 24.9% 24.0% 24.0% 23.5% 22.9% 

  Domiciliary 0.3% 0.3% 0.2% 0.2% 0.3% 0.3% 0.2% 0.2% 0.2% 0.2% 0.2% 

  (65) (60) (46) (31) (52) (52) (44) (36) (39) (35) (37) 

6 Race (%) 

  Aboriginal 1.5% 2.2% 2.0% 2.0% 2.0% 1.9% 2.1% 2.2% 2.4% 2.5% 2.3% 

  Asian 1.8% 3.6% 3.5% 4.0% 3.9% 3.8% 3.8% 4.1% 4.3% 4.5% 4.4% 

7 Age (%) 

  Teenage     (%) 7.8% 5.9% 5.6% 5.3% 5.3% 5.9% 5.4% 5.1% 5.6% 5.3% 5.4% 

   ?35 years   (%) 4.6% 10.4% 10.8% 11.6% 12.5% 13.5% 14.2% 15.0% 15.0% 16.3% 16.5% 

8 Marital Status (%) 

   Never married 7.6% 12.7% 12.2% 12.1% 12.0% 13.2% 12.3% 11.6% 12.0% 12.0% 12.3% 

 Widowed/ 
    divorced/ 2.0% 1.7% 1.7% 1.4% 1.7% 1.7% 1.6% 1.7% 1.5% 1.7% 1.6% 

     separated  (%)            

   (Single) (9.6%) (14.4%) (13.8%) (13.5%) (13.7%) (14.9%) (13.8%) (13.3%) (13.5%) (13.7%) (13.9%) 

9 Primigravidae 

  Mean age (years) 23.77 25.69 25.77 26.02 26.24 26.10 26.40 26.52 26.66 26.88 27.00 

  Teenage 16.2% 12.7% 12.2% 11.5% 11.7% 13.6% 12.2% 11.2% 12.2% 11.5% 11.3% 

   ?30 years 8.9% 22.2% 22.5% 24.3% 26.2% 26.5% 27.3% 28.0% 29.9% 31.9% 34.3% 

 
 



59 

  

 
TABLE 49 

OBSTETRIC ASPECTS OF PERINATAL STATISTICS, SA, 1981 and 1992 - 2001 

  1981 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 

1 Plurality 

 Multiple 
  births (%) 2.0% 2.8% 2.8% 2.8% 3.1% 3.4% 3.0% 3.3% 3.1% 3.3% 3.1% 

    Twins (363) (528) (548) (526) (608) (606) (528) (614) (564) (560) (550) 

    Triplets (21) (30) (21) (24) (9) (36) (24) (9) (6) (21) (3) 

    Quadruplets (0) (0) (0) (4) (0) (0) (0) (0) (0) (0) (0) 

2 Induction of 
   labour (%) 22.1% 20.6% 23.1% 23.6% 23.5% 23.5% 25.0% 27.3% 27.9% 27.3% 28.3% 

3 Method of    delivery 

 Normal 
   spontaneous 66.1% 63.6% 63.7% 62.6% 63.5% 63.5% 62.5% 62.8% 62.3% 61.7% 59.5% 

 LSCS elective 8.2% 9.3% 9.9% 10.0% 10.3% 9.7% 10.3% 10.0% 10.4% 10.4% 11.9% 

 LSCS Emerg 8.7% 12.8% 12.6% 13.7% 12.9% 13.4% 13.3% 13.8% 14.5% 14.8% 15.8% 

 Forceps 15.2% 10.9% 10.9% 10.4% 9.2% 8.8% 9.3% 8.2% 7.1% 6.4% 6.1% 

 Breech 1.1% 0.8% 0.6% 0.7% 0.7% 0.6% 0.7% 0.4% 0.5% 0.4% 0.4% 

 Ventouse 0.7% 2.6% 2.3% 2.6% 3.4% 4.0% 4.0% 4.7% 5.2% 6.3% 6.3% 

 Total LSCS (16.9%) (22.1%) (22.5%) (23.7%) (23.2%) (23.1%) (23.5%) (23.9%) (24.9%) (25.2%) (27.8%) 

4 Birthweight 
&lt;2500g 5.8% 6.7% 6.8% 6.7% 6.8% 7.4% 7.0% 7.0% 6.6% 7.2% 6.8% 

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

 Multiples 52.1% 53.9% 55.4% 53.8% 52.8% 57.0% 56.5% 54.7% 49.6% 55.9% 46.3% 

5 Gestational age 

 &lt;37 weeks  5.5% 7.5% 7.3% 7.3% 7.8% 8.1% 7.8% 8.0% 8.1% 8.6% 8.1% 

 Singletons 4.8% 6.2% 5.8% 6.1% 6.3% 6.5% 6.4% 6.4% 6.7% 6.9% 6.7% 

 Multiples 41.1% 52.5% 57.3% 50.4% 54.9% 53.9% 55.8% 54.4% 51.8% 57.3% 50.8% 

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

7 Level II care na 13.1% 13.5% 13.8% 14.2% 13.8% 13.5% 14.5% 16.6% 15.8% 15.2% 

8 Level III care 3.3% 2.5% 2.4% 2.5% 2.5% 2.5% 2.5% 2.8% 2.6% 3.0% 2.6% 

9 W&amp;CH ICU 
care na 0.4% 0.5% 0.4% 0.3% 0.2% 0.2% 0.2% 0.3% 0.2% 0.3% 

10 Hospitalisation 
   for 28 days 
   or more 

4.2% 2.1% 2.0% 2.2% 2.2% 2.0% 2.0% 2.0% 2.1% 2.5% 2.1% 

11 Neonatal deaths 96 79 72 66 71 70 59 46 38 57 64 

12 Stillbirths 147 148 123 128 148 132 139 121 115 106 120 

13 Perinatal deaths 243 227 195 194 219 202 198 167 153 163 184 

14 Perinatal mortality rate per 1000 births 

 ?400g/20 
  weeks 12.8 11.3 9.8 9.8 11.2 10.6 10.6 8.9 8.3 9.1 10.4 

 ?500g/22 
  weeks 11.6 8.5 7.7 7.4 8.3 7.6 6.6 6.5 5.7 6.1 6.9 

 ?1000g/28 
  weeks* 7.2 5.3 4.2 3.8 4.5 4.0 4.0 3.5 3.1 3.6 3.9 

15 Standardized 
 perinatal 
 mortality ratio 

117.6 85.7 79.1 72.5 76.5 72.5 72.1 69.1 60.2 62.0 70.6 

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



60 

  

6.2
5.9 6

6.2
5.8 5.9 5.9 5.6

5.3 5.3
5.9

5.4
5.1

5.6
5.3 5.4

0

2

4

6

8

Year

Figure 29.1: Percentage of teenage mothers among
women giv ing birth in S.A.

6.6
7.4 8

8.7 8.7 9.3
10.4 10.8

11.6
12.5

13.5
14.2

15 15
16.3 16.5

0

4

8

12

16

20

Year

Figure 29.2: Percentage of mothers aged 35 years and
over among women giv ing birth in S.A.

14.7
17.2 17.6 18.1

19.7 20.1
22.2 22.5

24.3
26.2 26.5 27.3

28
29.9

31.9
34.3

0

10

20

30

40

Year

Figure 29.3: Percentage of primigrav id women aged
30 years and over in S.A.

2.4
2.6

2.9 2.9

3.3

2.8

3.6 3.5

4 3.9 3.8 3.8
4.1

4.3
4.5 4.4

1.7 1.8
2.1 2

2.2 2.1 2.2 2 2 2 1.9
2.1 2.2

2.4 2.5 2.3

0

1

2

3

4

5

Year
Asian

Aboriginal

Figure 29.4: Percentage of confinements of Aboriginal
women and Asian women in S.A.

FIGURE 29: TRENDS IN PERINATAL STATISTICS IN SA, 1986-2001

 



61 

  

11.6
11 11.3

12.2
12.9

12.2 12.7 12.2 12.1 12
13.2

12.3
11.6 12 12

12.3

0

3

6

9

12

15

Year

2.4
2.7 2.7 2.7

3
2.8 2.8 2.8 2.8

3.1
3.4

3
3.3

3.1
3.3

3.1

0

1

2

3

4

Year

6.5 6.5 6.5
7.1

6.7 6.5 6.7
6.8 6.7 6.8

7.4
7 7

6.6
7.2

6.8

0

2

4

6

8

Year

99
91 91 93 92

77
86

79
72 76 72 72 69

60 62
71

0

50

100

Year

Figure 29.5: Percentage of mothers never married and with no
defacto partner among women giving birth in S.A.

Figure 29.6: Percentage of multiple births among S.A. births

Figure 29.7: Percentage of low birthweight babies among
S.A. births

Figure 29.8: S.A. standardised perinatal mortality ratio



62 

  

VII SUMMARY STATISTICS FOR 2001 

 These statistics refer to all births of at least 400g birthweight, or of at least 20 weeks gestation.  
Forty-two babies of less than 400g birthweight have been included, as described on page 1. 

1. Number of births 

 Reported number of births (from monthly notifications): 17704 
 Notified births with Supplementary Birth Records: 17704 
 Notified confinements with SBRs: 17427 
 Crude birth rate: 11.6 per 1000 population. 

2. Place of birth 

 Planned home births : 36 (0.2% of births in the State) 
 One unplanned home birth, not booked at any hospital. 
 Hospital births: 17667 
 Of hospital births, distribution by category of hospital: 
 Metropolitan teaching:  9143 (51.6% of State births) 
 Metropolitan private: 4465 (25.2% of State births) 
 Country: 4059 (22.9% of State births) 

3. Sex 

 Males 8930, Females 8774.  Male: Female sex ratio = 1.02:1 

4. Plurality and condition at birth 

PLURALITY CONDITION 
AT BIRTH Singleton Twins Triplets 

TOTAL 

Livebirth 17041 540 3 17584 

Stillbirth 110 10 0 120 

TOTAL 17151 550 3 17704 

 

5. Race of mother 

RACE NO OF CONFINEMENTS % 

Caucasian 16007 91.9 

Aboriginal 399 2.3 

Asian 773 4.4 

Other 248 1.4 

TOTAL 17427 100.0 

 



63 

  

 

6. Obstetric interventions in 17427 confinements 

 Induction of labour was performed in 4929 (28.3%) and labour was augmented in another 3781 
(21.7%) confinements. 

 Forceps were utilised in 1061 (6.1%), ventouse in 1095 (6.3%) and episiotomy in 2691 confinements 
(15.4%). 

 Caesarean section was performed in 4836 (27.8%), of which 2082 (11.9%) were elective, and 2754 
(15.8%) emergency operations. 

7. Low birthweight (&lt;2500g) 

Number of singleton births of low birthweight =943 (5.5% of singleton births). 
Number of multiple births of low birthweight =256 (46.3% of multiple births). 
Number of all births of low birthweight =1199 (6.8% of all births). 

8. Congenital Abnormalities 

Births notified with congenital abnormalities : 451 (2.5 %). 

9. Perinatal morality rate 

 BIRTHWEIGHT/ GESTATION 

Stillbirth rate 
per 1000 

births 

Neonatal death 
rate 

per 1000 
livebirths 

Perinatal mortality rate 
per 

1000 births 

1 ?400g/20 weeks 6.8 3.6 10.4 

2 ?500g/22 weeks 
  (WHO National Statistics) 4.5 2.4 6.9 

3 ?1000g/28 weeks if birthweight 
unavailable 
  (WHO International/ Standard 
Statistics*) 

2.9 1.0* 3.9* 

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

10. Terminations of Pregnancy 

Total number of terminations notified : 5571 
Abortion rate per 1000 women (15-44 years): 17.6 
Total abortion rate per 1000 women (15-44 years): 553.0 
Total first abortion rate per 1000 women (15-44 years): 339.0 
Abortion proportion: 0.24 

 
 



64 

  

 

REFERENCES 

 
1. South Australian Health Commission. Report of Maternal and Neonatal Services in South 

Australia. Operational Policy, Guidelines and Standards. Adelaide: South Australian Health 
Commission, 1995. 

 
2. 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. 

 
3. Maternal, Perinatal and Infant Mortality Committee. Maternal, Perinatal and Infant 

Mortality in South Australia 2001. Adelaide: Department of Human Services, 2002. 
 
4. The South Australian Birth Defects Register. Annual Report 2000. Adelaide: Women's and 

Children's Hospital, 2002. 
 
5. Committee Appointed to Examine and Report on Abortions Notified in South Australia.  

Thirty-second Annual Report - For the Year 2001. Adelaide: Department of Human 
Services, 2002. 

 
6. 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. 

 
7. Mallett R, Knox E G. Standardized perinatal mortality ratios: technique, utility and 

interpretation. Community Med 1979; 1: 6-13. 



65 

  

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 1981). 
 
2. Maternal, Perinatal and Infant Mortality in South Australia. Annual Report of the Maternal, 

Perinatal &amp; Infant Mortality Committee (from 1985). 
 
3. Committee appointed to examine and report on abortions notified in South Australia (from 

1985). 
 
4. Pregnancy and Neonatal Care Bulletin (from 1983): for individual hospitals. 
 
 
The Unit provides data to the South Australian Birth Defects Register at the Women s and 
Children s Hospital and the National Perinatal Statistics Unit in Sydney.  The latter in turn 
provides congenital abnormality data to the International Clearinghouse for Birth Defects 
Monitoring Systems (currently in Rome).  These reports are as follows: 
 
1. The South Australian Birth Defects Register Annual Report (from 1986). Clinical Genetics 

Service, Women s and Children s Hospital, King William Road, North Adelaide, South 
Australia 5006. Telephone (08) 82046518. 

 
2. Australia s Mothers and Babies (from 1991). AIHW National Perinatal Statistics Unit, 

Sydney Children s Hospital, Level 2, McNevin Dickson Building, Randwick Hospital 
Campus, Randwick NSW 2031. Telephone (02) 9382 1014.  

 
3. Congenital Malformations Australia (from 1981).  AIHW National Perinatal Statistics Unit. 
 
 
 
OTHER REPORTS 
 
1. Connon, A.F., Macharper T.  Teenage pregnancies in South Australia.  Adelaide:  South 

Australian Health Commission, September 1986. 
 
 
2. Hart, G., Macharper T.  Medical termination of pregnancy in South Australia 1970-1984.  

Adelaide:  South Australian Health Commission, 1986. 
 
3. South Australian Health Commission, Epidemiology Branch:  Characteristics of 

pregnancies and births among migrant women in South Australia. Adelaide : South 
Australian Health Commission, October 1986. 

 



66 

  

4. 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. 

 
5. 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. 

 
6. South Australian Health Commission, Epidemiology Branch.  Variations in Perinatal Risk 

by Hospital of Birth in South Australia. Adelaide:  South Australian Health Commission, 
January 1987. 

 
7. 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. 

 
8. South Australian Health Commission Epidemiology Branch:  Pregnancy Outcome 

Attributes by Postcode:  South Australia 1981-1986.  South Australian Health Commission, 
Adelaide:  August 1988. 

 
9. Australian Bureau of Statistics, Aboriginal Health Organisation of South Australia Inc. 

Aboriginal Births and Deaths, Review of Data Quality and Statistical Summary, South 
Australia 1988. Commonwealth of Australia, February 1990. 

 
10. South Australian Health Commission. A Social Health Atlas of South Australia.  Adelaide: 

April 1990. 
 
11. 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. 

 
12. 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. 

 
13. Kirke, K., Divakaran-Brown, C., Priest, K., Roder, D.  South Australian Health Statistics 

Chartbook. Supplement 4: Aboriginal Health. Adelaide: Public and Environmental Health 
Service, South Australian Health Commission, February 1993. 

 
14. 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. 

 
15. 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. 

 
16. South Australian Cancer Registry. Associations between perinatal characteristics and risk of 

childhood cancer: South Australian cancer cases born in 1981-1993. In: Epidemiology of 



67 

  

Cancer in South Australia. Incidence, Mortality and Survival 1977 to 1994. Adelaide South 
Australian Health Commission, 1995. 

 
17. Pregnancy Outcome Unit. Perinatal Statistics Collection. Guidelines for the Supplementary 

Birth Record. Adelaide: South Australian Health Commission, December 1997. 
 
18. Nguyen A-M, Priest K, McCaul K. Roder D. South Australian Health Statistics Chartbook 
 1998-99 Edition. A Working Document. Adelaide: Epidemiology Branch, Department of 

Human Services, 1999. 
 
19. 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. 

 
 
 
PAPERS 
 
1. Hart, G., MacHarper, T., Moore, D., Roder, D.  Aboriginal pregnancies and births in South 

Australia. Med J Aust 1985; 143: S54-56. 
 
2. Hart, G., Macharper T.  Clinical aspects of induced abortion in South Australia from 1970-

1984.  Aust. NZ J Obstet Gynecol 1986; 26: 219-224. 
 
3. Hart, G., Macharper T.  Induced abortion trends in South Australia.  Am J Public Health 
 1987; 77: 200-202. 
 
4. 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 Gynecol 1988; 
28: 90-95. 

 
5. Jonas, O., Chan, A., Macharper, T. Caesarean Section in South Australia, 1986. Aust NZ J 

Obstet Gynaecol 1989; 29: 99-106. 
 
6. 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. 
 
7. Jonas, O., Stern, L.M., 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. 
 
8. Jonas, O., Chan, A., Macharper, T., Roder, D. Pregnancy and Perinatal Risk 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. 

 
9. Crotty, M., Ramsay, A.T., Smart, R., Chan, A. Planned Homebirths in South Australia 

1976-1987 Med J Aust 1990; 153: 664-671. 
 
10. Jonas, O., Chan, A., Roder, D., Macharper, T. Pregnancy Outcomes in primigravid women 

aged 35 years and over in South Australia, 1986-1988.  Med J Aust 1991; 154: 246-249. 
 



68 

  

11. Zhang, B., Chan, A. Teenage Pregnancy in South Australia, 1986-1988. Aust. NZ J Obstet 
Gynaecol 1991; 31: 291-298. 

 
12. 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. 

 
13. Chan, A., Roder, D., Priest, K., Esterman, A. A perinatal perspective on South Australia in 

the 1980s. Med J Aust 1992; 157: 515-518. 
 
14. 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. 

 
15. Jonas, O., Roder, D. Breech Presentation in South Australia, 1987-1989. Aust NZ J Obstet 

Gynaecol 1993; 33: 17-21. 
 
16. Roder, D., Chan, A., Esterman, A. Birthweight   specific trends in perinatal mortality by 

hospital category in South Australia, 1985   1990.  Med J Aust 1993; 158 : 664-667. 
 
17. Chan, A., Robertson, E.F., Haan, E.A., Keane, R.J., Ranieri, E., Carney, A. Prevalence of 

neural tube defects in South Australia, 1966   91: effectiveness and impact of prenatal 
diagnosis. Br Med J 1993; 307 : 703-6. 

 
18. Bower, C., Norwood, F., Knowles. S., Chambers H., Haan, E., Chan, A. Amniotic band 

syndrome: a population-based study in two Australian States. Paediatr Perinatal Epidemiol 
1993; 7: 395-403. 

 
19. 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. 

 
20. Roder, D., Chan, A., Priest K. Perinatal mortality trends among South Australian Aboriginal 

births 1981-92. J Paediatr Child Health 1995; 31 : 446-450. 
 
21. Chan A., Keane, R.J., 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. 

 
22. Chan, A. Epidemiology of the rising Caesarean section rate. Proceedings, 14th Annual 

Congress Australian Perinatal Society, Adelaide, March 1996, A70. 
 
23. Scott, J., Chan, A. Planned birthing unit deliveries in South Australia. Proceedings, 14th 

Annual Congress Australian Perinatal Society, Adelaide, March 1996, P21. 
 
24. 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. 

 



69 

  

25. 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. 

 
26. Byron-Scott, R., Chan, A., Haan, E.A., 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. 

 
27. Chan, A., Keane, R.J., Scott, J. Elective Caesarean section and child deprivation. Lancet 

1996; 347: 1196. 
 
28. Chan A., Hanna, M., Abbott, M., Keane, R.J. Oral retinoids and pregnancy. Med J Aust 

1996; 165: 164-167. 
 
29. Chan, A., McPhee, A.J. A safer leap into this dangerous world. Lancet 1996; 348 (suppl II) 
:12. 
 
30. 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. 

 
31. 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. 

 
32. 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. 
 
33. 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. 

 
34. 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. 
 
35. 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. 

 
36. 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 
Perinatal Epidemiol. 1998; 12 : 136-151. 

 
37. Cheffins, T., Chan, A., Keane, RJ., Haan, 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 

 
38. 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. Brit Med J 
1998; 317 : 923-4. 



70 

  

 
39. 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. 
 
40. 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. 

 
41. 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. 

 
42. Haslam R, McPhee A, Chan A, Keane R. Neonatal mortality   a system of classification 

and trends in South Australia. Proceeding of the 3rd Annual Congress of the Perinatal 
Society of Australia and New Zealand, Melbourne, 1999. P86. 

 
43. 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. 

 
44. 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. 

 
45. Chan A, Cundy PJ, Foster BK, Keane RJ, Byron-Scott R. Screening for congenital 

dislocation of the hip (letter). Lancet 2000;355:232-33. 
 
46. 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. 

 
47. 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. 

 
48. 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 prevalence of Down s syndrome and the use of amniocentesis and chorionic villus 
sampling in South Australia. Br J Obstet Gynaecol 2000;107:1453-9. 

 
49. 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. 

 
50. 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. Med J Aust 2001;174:389-93. 

 



71 

  

51. 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. Med J Aust 2001;174:631-636. 

 
52. Chan A, Foster BK, Cundy PJ. Invited commentary. Problems in the diagnosis of neonatal hip 

instablity. Acta Paediatr 2001;90: 836-9. 
 
53. 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. 

 
54. 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. 

 
55. 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. 
 
 
 



7 No. of previous pregnancies
8 No. 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 No. of previous Caesareans

6 Birthweight (grams)

7 Gestation at birth
(best clinical estimate in weeks)

27 Method of delivery
1. Normal spontaneous
2. Forceps
3. Assisted breech
4. LSCS (elective)
5. LSCS (emergency)
If LSCS state reason/s . . . . . . . . . . . .

6. Ventouse          8. Breech spontaneous
7. Breech extraction 9. Unknown

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)

19 Average no. of tobacco cigarettes
smoked per day in 2nd half of pregnancy

None
No. per day = ............................
&lt;1 (occasional)
Unknown no.

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

Please return top copy to
Pregnancy Outcome Unit,
PO Box 6, Rundle Mall,
Adelaide SA  5000

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. O2
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)

No. of days

3.     Neonatal Intensive Care Unit (NICU)
- FMC/WCH (Level 3)

No. of days

4.     Paediatric Intensive Care Unit (PICU)
- WCH

No. of days

15 Was transfer to NICU/PICU for a
congenital abnormality?

Yes No

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          ................................

16 Number of antenatal visits

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

4 Hour of birth
(24 hour clock)

5 Sex
1. Male  2. Female  3. Indeterminate

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

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

2001 SUPPLEMENTARY BIRTH RECORD
FOR COMPLETION BY MIDWIVES AND NEONATAL NURSES

Mother s name .............................................................................................................. Hospital/Place of birth ...............................................................
Surname Initials

Child s surname (if different) ........................................................................................ Mother s Case Record Number .................................................

Mother s address .......................................................................................................... Plurality  (1=single, 2=twin, 3=triplet, 4=quad)

.........................................................................      Postcode                   For multiple births,  please complete a separate baby form for each baby.

Personal information above this line is confidential      SLA

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

6 Baby s father

Baby s mother

MOTHER S  INFORMATION

OCCUPATION

PREVIOUS  PREGNANCY  OUTCOMES

OUTCOME OF BABY

CONDITION  AT  BIRTH

LABOUR  AND  DELIVERY

BABY  DETAILS

28 Complications of labour, delivery and
puerperium
1.   None
2.   PPH (Primary) (600mls 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)

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)

34 Mother s outcome for birth
hospital/home birth
1.   Discharged   2.   Transferred   3.    Died

Transferred to

on

Date

day month year

THIS  PREGNANCY

35 MOTHER S  FINAL  DISCHARGE/
      DEATH

4    0    1

18 Tobacco smoking status at first visit
1. Smoker
2. Quit in pregnancy before first visit
3. Non smoker
4. Unknown smoking status

day month year

72 APPENDIX 1



HAS THE FATHER OF THIS CHILD  A HISTORY OF EXPOSURE TO ANY
POTENTIAL TERATOGENS? Yes No Not known

(specify) ....................................................................................................

ADDITIONAL INFORMATION (eg drinking water supply/local epidemics)

.................................................................................................................

PRENATAL DIAGNOSIS

Please tick all tests performed                 Please tick if
during this pregnancy               abnormal result

1.        MSAFP (NTD etc)
2.        Triple/Quadruple screen (Down s, etc)
3.        Ultrasound (morphology)
4.        Chorion villus sampling
5.        Amniocentesis
6.        Cordocentesis

8.        Other (specify) ............................................................
9.        Not known

Comments ...................................................................................................

....................................................................................................................

1 ................................................................................................

2 ................................................................................................

3 ................................................................................................

4 ................................................................................................

5 ................................................................................................

6 ................................................................................................

7 ................................................................................................

8 ................................................................................................

9 ................................................................................................

10 ..............................................................................................

SPECIFIC SYNDROME/S (if  known) ........................................

..................................................................................................

FAMILY HISTORY OF CONGENITAL ABNORMALITY          Yes   No  Not known

1. Parents (specify) ................................................................

2. Siblings of this baby (including known stillbirths
   and 2nd trimester terminations of pregnancy)

(specify) .................................................................................

3. Other relatives (specify) .....................................................

..............................................................................................

RESIDENCE OF MOTHER DURING THE FIRST 16 WEEKS OF PREGNANCY

..............................................................................................

S.A. PREGNANCY OUTCOME STATISTICS UNIT, SOUTH AUSTRALIAN HEALTH COMMISSION,
PO Box 6, Rundle Mall, Adelaide SA  5000

CONGENITAL ABNORMALITY FORM

BABY S SURNAME .....................................................................................

BABY S FIRST NAME .................................................................................

SEX ................... IF MULTIPLE BIRTH, BIRTH ORDER .............................

DATE OF BIRTH ............. / ........... / .......... UR NO. ....................................

HOSPITAL ...................................................................................................

ADDRESS OF MOTHER .............................................................................

....................................................................................................................

ACC NO.    4

CONGENITAL ABNORMALITIES / BIRTH DEFECTS PRESENT
(Please list all defects &amp; specify where relevant right/left, anterior/posterior)

                       Office use only

NAME OF NOTIFYING DOCTOR ................................................................................ Signed .................................................................. Date .....................................

NAME &amp; ADDRESS OF OBSTETRICIAN/MIDWIFE (if not the same) ........................................................................................................................................................

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 ..........................................................

Comments ................................................................................................

.................................................................................................................

73

APPENDIX 2



74 

  

APPENDIX 3: DEFINITIONS 

 Livebirth:  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. 

 

 Crude birth rate =       Number of livebirths in any year
Average population in that year

 X 1000 

 
 Neonatal death:       Death of a liveborn infant within 28 days of birth. 

 

Neonatal death rate =   No of neonatal deaths in any year
No of livebirths in that year

 X 1000 

 
 
 Fetal death:  Death prior to the complete expulsion or extraction from its mother 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, or 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 
 

           =    No of late fetal deaths or stillbirths in any year
Number of livebirths and stillbirths in that year

  X 1000 

 
 
 Perinatal death:  Includes late fetal death (stillbirth) and neonatal death. 
 

Perinatal mortality rate (PMR) 
 

                  =   
No of stillbirths and neonatal deaths

No of stillbirths and livebirths
 X 1000 

 
 For South Australian statistics, the rate refers to all births 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 WHO). 
 
 For international comparisons, the rate refers to all births of at least 1000 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). 



75 

  

 
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: 

 
  descent 
  self identification 
  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). 



76 

  

 
 
 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. 

 
Confinements: The number of women giving birth 
 
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 livebirths or stillbirths. 
 
 Induction of labour:  An intervention undertaken to stimulate the onset of labour by 

pharmacological or other means. 
 

Caesarean section: Delivery 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. 

 
Pre-term: 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 2500g. 
 
Very low birthweight:  Birthweight of less than 1500g. 
 



77 

  

 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: 

 
SCORE 

SIGN 
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 

 
 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. 
 

 Termination of pregnancy:  Termination performed by a medical practitioner in a prescribed 
hospital in South Australia, on specified indications, up to the 28th week of gestation, under the 
Criminal Law Consolidation (Medical Termination of Pregnancy) Regulations 1996.  Aborted 
fetuses of at least 400g birthweight or 20 weeks gestation are classified as late fetal deaths and 
should be included in perinatal mortality statistics.  Those of shorter gestation (the majority) are 
early fetal deaths. 

 
Abortion rate 
 
           = 

Number of induced abortions in a group of women over a certain period of time
Average population of same group in the same period  x 1000 

 
The abortion rate per 1000 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

Abortions + births
 

 
It is more usual to include only livebirths in the denominator.  This is often 
 

called the abortion ratio, which is strictly         
Abortion
Livebirths

 

 
Total abortion rate = the sum of the 5 year age-specific abortion rates multiplied by 5.  This 
represents the number of abortions 1000 women would have during their lifetime if they 
experienced the rates of the year shown. 



78 

  

 
 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 (World Health Organisation). 

 
 As an extension of the W.H.O. definition, and as is the practice in Australia, accidental and 

incidental deaths occurring in pregnant women are included by the Maternal, Perinatal and Infant 
Mortality Committee in its definition of maternal death. 

 
 
Maternal deaths in Australia are divided into three groups: 
 

 1. Direct obstetric deaths: those resulting from obstetric complications of the pregnant state 
(pregnancy, labour and puerperium) from interventions, omissions, inappropriate treatment, 
or from a chain of events resulting from any of the above. 

 
 2. Indirect obstetric deaths: those resulting from pre-existing disease or disease that developed 

during pregnancy and which was not due to direct obstetric causes, but which was 
aggravated by physiological effects of pregnancy. 

 
 3. Incidental deaths in pregnancy: 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. 

 
 
 
 


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