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November 2016

Pregnancy Outcome Unit,  
SA Health

Pregnancy 
Outcome

in South Australia
  2014



October 2016 
Pregnancy Outcome in South Australia 2014 
  SA Health

Address: 
Pregnancy Outcome (Statistics) Unit 
Epidemiology Branch 
SA Health, Government of South Australia 
Citi Centre Building 
11 Hindmarsh Square  
Adelaide 5000 
South Australia

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

Telephone: (08) 8226 6382 
Fax: (08) 8226 6672

Web: www.sahealth.gov.au 

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

ISSN 0819-3835

Suggested citation: Scheil W, Jolly K, Scott J, Catcheside B, Sage L, Kennare R. Pregnancy Outcome in South Australia 2014. 
Adelaide: Pregnancy Outcome Unit, SA Health, Government of South Australia, 2016.



Pregnancy Outcome in  
South Australia 2014

Wendy Scheil
Kerry Jolly
Joan Scott

Britt Catcheside
Leonie Sage

Robyn Kennare

November 2016

Pregnancy Outcome Unit 
SA Health



Staff
Wendy Scheil  Head/Senior Medical Consultant

Joan Scott  Senior Midwife

Leonie Sage  Senior Midwife, Abortion Statistics 

Maureen Fisher  Administrative Officer

Judith Thompson  Administrative Officer

Kerry Jolly  Midwife

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

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

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

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

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

 &gt; the Genetics and Molecular Pathology Directorate, Women s and Children s Hospital, for cytogenetics reports;

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

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

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

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

 &gt; Alison Scott for assisting with data entry;

 &gt; Maureen Fisher and Britt Catcheside for the graphics; 

 &gt; Fred Calabrese of the Epidemiology Branch for his assistance with the import of electronically transferred data from 
the Women s and Children s Hospital;

 &gt; Corporate Data Collection Systems, SA Health for updating the maps; and

 &gt; Media and Communications Branch of SA Health for publication.

Pregnancy Outcome in South Australia 2014page 2

Acknowledgements



Contents

Acknowledgements ........................................................................................................2

Executive Summary .......................................................................................................10

1. Numbers and fertility rates ........................................................................................................................10

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

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

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

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

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

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

8. Aboriginal women and babies ..................................................................................................................11

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

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

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

12. Abortions ...............................................................................................................................................12

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

I. Introduction ................................................................................................................13

1. The Perinatal Statistics Collection ..............................................................................................................13

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

II. Mothers and Babies: Characteristics &amp; Outcomes ...................................................14

1. Place of residence of mother ....................................................................................................................14

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

3. Maternal and baby race ............................................................................................................................20

4. Maternal age ............................................................................................................................................21

5. Country of birth .......................................................................................................................................23

6. Marital status and type of patient .............................................................................................................25

7. Occupation of father and mother .............................................................................................................26

8. Previous pregnancy outcomes ...................................................................................................................27

9a. Gestation at first antenatal visit ...............................................................................................................28

9b. Body Mass Index (BMI) ............................................................................................................................28

9c. Antenatal visits .......................................................................................................................................29

9d. Type of antenatal care ............................................................................................................................29

10. Smoking .................................................................................................................................................30

11. Medical conditions .................................................................................................................................31

12. Obstetric complications ..........................................................................................................................31

Pregnancy Outcome in South Australia 2014 page  3

Contents



13. Procedures performed in current pregnancy ............................................................................................32

14a. Onset of labour ....................................................................................................................................32

14b. Reasons for induction of labour ............................................................................................................33

15a. Presentation and method of birth .........................................................................................................34

15b. Reason for caesarean section ................................................................................................................36

16. Complications of labour and birth and perineal status after birth ............................................................37

17. Fetal monitoring during labour ...............................................................................................................38

18. Analgesia for labour and anaesthesia for birth ........................................................................................38

19. Postnatal length of stay of women .........................................................................................................39

20. Sex of baby ............................................................................................................................................40

21. Birthweight and gestation ......................................................................................................................40

22. Birth injuries ...........................................................................................................................................41

23. Treatment given in neonatal period .........................................................................................................41

24. Level of care utilised ...............................................................................................................................41

25. Length of stay of babies .........................................................................................................................42

26. Congenital anomalies .............................................................................................................................42

27. Multiple births ........................................................................................................................................43

28. Perinatal mortality ..................................................................................................................................45

29. Home births ...........................................................................................................................................47

30. Birthing unit births ..................................................................................................................................49

III. Terminations of Pregnancy ......................................................................................51

1. Numbers and rates ...................................................................................................................................51

2. Age of women .........................................................................................................................................52

3. Place of residence and place where termination performed .......................................................................54

4. The reason for termination .......................................................................................................................55

5. Gestation, method and complications .......................................................................................................55

6. Previous terminations. Total termination of pregnancy rate and total first termination of pregnancy rate ...57

IV. Obstetric Profiles by Hospital Category ..................................................................59

V. Clinical and Maternity Performance Indicators .......................................................68

1. Clinical indicators .....................................................................................................................................68

1: Smoking in pregnancy  .........................................................................................................................68

2: Antenatal care in the first trimester for all women giving birth ..............................................................69

3: Episiotomy for women having their first baby and giving birth vaginally ................................................69

4: Apgar score of less than 7 at 5 minutes for births at or after term .........................................................70

5: Induction of labour for selected primiparae ...........................................................................................70

Pregnancy Outcome in South Australia 2014page 4

Contents



6: Caesarean section for selected primiparae ............................................................................................70

7: Normal (non-instrumental) vaginal birth for selected primiparae ............................................................70

8: Instrumental vaginal birth for selected primiparae .................................................................................71

9: General anaesthetic for women giving birth by caesarean section .........................................................71

10: Small babies among births at or after 40 weeks gestation ...................................................................71

2. Maternity performance indicators, hospitals with at least 550 births per year ............................................72

VI. Trends in Perinatal Statistics in South Australia, 1981-2014 .................................76

Trends in Perinatal Statistics in South Australia (SA), 1985   2014 .................................................................79

VII. Summary Statistics for 2014 ..................................................................................82

1. Number of births ..................................................................................................................................82

2. Place of birth ........................................................................................................................................82

3. Sex .......................................................................................................................................................82

4. Plurality and condition at birth ..............................................................................................................82

5. Race of women ....................................................................................................................................82

6. Obstetric interventions in 20,448 women who gave birth .....................................................................83

7. Low birthweight (&lt;2,500g) ...................................................................................................................83

8. Congenital anomalies ...........................................................................................................................83

9. Perinatal mortality rates (numbers of deaths in parentheses) .................................................................83

10. Terminations of pregnancy ..................................................................................................................83

References .....................................................................................................................84

Publications ...................................................................................................................85

Annual Reports .............................................................................................................................................85

Other reports/papers ....................................................................................................................................85

1. Birth defects .........................................................................................................................................85

2. Termination of pregnancy .....................................................................................................................88

3. Perinatal epidemiology..........................................................................................................................88

4. Perinatal mortality.................................................................................................................................91

5. Caesarean section .................................................................................................................................92

Appendix 1: Definitions ................................................................................................92

Appendix 2: 2014 Supplementary Birth Record Form .................................................96

Appendix 3: Congenital Abnormality Form ................................................................97

Pregnancy Outcome in South Australia 2014 page  5

Contents



Tables

Table 1: Births and crude birth rate by ABS Statistical Geographical Boundaries (ASGS 2014) regions,  

South Australia, 2014 ..................................................................................................................14

Table 2: Total births notified in 2014, by place of birth and plurality, South Australia  ...................................15

Table 3a: Hospital births by Perinatal Service Delineation, South Australia, 2014 ...........................................18

Table 3b: Hospital births in South Australia in 2014 by race and hospital ......................................................19

Table 4a: Race of women who gave birth, South Australia, 2014 .................................................................21

Table 4b: Table 4b: Race and birthplace category of women who gave birth, South Australia, 2014 .............21

Table 4c: Age and race of women who gave birth, South Australia, 2014 ....................................................22

Table 4d: Age  specific fertility rates (ASFR), South Australia, 2014 ..............................................................23

Table 5a: Country of birth, major groups, women who gave birth, South Australia, 2014 ............................23

Table 5b: Specified country of birth, women who gave birth, South Australia, 2014 .....................................24

Table 6a: Marital status and age, women who gave birth, South Australia, 2014 .........................................25

Table 6b: Type of patient and marital status, women who gave birth, South Australia, 2014 ........................25

Table 7: Occupation of father and mother, women who gave birth, South Australia, 2014 ...........................26

Table 8a: Parity by race, women who gave birth, South Australia, 2014 .......................................................27

Table 8b: Previous pregnancy outcomes, women who gave birth, South Australia, 2014  .............................27

Table 9a: Gestation at first antenatal visit, women who gave birth, by race,  ................................................28

Table 9b:BMI of women who gave birth, South Australia, 2014 ...................................................................28

Table 9c: Antenatal visits by race, women who gave birth, South Australia, 2014 .........................................29

Table 9d: Type of antenatal care, women who gave birth, South Australia, 2014 ..........................................29

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

women who gave birth, South Australia, 2014 ............................................................................30

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

Aboriginal and Aboriginal women who gave birth, South Australia, 2014 ....................................30

Table 11: Medical conditions in current pregnancy, women who gave birth, South Australia, 2014 ..............31

Table 12: Frequency of some obstetric complications, women who gave birth, South Australia, 2014 ..........31

Table 13: Procedures performed in current pregnancy, women who gave birth, South Australia, 2014 .........32

Table 14a: Onset of labour, women who gave birth, South Australia, 2014 ..................................................32

Table 14b: Method of induction of labour, women who gave birth, South Australia, 2014 ...........................32

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

birth, South Australia, 2014 .........................................................................................................33

Table 15a: Method of birth, women who gave birth, South Australia, 2014 .................................................34

Table 15b: Method of birth by presentation, all births, South Australian 2014 ..............................................35

Table 15c: Method of birth in breech presentation, by plurality, all births, South Australia, 2014 ..................35

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

South Australia, 2014 ..................................................................................................................37

Pregnancy Outcome in South Australia 2014page 6

Tables



Table 17a: CTG performed during labour, women who gave birth, South Australia, 2014 ............................38

Table 17b: Fetal scalp pH taken during labour, women who gave birth, South Australia, 2014 .....................38

Table 18a: Analgesia for labour, women who gave birth, South Australia, 2014 ...........................................38

Table 18b: Anaesthesia for birth, women who gave birth, South Australia, 2014 .........................................39

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

hospitals, 2014 ............................................................................................................................39

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

birth in South Australian hospitals, 2014 ......................................................................................39

Table 20: Sex of baby, all births, South Australia, 2014 .................................................................................40

Table 21: Birthweight distribution of all births, South Australia, 2014 ...........................................................40

Table 22: Birth injuries in 20,604 live births, South Australia, 2014 ...............................................................41

Table 23: Neonatal treatment given, all live births, South Australia, 2014 .....................................................41

Table 24: Level of nursery care utilised by birthweight, all live births, South Australia, 2014 ..........................41

Table 25: Length of stay of liveborn babies in hospital, South Australia, 2014 ..............................................42

Table 26: Selected congenital anomalies notified to the perinatal statistics collection 2004-2014,  

South Australia. ...........................................................................................................................43

Table 27a: Birthweight by plurality, all births, South Australia, 2014 .............................................................44

Table 27b: Gestation at birth by plurality all births, South Australia, 2014 ....................................................44

Table 27c: Perinatal outcome by plurality, all births, South Australia, 2014 ...................................................44

Table 28a: Perinatal mortality by birthweight, all births, South Australia, 2014 .............................................45

Table 28b: Perinatal mortality by gestational age at birth, South Australia, 2014 ..........................................46

Table 28c: Perinatal mortality, South Australia, 2014 (all births of specified birthweight/gestation) ................46

Table 28d: Perinatal mortality by race, all births, South Australia, 2014 ........................................................47

Table 29: Planned home births by age of women, South Australia, 2014 ......................................................47

Table 30: Method of birth in planned home births, South Australia, 2014 ....................................................48

Table 31: Birthweight distribution of planned home births, South Australia, 2014 ........................................48

Table 32: Perinatal outcome in planned home births, South Australia, 2014 .................................................48

Table 33: Planned birthing unit births by age of women, South Australia, 2014 ...........................................49

Table 34: Method of birth in planned birthing unit births, South Australia, 2014 ..........................................49

Table 35: Birthweight distribution of planned birthing unit births, South Australia, 2014 ..............................50

Table 36: Perinatal outcome in planned birthing unit births, South Australia, 2014 .......................................50

Table 37: Number of pregnancy terminations, and rate per 1,000 women aged 15-44 years,  

South Australia, 1970-2014 .........................................................................................................51

Table 38: Terminations of pregnancy by age, South Australia, 2014 .............................................................52

Table 39: Termination of pregnancy and live birth rates and termination of pregnancy proportions by age, 

South Australia, 2014 ..................................................................................................................53

Pregnancy Outcome in South Australia 2014 page  7

Tables



Table 40: Terminations by place of residence, South Australia, 2014 .............................................................54

Table 41: Terminations by hospital category, South Australia, 2014 ..............................................................54

Table 42: Terminations by category of doctor, South Australia, 2014 ............................................................55

Table 43: Reason for termination for fetal reasons, South Australia, 2014 ....................................................55

Table 44a: Complications of termination procedures, South Australia, 2014 .................................................56

Table 44b: Complications by method of termination procedure, South Australia, 2014 ................................56

Table 45a: Women with previous terminations by age, South Australia, 2014 ..............................................57

Table 45b: Calculation of total induced abortion rate (TAR), South Australia, 2014 .......................................58

Table 45c: Calculation of total first induced abortion rate (TFAR), South Australia, 2014 ...............................58

Table 46: Obstetric profiles by hospital category, South Australia, 2014: live births and  

stillbirths of &gt;=400g or &gt;=20 weeks gestation .............................................................................61

Table 47: Socio-demographic aspects of perinatal statistics, South Australia, 1981 and 2005-2014 ..............77

Table 48: Obstetric aspects of perinatal statistics, South Australia, 1981 and 2004   2014 ...........................78

Figures

Figure 1a: South Australian hospitals with obstetric beds in 2014 ................................................................16

Figure 1b: Hospitals with obstetric beds in 2014, Central Region of SA 2014  ..............................................17

Figure 2: Distribution of hospital births by hospital category, South Australia, 2014 ......................................18

Figure 3: Age and race of women who gave birth, 2014 ..............................................................................22

Figure 4: Reasons for induction of labour, SA, 2014 .....................................................................................33

Figure 5a: Method of birth, women who gave birth, South Australia, 2014 .................................................34

Figure 5b: Reason for caesarean section, 2014  ............................................................................................36

Figure 5c: Reason for elective caesarean section, 2014 .................................................................................36

Figure 5d: Reason for emergency caesarean section, 2014 ...........................................................................37

Figure 6: Perinatal mortality rate by birthweight, all births, South Australia, 2014.........................................45

Figure 7: Pregnancy termination rate per 1,000 women aged 15-44 years, South Australia, 1970-2014 .......51

Figure 8a: Termination of pregnancy and live births by age, South Australia, 2014 .......................................53

Figure 8b: Teenage pregnancy, termination of pregnancy and birth rates, South Australia, 1970-2014 .........54

Figure 9: Percentage of Aboriginal women by hospital category ...................................................................62

Figure 10: Percentage of women with &lt;7 antenatal visits by hospital category .............................................62

Figure 11: Percentage of teenage women by hospital category ....................................................................62

Figure 12: Percentage of women 35 years or more by hospital category .......................................................63

Figure 13: Percentage of single women by hospital category ........................................................................63

Figure 14: Percentage of women with 4 or more prior livebirths by hospital category ...................................63

Pregnancy Outcome in South Australia 2014page 8

Figures



Figure 15: Percentage of women with 1 or more prior perinatal deaths by hospital category ........................64

Figure 16: Percentage of women with obstetric complications by hospital category ......................................64

Figure 17: Percentage of women with complications during labour or birth by hospital category ..................64

Figure 18: Percentage of women with induction of labour by hospital category ...........................................65

Figure 19: Percentage of women having epidural analgesia by hospital category ..........................................65

Figure 20: Percentage of breech births by hospital category .........................................................................65

Figure 21: Percentage of emergency caesarean sections by hospital category ...............................................66

Figure 22: Percentage of elective caesarean sections by hospital category ....................................................66

Figure 23: Percentage of total caesarean sections by hospital category .........................................................66

Figure 24: Percentage of births with birthweight below 2,500g by hospital category ....................................66

Figure 25: Percentage of births with gestation less than 37 weeks by hospital category ................................67

Figure 26: Percentage of births with prolonged hospitalisation by hospital category .....................................67

Figure 27: Percentage of live births requiring neonatal intensive care by hospital category ............................67

Figure 28: Percentage of births with birth defects by hospital category .........................................................67

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

with &gt;=550 births per year, 2014 .................................................................................................73

Figure 29b: Caesarean section rate for selected primiparae, SA hospitals with &gt;=550 births per year, 2014 ..73

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

caesarean section &amp; no intervening births, SA hospitals with &gt;=550 births per year, 2014 ............74

Figure 29d: Proportion of selected primiparae with an intact perineum after a vaginal birth, SA hospitals  

with &gt;=550 births per year, 2014 .................................................................................................74

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

abnormality, SA hospitals with &gt;=550 births per year, 2014 .........................................................74

Figure 29f: SPMR (Standardized Perinatal Mortality Ratio) for all births, SA hospitals with &gt;=550 births  

per year, 2014 .............................................................................................................................75

Figure 29g: SPMR (Standardized Perinatal Mortality Ratio) for all births, SA hospitals with &gt;=550 births  

per year, 2010-2014 ....................................................................................................................75

Figure 30.1: Percentage of teenage women among women giving birth in SA .............................................79

Figure 30.2: Percentage of women aged 35 years and over among women giving birth in SA ......................79

Figure 30.3: Percentage of primiparous women aged 35 years and over in SA .............................................79

Figure 30.4: Percentage of Aboriginal women and Asian women among women giving birth in SA .............80

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

giving birth in SA .........................................................................................................................80

Figure 30.6: Percentage of multiple births among births in SA......................................................................80

Figure 30.7 Percentage of low birthweight babies among births in SA .........................................................81

Figure 30.8: SA standardised perinatal mortality ratio (SPMR) .......................................................................81

Pregnancy Outcome in South Australia 2014 page  9

Figures



Executive Summary
This report on pregnancy outcomes in South Australia for 2014 provides statistics derived mainly from the South 
Australian perinatal statistics collection of births. These are compiled from notifications submitted by hospital and 
homebirth midwives and neonatal nurses. For a more complete picture of pregnancy outcome, some figures from 
the abortion statistics collection are also included. More statistics on abortions in the state in 2014 are available in 
the Annual Report of the Abortion Reporting Committee for the Year 2014. Comparisons of selected pregnancy 
characteristics and outcomes are provided for six different hospital categories in the state. Individual hospital reports 
(Pregnancy and Neonatal Care Bulletins) with these comparisons made in greater detail are provided to hospitals in 
the state with at least 100 births per year. Group reports are provided for hospitals with smaller numbers of births. 
Comparisons of maternity performance indicators are also provided for hospitals with at least 550 births per year.

1. Numbers and fertility rates
The number of births notified in South Australia in 2014 was 20,749, 486 more than the previous year. The number 
of women who gave birth was 20,448. The total fertility rate was 1.83 live births per woman, slightly lower than 
2013 s rate of 1.85. Fertility rates increased in the older age groups of 30 years and above, remaining highest in the 
30-34 years age group, followed by the 25-29 years age group.

2. Place of birth
Compared to 2013, the numbers of births increased at all metropolitan teaching hospitals. Births increased at two of 
the metropolitan private hospitals, decreased at two and remained steady at the last. 1,232 women (6%) gave birth in 
birthing units in teaching hospitals and 96 (0.5%) had planned home births.

3. Teenage women
Six hundred and thirty four teenage women gave birth; accounting for 3.1% of women who gave birth. 553 teenage 
women had terminations of pregnancy, accounting for 10.3% of terminations. In 2014, the proportion of  known  
pregnancies terminated was 47% for teenagers compared with 18% for women of all ages. The teenage pregnancy 
rate declined in the 1970s and 1980s before increasing in the early 1990s and declining again after 1996. The 
teenage pregnancy rate in 2014 of 22.1per 1,000 women aged 15-19 years, was the lowest rate recorded since 
1970.

4. Older women and first time mothers
The mean age of women giving birth increased from 26.6 years in 1981 to 29.9 years in 2014. For first time mothers 
it increased from 24.4 years to 28.4 years over the same period. The proportion of women aged 35 years or more 
increased from 4.6% in 1981 to a high of 21.1% in 2009 and was 20.6% in 2014. Among first time mothers, this 
proportion increased from 1.2% to 12.8% in 2009 and was also 12.9% in 2014. As in the previous decade, more 
women gave birth in the 30-34 years than in the 25-29 years age group. 

5. Country of birth and race
Seventy-four percent of women who gave birth in 2014 were Australian-born.  Of women born overseas who gave 
birth, the largest proportions came from India (4% of women), the United Kingdom and Ireland (2.4%), China 
(2.7%), Vietnam (1.4%), New Zealand and the Philippines (1.%), Afghanistan and Sudan (0.8%), Iran, Malaysia and 
Pakistan (0.6%) and Cambodia and Nepal (0.4%). Of the women who gave birth in the state in 2014, 13.0% (2,655 
women) were Asian, compared with 2% in 1981. They gave birth mainly in teaching hospitals.

6. Smoking during pregnancy and Body Mass Index
The proportion of women smoking at the first antenatal visit has declined steadily from 25% in 1998 to 10.1% in 
2014. Additionally 2.8% of women had quit smoking before the first antenatal visit.

Statistics on Body Mass Index were available for 84% of women who gave birth in 2014 (a vast improvement from 
42% in 2007. They indicated that 44% of all women giving birth were overweight, including 12.1% classified as 
obese and 8.5% severely or morbidly obese.

Pregnancy Outcome in South Australia 2014page 10

Executive Summary



7. Antenatal care and length of stay
Week of gestation at the first antenatal visit was reported for 95% of women who gave birth. Seventy-nine percent 
of these women attended for antenatal care within the first 14 weeks of pregnancy while ninety-nine percent of 
women attended at least one antenatal visit. Of those women for whom the number of antenatal visits was reported, 
91% of women attended seven or more antenatal visits. Although many women had more than one type of 
antenatal care, the most common types used were hospital clinics (43%), obstetricians in private practice (27%) and 
general practitioners (21.2%). The median length of stay of women after a birth was three days; it was two days for 
those who had a vaginal birth and four days for those who had a caesarean section.  It was two days longer among 
private patients for both vaginal births and caesarean births.

8. Aboriginal women and babies
Seven hundred and twelve Aboriginal women gave birth in South Australia in 2014, accounting for 3.5% of all 
women who gave birth in the state. Fifteen percent of Aboriginal women were teenagers (compared with 2.8% 
of non-Aboriginal women). Of the Aboriginal women for whom week of gestation at the first antenatal visit was 
reported, 55% attended for antenatal care within the first 14 weeks of pregnancy (compared with 80% of non-
Aboriginal women).  Of the Aboriginal women for whom the number of antenatal visits was reported, 69% attended 
at least seven antenatal visits during pregnancy (compared with 91% of non-Aboriginal women).  In 2014, at the first 
antenatal visit, 44 % of Aboriginal women reported that they smoked a decrease from 45% in 2013). This proportion 
was 8.8% among non-Aboriginal women. In 2014, the proportion of preterm births (&lt;37 weeks gestation) was 
17.9% among babies of Aboriginal women compared with 8.9% among babies of non-Aboriginal women. Among 
live born babies (excluding terminations of pregnancy), the proportions of low birthweight babies (&lt;2,500g) were 
14.8% and 6.3% respectively. The perinatal mortality rate of babies of Aboriginal women was 12.5 per 1,000 births 
in 2014 compared with 8.7 per 1,000 births for births to non-Aboriginal women. 

For the first time in 2012, the Indigenous status of the baby was also collected independently of the mother. There 
were 947 Indigenous babies, representing 4.6% of all babies born in 2014. They comprised 917 (96.8%) Aboriginal, 
9 (1%) Torres Strait Islander and 21 (2.2%) Aboriginal and Torres Strait Islander.

9. Procedures
Ninety-eight percent of women who gave birth had an ultrasound examination; 32% had labour induced while 
another 17.5% had spontaneous labour augmented; epidurals were used for pain relief during labour for 29% of 
women, and 14% had an episiotomy (22% of women who gave birth vaginally). The main reasons for induction of 
labour were prolonged pregnancy (16%), hypertension (13%), diabetes or gestational diabetes (10%), poor fetal 
growth (8%) and premature rupture of membranes (9%). Forty-eight percent of inductions of labour were performed 
for other than defined indications.  

10. Method of birth
Fifty-four percent of women had normal spontaneous vaginal births. Six percent gave birth by ventouse and another 
5.3% by forceps (compared with 1% and 15% respectively in 1981 when records began). In 2014 the proportion 
of women giving birth by caesarean section was 34%, a proportion that has been relatively stable for several years. 
Of those who had previously given birth, 31% had previously had a caesarean section. Only 15.9% of women had a 
vaginal birth following a previous first caesarean without intervening births, compared with 30% in 1998 (when first 
collected). The main reasons given for caesarean section were previous caesarean section (37%) failure to progress in 
labour or cephalopelvic disproportion (26%) fetal distress (14%) and malpresentation (11%). 

11. Multiple births
In 2014 multiple births accounted 2.9% of births while women with twins or triplets accounted for 1.4% of women 
who gave birth in 2014. These proportions increased in the 1980s and 1990s as a result of the use of assisted 
conception and the increasing proportion of older women (who have higher rates of multiple pregnancies than 
younger women) having children. The peak proportion of multiple births was recorded in 2002 and 2003 (3.6%).  
The subsequent decline in the proportion of multiple births was probably related to the increasing use of single 
embryo transfer in assisted conception practice.

Pregnancy Outcome in South Australia 2014 page  11

Executive Summary



12. Abortions
There were 4650 terminations of pregnancy recorded, 31 fewer than in 2013. The induced abortion rate was 13.8 
per 1,000 women aged 15-44 years, compared with 14.4 per 1,000 women aged 15-44 years in 2013. The rate 
remained relatively stable from 2005 (15.3) until 2011 (15.5) and has since continued to decline. Approximately 
97% of terminations were performed in metropolitan public hospitals, including the Pregnancy Advisory Centre, and 
77% were performed by doctors in family advisory clinics in these hospitals. Ninety-one percent of terminations were 
performed within the first 14 weeks of pregnancy and 2.3% (107) were performed at or after 20 weeks gestation. 
Forty-nine percent of terminations performed at or after 20 weeks gestation were for fetal reasons. Approximately 
18% of reported pregnancies ended as terminations in 2014.

13. Perinatal mortality
The perinatal mortality rate for all births in 2014 was 8.9 per 1,000 births, the stillbirth rate seven per 1,000 births 
and the neonatal mortality rate 1.9 per 1,000 live births. For international comparison, the World Health Organisation 
recommends including only stillbirths of at least 1,000g birthweight (or 28 weeks gestation if birthweight unavailable) 
and early neonatal deaths within the first 7 days of life (instead of 28 days) in calculating the perinatal mortality rate. 
This rate for international comparison for South Australia for 2014 was 2.2 per 1,000 births, with an early neonatal 
mortality rate of 0.4 per 1,000 live births. 

Pregnancy Outcome in South Australia 2014page 12

Executive Summary



I. Introduction
This report summarises the statistics for 2014 from the South Australian Perinatal Statistics Collection and the South 
Australian Abortion Statistics Collection, both of which are held in the Pregnancy Outcome Unit. Some definitions 
used by the Unit are provided in Appendix 1. Guidelines1 listing definitions are issued to all South Australian obstetric 
units to promote the uniform completion of forms.

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

Information on congenital abnormalities detected at birth or in the neonatal period (within 28 days of birth) is 
provided by doctors using the Congenital Abnormality Form (Appendix 3). Few statistics on birth defects are included 
in this report as these are reported annually by the South Australian Birth Defects Register at the Women s and 
Children s Hospital.2 this Register collects statistics on birth defects up to the child s fifth birthday in addition to those 
noted at birth. 

Perinatal data are provided under legislation, the South Australian Health Care Regulations 2008, Part 5 Pregnancy 
outcome data and statistics. The South Australian Perinatal Statistics Collection includes all births occurring in South 
Australia, including those to women who normally reside interstate. Births of South Australian residents which occur 
in other states are not included. The perinatal data have been collected since 1981, but there have been changes in 
the data items collected over the years. 

Perinatal death certificates are obtained from the Births, Deaths and Marriages Registration Division, chromosome 
analysis reports from the Genetics and Molecular Pathology Directorate at Women s and Children s Hospital, autopsy 
reports from pathology departments and Coroner s autopsy reports and findings from the Coroner s Office. These are 
linked with the SBRs to provide more complete information on births and deaths. All maternal, perinatal and infant 
deaths in the state are reviewed by the Maternal, Perinatal and Infant Mortality Committee and details of these are 
reported in the annual report of the Committee entitled  Maternal, Perinatal and Infant Mortality in South Australia 
2014. 3 

2. The Abortion Statistics Collection
Notifications made by doctors of medical terminations of pregnancy under the Criminal Law Consolidation (Medical 
Termination of Pregnancy) Regulations 2012, are included in this collection. This Collection commenced in 1970, 
when specific abortion legislation was introduced under the Criminal Law Consolidation Act. Termination of 
pregnancy became legal in the state if performed in a prescribed hospital by a medical practitioner for a woman 
who has been resident at least two months in the state. The practitioner and another medical practitioner must have 
examined the woman and formed the opinion that the continuation of the pregnancy would involve greater risk to 
her life or greater risk of injury to her physical or mental health than if the pregnancy were terminated; or that there 
is a substantial risk that if the pregnancy were not terminated and the child were born, the child would suffer from 
such physical or mental abnormalities as to be seriously handicapped. A termination may not be performed on a 
woman who is pregnant with a child  capable of being born alive  unless it is performed to save the woman s life. 
The legislation states that evidence that a woman has been pregnant for a period of 28 weeks or more is prima facie 
proof that she was pregnant with a child that was capable of being born alive. 

Pregnancy Outcome in South Australia 2014 page  13

Introduction



II. Mothers and Babies: Characteristics &amp; Outcomes
The births in 2014 in South Australia described in this report include live births, stillbirths and terminations of 
pregnancy of at least 400g birthweight or 20 weeks gestation. Sixty births of less than 400g birthweight have been 
included, consisting of 49 stillbirths and 11 live births. The 11 live births were born at 20-28 weeks gestation and all 
died in the neonatal period. SBRs were received for all 20,749 births reported by hospital and home birth midwives 
in their monthly notification lists. These comprised 20,604 live births and 145 stillbirths. The number of women who 
gave birth was 20,448 (523 more women than in 2013). Findings relating to Aboriginal women and babies in the 
text of this report have been italicised for easy identification, in accordance with the request of the Aboriginal Health 
Council of South Australia.

1. Place of residence of mother
This table uses the ABS Statistical Geographical Boundaries (ASGS 2014), with SA4 boundaries for the four Adelaide 
Metropolitan Regions, and SA3 boundaries to present the nine non-metropolitan components in South Australia.  
The distribution of births according to the mother s place of residence by these Regions is provided in Table 1 together 
with the estimated resident population and crude birth rate. The crude birth rate in 2014 for South Australia was 12.2 
per 1,000 population. It was lowest in the Fleurieu   Kangaroo Island, and Yorke Peninsula regions. It was highest in 
the Adelaide - North Region and was also high in Eyre Peninsula, South West, and Outback   North and East Regions.

Table 1: Births and crude birth rate by ABS Statistical Geographical Boundaries (ASGS 2014) regions,  
South Australia, 2014

ASGS 2014 
(Mother s residence)

Total births Live births
Estimated resident 

population, June 
30, 2014+

Crude birth 
rate per 1,000 

population
Number Percent Number Number

Adelaide - Central and Hills 2,893 13.9 2,876 295,327 9.7

Adelaide - North 6,299 30.4 6,265 418,797 15.0

Adelaide - South 4,305 20.7 4,275 358,924 11.9

Adelaide - West 2,793 13.5 2,775 231,583 12.0

Barossa 387 1.9 384 34,666 11.1

Lower North 233 1.1 233 22,632 10.3

Mid North 326 1.6 322 27,494 11.7

Yorke Peninsula 239 1.2 234 25,022 9.4

Eyre Peninsula and South West 807 3.9 800 58,555 13.7

Outback - North and East 375 1.8 371 29,479 12.6

Fleurieu - Kangaroo Island 408 2.0 406 49,287 8.2

Limestone Coast 805 3.9 794 64,913 12.2

Murray and Mallee 748 3.6 744 69,035 10.8

Interstate 131 0.6 125 na na

Total 20,749 100.0 20,604 1,685,714 12.2

+ Australian Bureau of Statistics. Population estimates by age and sex, South Australia, 2014. Canberra: ABS, 2014  
(Catalogue No 3235.0). 

na: not applicable  

Pregnancy Outcome in South Australia 2014page 14

Mothers and Babies



2. Place of birth of baby
Of the 20,749 births in 2014, 102 (0.5%) were home births and of those, 96 were planned homebirths.  
The remaining 20,647 births occurred in hospitals or in 90 cases, before arrival at hospitals into which the women  
had been booked. These 90  Born Before Arrival (BBA) births have been included in the statistics for those hospitals. 
The distribution of births by place of birth (home or hospital) and plurality is provided in Table 2. Locations of  
South Australian hospitals with obstetric beds in 2014 are provided in Figures 1a and 1b.

Table 2: Total births notified in 2014, by place of birth and plurality, South Australia 

Condition at 
birth

Home births Hospital births
Total

Singleton Twin Singleton Twin Triplet

Live birth 102 - 19,920 561 21 20,604

Stillbirth 0 - 132 13 0 145

Total births 102 - 20,052 574 21 20,749

Of the 20,647 hospital births, 80.9% occurred in metropolitan hospitals (teaching and private) and 19.1% in country 
hospitals. This distribution is summarised in Table 3a and Figure 2. Table 3b provides the numbers of births and 
women by race in individual hospitals. Metropolitan hospitals are listed in order of number of births and country 
hospitals in alphabetical order within their Perinatal Service Delineation and category of number of births. Fifty-eight 
percent of hospital births in South Australia in 2014 occurred in metropolitan teaching hospitals. Maternity and 
neonatal services at SA hospitals are delineated according to six levels of service, as defined in the policy,  Standards 
for Maternal and Neonatal Services in SA, 2010 .4  The Women s and Children s Hospital is defined as providing Level 
5 maternity services and Level 6 neonatal services, as it provides a high risk pregnancy service and neonatal intensive 
care, but has no maternity intensive care facility on site. The Lyell McEwin Hospital provides Level 6 maternity services 
and Level 5 neonatal services with maternity intensive care services and special care neonatal services. Flinders Medical 
Centre provides Level 6 maternity and neonatal services with both maternity and neonatal intensive care services. All 
the metropolitan private maternity hospitals have special care nurseries, as do Mt Gambier and Port Augusta hospitals. 

Compared with 2013, the total number of births increased overall at the three metropolitan teaching hospitals. 
The total number of births in metropolitan private hospitals also increased, births increasing at Ashford and Calvary, 
remaining stable at North Eastern Community and decreasing marginally at Burnside and Flinders Private.

The total number of births in country hospitals increased slightly. In the Level 4:4 country centres, there were 
increased births at both Mount Gambier and Port Augusta. Decreases occurred at the majority of hospitals with 
more than 100 births per year (ie. Gawler Health Service, Barossa Health (Tanunda), Murray Bridge, Naracoorte, the 
Northern Yorke Peninsula Regional Health Service (Wallaroo) and Whyalla). Number of births remained stable at 
Riverland General Hospital (Berri), and increases were seen at Mount Barker, Port Lincoln, Port Pirie and South Coast 
District (Victor Harbor). At smaller country centres with &lt;100 births per year, numbers increased at Kangaroo Island, 
Mid North Health (Jamestown) and Southern Flinders Health (Crystal Brook). A decrease in birth numbers occurred at 
Kapunda, Loxton, Millicent and Waikerie. Numbers remained relatively constant at Ceduna and Lower North Health 
Centre (Clare).

Pregnancy Outcome in South Australia 2014 page  15

Mothers and Babies



Figure 1a: South Australian hospitals with obstetric beds in 2014

Pregnancy Outcome in South Australia 2014page 16

Mothers and Babies



Figure 1b: Hospitals with obstetric beds in 2014, Central Region of SA 2014 

Pregnancy Outcome in South Australia 2014 page  17

Mothers and Babies



Table 3a: Hospital births by Perinatal Service Delineation, South Australia, 2014

Hospital category Number of births Percent hospital births

Metropolitan teaching 12,034 58.3

   Women s &amp; Children s Hospital   (W&amp;CH) (4,863) (23.6)

   Flinders Medical Centre (FMC) (3,632) (17.6)

   Lyell McEwin Hospital (LMH) (3,538) (17.1)

Metropolitan private 4,659 22.6

Country 3,954 19.1

   Level 4:4 (951) 4.6

   Level 3:3&gt;100 births  per annum (2,571) 12.5

   Level 3:3&lt;100 births per annum (421) 2.0

   Other Country (11) 0.0

Total 20,647 100.0

Figure 2: Distribution of hospital births by hospital category, South Australia, 2014 (n=20,647)

b

17.6%

0 10 20 30 40 50 60 70

Percentage of hospital births

19.1%

22.6%

58.3%

a Ashford 7.4%
b Burnside 5.5%
c Calvary 4.0%
d Flinders Private 2.4%
e North Eastern Community 3.3%

r Mt Gambier 2.9%
s Port Augusta 1.7%
t Gawler 2.6%
u Mount Barker 2.2%
v Port Lincoln 1.5%
w Murray Bridge 1.0%
x Whyalla 
y Other country hospitals with &gt;100 births per year 4.0%
z Hospitals with &lt;100 births per year 2.1%

W&amp;CH LMHFMC

e

u v w

23.6% 17.1%

a c

r s x y zt

d

Pregnancy Outcome in South Australia 2014page 18

Mothers and Babies



Table 3b: Hospital births in South Australia in 2014 by race and hospital*

Hospital Caucasian Aboriginal Asian Other
Total 

births

Total number 
of women who 

gave birth

Metropolitan teaching

Women s &amp; Children s Hospital (W&amp;CH) 2,830 202 1,307 524 4,863 4,734

Lyell McEwin Hospital (LMH) 2,583 143 497 409 3,632 3,594

Flinders Medical Centre (FMC) 2,802 101 381 254 3,538 3,486

The Queen Elizabeth Hospital (TQEH) 0 0 0 1 1 1

Total 8,215 446 2,185 1,188 12,034 11,815

Metropolitan private

Ashford 1,353 5 130 30 1,518 1,496

Burnside War Memorial (BWMH) 1,034 1 94 17 1,146 1,128

Calvary 732 2 63 20 817 803

Flinders Private 446 0 31 13 490 484

North Eastern Community (NECH) 637 1 34 16 688 683

Total 4,202 9 352 96 4,659 4,594

Country

Level 4:4* Country 

Mt. Gambier 539 21 20 21 601 592

Pt Augusta 231 98 9 12 350 344

Subtotal 770 119 29 33 951 936

Level 3:3* Country ?100 births

Barossa Health (Tanunda Centre) 101 0 2 0 103 103

Gawler Health Service  515 13 12 5 545 545

Mt. Barker 420 7 13 13 453 453

Murray Bridge Soldiers  Memorial 169 16 16 12 213 213

Naracoorte 135 3 15 4 157 156

Northern Yorke Peninsula Regional 
Health Service (Wallaroo)

106 6 4 4 120 120

Pt. Lincoln 281 24 11 2 318 120

Pt. Pirie 138 16 4 2 160 318

Riverland Regional (Berri) 134 14 14 8 170 160

South Coast District  (Victor Harbor) 92 0 5 3 100 170

Whyalla 197 22 7 6 232 232

Subtotal 2,288 121 103 59 2,571 2,570

* Perinatal Service Delineation   see text for further explanation.

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

Pregnancy Outcome in South Australia 2014 page  19

Mothers and Babies



Table 3b continued

Hospital Caucasian Aboriginal Asian Other
Total 

births
Total women 

who gave birth 

Level 3:3* Country &lt;100 births

1-99 births per annum

Ceduna 27 11 2 2 42 42

Kangaroo Island 35 2 3 0 40 40

Kapunda 33 1 0 0 34 34

Lower North Health Centre (Clare) 79 1 1 0 81 81

Loxton 86 3 0 0 89 89

Mid North Health (Jamestown) 48 3 0 0 51 51

Southern Flinders Health Service 
(Crystal Brook)

38 2 0 0 40 40

Waikerie 38 0 1 5 44 44

Subtotal 384 23 7 7 421 421

Other Country

Amata 0 1 0 0 1 1

Balaklava 1 0 0 0 1 1

Cowell District 1 0 0 0 1 1

Eastern Eyre Health (Kimba) 1 0 0 0 1 1

Millicent 3 0 0 0 3 2

Peterborough 1 0 0 0 1 1

Quorn 3 0 0 0 3 3

Subtotal 10 1 0 0 11 10

Total (country) 3,452 264 139 99 3,954 3,937

Grand total 15,869 719 2,676 1,383 20,647 20,346

* Perinatal Service Delineation   see text for further explanation

3. Maternal and baby race
The distribution of women who gave birth, by race is provided in Table 4a and also by category of birthplace in Table 
4b. In these tables and all others where distribution by race is shown,  Aboriginal  includes Aboriginal (691 women), 
Torres Strait Islander (9 women) and those who are Aboriginal and Torres Strait Islander (12 women). Aboriginal 
women accounted for 3.5% of women and gave birth mainly in metropolitan teaching hospitals and country 
hospitals. Asian women accounted for 13% of women, and gave birth mainly in metropolitan teaching hospitals, but 
13.2% gave birth in private hospitals.

For the first time in 2012, the Indigenous status of the baby was also collected independently of the mother. In 2014 
there were 947 Indigenous babies, representing 4.6% of all babies born. They comprised 917 (96.8%) Aboriginal,  
9 (1%) Torres Strait Islander and 21 (2.2%) Aboriginal and Torres Strait Islander.

Pregnancy Outcome in South Australia 2014page 20

Mothers and Babies



Table 4a: Race of women who gave birth, South Australia, 2014

Race Number of women % Women

Caucasian 15,717 76.9

Aboriginal 712 3.5

Asian 2,655 13.0

Other 1,364 6.6

Total 20,448 100.0

Table 4b: Table 4b: Race and birthplace category of women who gave birth, South Australia, 2014

Birthplace

Race of women

TotalCaucasian Aboriginal Asian Other

Number % Number % Number % Number % Number %

Metropolitan 
teaching hospital

8,042 51.2 439 61.7 2,163 81.5 1,171 85.9 11,815 57.8

Metropolitan  
private hospital

4,142 26.4 9 1.3 351 13.2 92 6.7 4,594 22.5

Country hospital 3,436 21.9 263 36.9 139 5.2 99 7.3 3,937 19.2

Home 97 0.6 1 0.1 2 0.1 1 0.1 102 0.5

Total 15,717 (76.9) 712 (3.5) 2,655 (13.0) 1,364 (6.6) 20,448 100.0

4. Maternal age
Among the five-year age groups, the largest number of women who gave birth was in the 30-34 years age group 
(Table 4c). The proportion of women in this age group (34%) has exceeded that of the 25-29 years age group 
(28.6%) since 2001.  Teenage women accounted for 3.1% of women who gave birth and older women aged 35 
years or more accounted for 20.6% (Table 4c and Figure 3). Aboriginal women were generally younger than non-
Aboriginal women: 15% were teenagers and only 9% were 35 years or older. Among Asian women, on the other 
hand, only 0.3% were teenagers but 19.4% were 35 years or older. 

The age-specific fertility rates have increased in 30-34, 35-39 and 40+age groups. The fertility rates decreased in the 
15-19, 20-24 and 25-29 groups, when compared with 2013 (Table 4d). The rate was highest in the age group 30-34 
years (125.7 per 1,000 women), followed by the 25-29 years age group (100.9per 1,000 women). The general fertility 
rate (see Appendix 1) was 61.3 per 1,000 women aged 15-44 years down from 61.7 in 2013. The total fertility rate 
(see Appendix 1) was 1.83 live births per woman, lower than 2013 which at 1.85 was the same as 2010, but still 
below replacement level (2.1).

Pregnancy Outcome in South Australia 2014 page  21

Mothers and Babies



Table 4c: Age and race of women who gave birth, South Australia, 2014

Age  
(years)

Caucasian Aboriginal Asian Other Total

Number % Number % Number % Number % Number %

&lt;15 1 0.0 1 0.1 0 0.0 0 0.0 2 0.0

15-19 485 3.1 106 14.9 8 0.3 33 2.4 632 3.1

20-24 2,261 13.7 214 30.1 181 6.8 203 14.9 2,759 13.5

25-29 4,426 28.2 209 29.4 809 30.5 427 31.3 5,871 28.7

30-34 5,323 33.9 118 16.6 1,091 41.1 439 32.2 6,971 34.1

35-39 2,678 17.0 55 7.7 467 17.6 212 15.5 3,412 16.7

40-44 610 3.9 9 1.3 92 3.5 48 3.5 759 3.7

45+ 33 0.2 0 0.0 7 0.3 2 0.1 42 0.2

Total 15,717 (76.9) 712 (3.5) 2,655 (13.0) 1,364 (6.7) 20,448 100.0

Figure 3: Age and race of women who gave birth, 2014 (n=20,448)

0%

20%

40%

60%

80%

100%

Caucasian 
n=15,717

Aboriginal
n=712

Asian
n=2,655

Other
n=1,364

Total
n=20,448

Pe
rc

en
ta

g
e 

o
f 

w
o

m
en

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

Pregnancy Outcome in South Australia 2014page 22

Mothers and Babies



Table 4d: Age  specific fertility rates (ASFR), South Australia, 2014

Age 
(years) Number of live births

Estimated resident  
female population*

Age-specific fertility rate per  
1,000 women (ASFR) 

&lt;15 2 na na

15-19 630 58,613 # 11.8

20-24 2,771 58,816 47.1

25-29 5,898 58,902 100.1

30-34 7,042 56,023 125.7

35-39 3,453 51,536 67.0

40-44 760 56,995 # 14.1

45+ 44

Total 20,600 340,885 60.4

* Australian Bureau of Statistics. Population Estimates by Age and Sex, South Australia 2014.Canberra: ABS, 2014 (Catalogue No 3235.0).

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

    Sum of 5-year ASFRs = 365.8 per 1,000 women. Total fertility rate = 365.8 x 5 = 1,829.2 live births per 1,000 women =1.83 live births per woman.

5. Country of birth
The distribution of women by country of birth is provided in Table 5a by major group, and in Table 5b by specified 
countries of birth that had 40 or more women who gave birth. Of the 25.8% of women born outside Australia, the 
largest proportion was born in India (4% of women). Other countries contributing relatively large proportions of 
migrant women were the China (2.7%), United Kingdom and Ireland (2.4%), Vietnam (1.4%) the Philippines (1%), 
New Zealand (1%), Sudan (0.8%), Afghanistan (0.8%), Iran, Malaysia, Pakistan (0.6%each), Cambodia, Nepal,  
Sri Lanka, South Africa and Thailand  (0.4% each), Bangladesh, Congo, Indonesia, Japan, Myanmar (Burma),  
South Korea and the United States of America (0.3% each), and Burundi, Canada, Germany, Iraq and Poland. 

Table 5a: Country of birth, major groups,* women who gave birth, South Australia, 2014

Country of birth Number %

1 Oceania and Antarctica 15,405 75.3

2 Europe and the USSR 911 4.5

3 The Middle East and North Africa 497 2.4

4 Southeast Asia 936 4.6

5 Northeast Asia 752 3.7

6 Southern Asia 1,320 6.4

7 Northern America 103 0.5

8 South America, Central America and the Caribbean 117 0.6

9 Africa (excluding North Africa) 405 2.0

Unknown 2 0.0

Total 20,448 100.0

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

Pregnancy Outcome in South Australia 2014 page  23

Mothers and Babies



Table 5b: Specified country of birth,* women who gave birth, South Australia, 2014

Specified country of birth Number % of women % of migrant women who gave birth (n=5,279)

1100 Australia 15,169 74.2

6104 India 809 4.0 15.3

5101 China 551 2.7 10.4

2101 UK/Ireland 486 2.4 9.2

4110 Vietnam 285 1.4 5.4

4107 Phillipines 208 1.0 3.9

1301 New Zealand 195 1.0 3.7

3207 Sudan 165 0.8 3.1

6101 Afghanistan 154 0.8 2.9

3103 Iran 126 0.6 2.4

6107 Pakistan 116 0.6 2.2

4105 Malaysia 115 0.6 2.2

9220 South Africa 86 0.4 1.6

4102 Cambodia 85 0.4 1.6

6108 Sri Lanka 85 0.4 1.6

4109 Thailand 77 0.4 1.5

6106 Nepal 72 0.4 1.4

4103 Indonesia 67 0.3 1.3

5103 Japan 67 0.3 1.3

5105 South Korea 67 0.3 1.3

7104 USA 65 0.3 1.2

6102 Bangladesh 64 0.3 1.2

4106 Myanmar (Burma) 64 0.3 1.2

9106 Congo 54 0.3 1.0

2305 Germany 50 0.2 0.9

2504 Poland 49 0.2 0.9

9114 Liberia 45 0.2 0.9

3104 Iraq 43 0.2 0.8

3111 Saudi Arabia 43 0.2 0.8

2212 Yugoslavia 41 0.2 0.8

All other countries 943 4.6 17.9

Unknown 2 0.0 0.0

Total 20,448 100.0 100.0

* ASCCSS, Australian Bureau of Statistics

Pregnancy Outcome in South Australia 2014page 24

Mothers and Babies



6. Marital status and type of patient
While 91.1% women who gave birth in 2014 were married or in a de facto relationship, 8.9% were single (7.8% 
were never married and 1.1% were widowed, separated or divorced, Table 6a). Of never married women, a fifth were 
teenagers and a third were in their early twenties. Relatively more single women were hospital/public patients than 
married women and women in de facto relationships (93% v 71.5%, Table 6b). Almost 27 percent (26.6%) of all 
women were private patients.

Table 6a: Marital status and age, women who gave birth, South Australia, 2014

Age 
(years)

Marital status of women

TotalNever married Married/de facto
Widowed/ 

separated /divorced Unknown

Number % Number % Number % Number % Number %

&lt;20 305 19.1 326 1.8 3 1.4 0 0.0 634 3.1

20-24 489 30.6 2,232 12.0 38 17.4 0 0.0 2,759 13.5

25-29 353 22.1 5,461 29.3 54 24.8 3 25.0 5,871 28.7

30-34 283 17.7 6,610 35.5 71 32.6 7 58.3 6,971 34.1

35-39 134 8.4 3,239 17.4 38 17.4 1 8.3 3,412 16.7

40-44 35 2.2 710 3.8 13 6.0 1 8.3 759 3.7

45+ 1 0.1 40 0.2 1 0.5 0 0.0 42 0.2

Total 1,600 (7.8) 18,618 (91.1) 218 (1.1) 12 (0.1) 20,448 100.0

Table 6b: Type of patient and marital status, women who gave birth, South Australia, 2014

Type of  
patient

Marital status of women

TotalNever married Married/ de facto
Widowed/ 

separated/ divorced Unknown

Number % Number % Number % Number % Number %

Hospital/
public

1,488 93.0 13,316 71.5 204 93.6 11 91.7 15,019 73.4

Private 112 7.0 5,302 28.5 14 6.4 1 8.3 5,429 26.6

Total 1,600 (7.8) 18,618 (91.1) 218 (1.1) 12 (0.1) 20,448 100.0

Pregnancy Outcome in South Australia 2014 page  25

Mothers and Babies



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

A much larger proportion of mothers than fathers (24.1 versus 0.5%) were included in the occupation  home duties . 
Larger proportions were also found for the groups of clerks and salespeople and personal service workers. More 
fathers were managers and administrators, tradespeople, plant and machine operators and labourers. Occupation was 
unknown for 9.6% of fathers and 3.7% of mothers.

Table 7: Occupation* of father and mother, women who gave birth, South Australia, 2014

Occupation

Father Mother

Number % Number %

1 Managers and administrators 2,998 14.7 1,584 7.7

2 Professionals 3,161 15.5 3,457 16.9

3 Para professionals 1,185 5.8 1,521 7.4

4 Tradespersons 3,536 17.3 590 2.9

5 Clerks 464 2.3 2,034 9.9

6 Salespersons and personal service workers 1,239 6.1 2,952 14.4

7 Plant and machine operators and drivers 1,163 5.7 59 0.3

8 Labourers and related workers 2,441 11.9 505 2.5

9 Students 594 2.9 850 4.2

Pensioners 94 0.5 53 0.3

Home duties 110 0.5 4,922 24.1

Unemployed 1,058 5.2 859 4.2

Other 449 2.2 312 1.5

Unknown 1,956 9.6 750 3.7

Total 20,448 100.0 20,448 100.0

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

Pregnancy Outcome in South Australia 2014page 26

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8. Previous pregnancy outcomes
Forty-two percent of women had no previous birth and 30.6% were pregnant for the first time. Among Aboriginal 
women and those of  other  races, these proportions were lower, with 29.2% and 36.7% respectively giving birth for 
the first time. The proportion of women giving birth for the first time was the highest among Asian women (48.6%). 

The proportion of women of parity 4 or greater was much higher among Aboriginal women (13.5%) and women of 
 other  races (11%), than among Caucasian women (2.8%) and Asian women (1.2%) (Table 8a).

Table 8a: Parity by race, women who gave birth, South Australia, 2014

Parity

Race of women

TotalCaucasian Aboriginal Asian Other

Number % Number % Number % Number % Number %

0-primigravida 4,793 30.5 147 20.6 943 35.5 372 27.3 6,255 30.6

0-multigravida 1,742 11.1 61 8.6 349 13.1 128 9.4 2,280 11.2

1 5,686 36.2 192 27.0 995 37.5 396 29.0 7,269 35.5

2 2,278 14.5 124 17.4 271 10.2 211 15.5 2,884 14.1

3 769 4.9 92 12.9 65 2.4 106 7.8 1,032 5.0

4 257 1.6 42 5.9 19 0.7 74 5.4 392 1.9

?5 192 1.2 54 7.6 13 0.5 77 5.6 336 1.6

Total 15,717 76.9 712 3.5 2,655 13.0 1,364 6.7 20,448 100.0

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

Table 8b: Previous pregnancy outcomes, women who gave birth, South Australia, 2014  
(multigravidae only, n= 14,193)

Previous pregnancy outcome Number %

Miscarriage 4,959 34.9

Termination of pregnancy 2,860 20.2

Stillbirth 204 1.4

Neonatal death 73 0.5

Ectopic pregnancy 349 2.5

Of the 11,913 women who had previously given birth, 3,635 (30.5%) had a previous caesarean section.

Pregnancy Outcome in South Australia 2014 page  27

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9a. Gestation at first antenatal visit
In 2014 gestation at the first antenatal visit was reported as  unknown  for 5.5% of women (Table 9a). If these 
women with an unknown number of visits are excluded, among the remaining women, 78.8% attended within 
the first 14 weeks. This proportion was much lower for Aboriginal women (54.7%) than for non-Aboriginal women 
(79.7%).

Table 9a: Gestation at first antenatal visit, women who gave birth, by race, South Australia, 2014 (n=20,448)

Gestation 
at first 
antenatal 
visit

Race of women

TotalNon-Aboriginal Aboriginal

Number %

Adjusted % 
(excluding 

 unknown ) 
(n=18,667)

Number %

Adjusted % 
(excluding 

 unknown ) 
(n=662)

Number %

Adjusted % 
(excluding 

 unknown ) 
(n=19,329)

&lt;14 weeks 
gestation

14,877 75.4 79.7 362 50.8 54.7 15,239 74.5 78.8

14 weeks or 
greater*

3,790 19.2 20.3 300 42.1 45.3 4,090 20.0 21.2

Unknown 1,069 5.4 50 7.0 1,119 5.5

Total 19,736 96.5 100.0 712 3.5 100.0 20,448 100.0 100.0

*includes 48 women with no antenatal care

 
9b. Body Mass Index (BMI)
Reported height and weight at the first antenatal visit were used to calculate the Body Mass Index (BMI, see Appendix 
1) for women who gave birth. This was considered valid only for women who attended the first antenatal visit before 
20 weeks gestation. Among these 18,425 women (90.1% of all women who gave birth), height and weight were not 
reported for 1,227 women (6.7%). Therefore BMI could only be calculated for 17,198 women who gave birth in 2014 
(84%). Table 9b shows that 8,984 women recorded a BMI &gt;=25.0 (44% of all women giving birth), 4,205 (20.6%) 
had a BMI &gt;=30.0, and 1,728 (8.5%) had a BMI &gt;=35.0.

Table 9b: BMI of women who gave birth, South Australia, 2014

BMI 

(based on height and weight  
at first antenatal visit where gestation 
at first  antenatal visit was &lt;20 weeks)

Number %
Adjusted %  

(excluding  unknown ) 
(n=17,198)

&lt;18.5 (underweight) 461 2.5 2.7

18.5   24.9 (normal) 7,753 42.1 45.1

25.0   29.9 (overweight) 4,779 25.9 27.8

30.0   34.9 (obese) 2,477 13.4 14.4

35.0   39.9 (severely obese) 1,060 5.8 6.2

40 or more (morbidly obese) 668 3.6 3.9

Unknown 1,227 6.7

Total 18,425 100.0

Pregnancy Outcome in South Australia 2014page 28

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9c. Antenatal visits
Women who gave birth are grouped in Table 9c according to the number of reported antenatal visits: no visits, 1 - 6 
visits and 7 or more visits. However, for 4.6% of women (7.3% of Aboriginal women), the number of antenatal visits 
attended was not reported. If women for whom the number of antenatal visits was not reported are excluded, 69.4% 
of Aboriginal women compared with 91.2% of non-Aboriginal women were reported to have made seven or more 
visits. A low frequency of antenatal visits may be taken, particularly in term births, as an indication of inadequate 
antenatal care. Although the exact number of antenatal visits was reported for 19,516 (95.4%) women, 20,400 
(99.8%) women report having attended at least one antenatal visit.

Table 9c: Antenatal visits by race, women who gave birth, South Australia, 2014

Antenatal  
visits

Race of women

TotalCaucasian Aboriginal Asian Other

Number % Number % Number % Number % Number %

None 23 0.1 18 2.5 4 0.2 3 0.2 48 0.2

1-6 1,135 7.2 184 25.8 291 11.0 196 14.4 1,806 8.8

?7 13,875 88.3 458 64.3 2,232 84.1 1,097 80.4 17,662 86.4

Unknown 
number of 
visits 

684 4.4 52 7.3 128 4.8 68 5.0 932 4.6

Total 15,717 (76.9) 712 (3.5) 2,655 (13.0) 1,364 (6.7) 20,448 100.0

9d. Type of antenatal care
In 2012 the types of antenatal care collected were updated to better reflect current obstetric practice. Table 9d shows 
that the main types of antenatal care used were public hospital clinic (Specialist led) (42.8%), Obstetricians  +/- 
midwife in private practice (26.5%), General Practitioners and public hospital (shared care) (12.6%), Midwifery group 
practice at birth hospital (12%) and General Practice led (8.6%). Individual women may have used more than one 
type of antenatal care. There were 48 women (0.2%) who had no antenatal care.

Table 9d: Type of antenatal care, women who gave birth, South Australia, 2014 (n = 20,448)

Type of care Number %

No care 48 0.2

Midwifery group practice at birth hospital 2,446 12.0

Birth Unit/Centre 1,080 5.3

Public clinic (Specialist led) 8,746 42.8

GP and public hospital (shared care) 2,581 12.6

GP led 1,763 8.6

Obstetrician +/- midwife in private practice 5,419 26.5

Eligible midwife in private practice 73 0.4

Aboriginal Family Birthing Program (includes metropolitan  
and rural locations)

212 1.0

Other 15 0.1

Not stated 11 0.1

Pregnancy Outcome in South Australia 2014 page  29

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10. Smoking
Table 10a shows that 10.1% of all women were reported to be smokers at their first antenatal visit, and 2.8% had 
quit smoking before their first visit.  Smoking status was unknown for 0.8% of women. The proportion of all women 
smoking during pregnancy has been declining in the state, from 25% in 1998 to 10.1% in 2014. 

The proportion of Aboriginal women who reported that they smoked at the first antenatal visit was (44.4%) down 
slightly from 2013 (45%). However, this was considerably higher than non-Aboriginal women (8.8%). Additionally, 
4.9% of Aboriginal women reported that they quit smoking in pregnancy prior to their first antenatal visit, compared 
with 2.7% of non-Aboriginal women. 

The highest rates of smoking were among teenagers (29.7%) and women aged 20-24 years (18.4%). Smoking rates 
were high among all age groups of Aboriginal women varying from 36.4% among teenage women to 43% among 
those aged 20-24 years. 

In the second half of pregnancy (Table 10b), 8.9% of women (1,828 women) were reported to be smokers and 0.2% 
(51 women) smoked more than 20 cigarettes per day, but the number of cigarettes smoked or whether the woman 
smoked in the second half of pregnancy was not known for 1.4% of women. In the second half of pregnancy, 40.4% 
of Aboriginal women smoked, compared with 7.8% of non-Aboriginal women. A higher proportion of Aboriginal 
women (1.5% compared with 0.2%) also smoked more than 20 cigarettes per day, but the number of cigarettes 
smoked was not known for 4.2% of Aboriginal women and 1.3% of non-Aboriginal women.

Table 10a: Tobacco smoking status at first antenatal visit, non-Aboriginal and Aboriginal women who gave 
birth, South Australia, 2014

Smoking status

Non-Aboriginal Aboriginal Total

Number % Number % Number %

Smoker 1,746 8.8 316 44.4 2,062 10.1

Quit before 1st visit 537 2.7 35 4.9 572 2.8

Non-smoker 17,294 87.6 352 49.4 17,646 86.3

Unknown smoking status 159 0.8 9 1.3 168 0.8

Total 19,736 96.5 712 3.5 20,448 100.0

Table 10b: Average number of tobacco cigarettes smoked per day in the second half of pregnancy, non-
Aboriginal and Aboriginal women who gave birth, South Australia, 2014

Average number of tobacco 
cigarettes smoked per day

Non-Aboriginal Aboriginal Total

Number % Number % Number %

None 17,947 90.9 394 55.3 18,341 89.7

Occasional (&lt;1) 31 0.2 5 0.7 36 0.2

1-10 1,138 5.8 211 29.6 1,349 6.6

11-20 331 1.7 61 8.6 392 1.9

21-30 34 0.2 10 1.4 44 0.2

31-40 6 0.0 0 0.0 6 0.0

41+ 0 0.0 1 0.1 1 0.0

Unknown 249 1.3 30 4.2 279 1.4

Total 19,736 96.5 712 3.5 20,448 100.0

Pregnancy Outcome in South Australia 2014page 30

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11. Medical conditions
Medical conditions were recorded in the current pregnancy for 8,237 women (40.3%). The frequencies of specified 
medical conditions are provided in Table 11. Up to four conditions can be reported for each pregnancy.

Table 11: Medical conditions in current pregnancy, women who gave birth, South Australia, 2014

Medical condition Number % of women (n = 20,448)

1 None 12,211 59.7

2 Anaemia 1,335 6.5

3 Urinary tract infection 429 2.1

4 Hypertension (pre-existing) 221 1.1

5 Diabetes (pre-existing) 182 0.9

6 Epilepsy 115 0.6

7 Asthma 1,470 7.2

8 Other 6,183 30.2

12. Obstetric complications
Obstetric complications were recorded for 8,058 women who gave birth (39.4%). The reported frequencies of the 
more common complications are presented in Table 12. Up to four complications can be reported for each pregnancy.

There were no maternal deaths notified to the Maternal, Perinatal and Infant Mortality Committee in 2014.

Table 12: Frequency of some obstetric complications, women who gave birth, South Australia, 2014

Obstetric complication Number % of women  (n= 20,448)

No complication 12,390 60.6

Threatened miscarriage 214 1.0

Antepartum haemorrhage (APH) - Abruption 107 0.5

APH - Placenta praevia 117 0.6

APH   Other &amp; unknown causes 429 2.1

Pregnancy hypertension 1,428 7.0

Intrauterine growth restriction (suspected) 964 4.7

Gestational diabetes 1,887 9.2

Other complications including 26 women with impaired 
glucose tolerance 4,730 23.1

Pregnancy Outcome in South Australia 2014 page  31

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13. Procedures performed in current pregnancy
In 2012 procedures performed in the current pregnancy that are collected on the Supplementary Birth Record 
were updated to better reflect current obstetric practice, and are presented in Table 13. At least one ultrasound 
examination was performed for 97.5% of women, amniocentesis for 2.5% and chorion villus sampling for 0.6%.

For a proportion of women, it was not known whether a specific procedure had been performed, eg 1.7% for a first 
trimester screen and 1.7% for a second trimester screen. It is hoped that the increasing use of the Pregnancy Record 
will continue to reduce the number of  unknown  entries.

Table 13: Procedures performed in current pregnancy, women who gave birth, South Australia, 2014

Procedure
Yes No Unknown

Number % Number % Number %

First trimester anomaly screen  
(Ultrasound &amp; biochem) 14,174 69.3 5,935 29.0 339 1.7

Second trimester anomaly screen  
(biochem only) 2,681 13.1 17,428 85.2 339 1.7

Ultrasound dating scan 11,504 56.3 7,367 36.0 1,577 7.7

Ultrasound morphology scan 17,846 87.3 2,323 11.4 279 1.4

Other ultrasound scan 8,192 40.1 11,887 58.1 369 1.8

Amniocentesis 508 2.5 19,739 96.5 201 1.0

Chorion villus biopsy 127 0.6 20,121 98.4 200 1.0

Antenatal fetal blood sampling 11 0.1 20,239 99.0 198 1.0

Other surgical procedure 97 0.5 20,351 99.5 0 0.0

14a. Onset of labour
Labour occurred spontaneously in 48.9% of women who gave birth (Table 14a).  It was induced in 32.2%, and the 
methods of induction used were artificial rupture of membranes (ARM) in 71.3% of inductions, prostaglandins in 
49.3% and oxytocics in 57.9% (Table 14b).  Other  methods were used in 4.4% of inductions. In many cases more 
than one method was used.

Table 14a:  Onset of labour, women who gave birth, South Australia, 2014

Onset of labour Number %

Spontaneous 10,007 48.9

No labour   caesarean section 3,851 18.8

Induction 6,590 32.2

Total 20,448 100.0

Table 14b: Method of induction of labour, women who gave birth, South Australia, 2014

Method of induction Number % of women (n =20,448) % of inductions (n =6,590)

No induction 13,859 67.8  

ARM 4,702 23.0 71.4

Oxytocics 3,815 18.7 57.9

Prostaglandins 3,247 15.9 49.3

Pregnancy Outcome in South Australia 2014page 32

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14b. Reasons for induction of labour
Up to two reasons could be provided for induction. These reasons for induction of labour are defined (see page 55) in 
 The Australian Council on Healthcare Standards Obstetrics Indicators - Clinical Indicator Users  Manual Version 5 for 
use in 2007 .

Figure 4 demonstrates that 15.5% of women were induced for prolonged pregnancy (41 or more completed weeks), 
13.3% for hypertension, 10.4% for diabetes (including gestational diabetes and glucose intolerance), 8% for 
intrauterine growth restriction (IUGR) and 8.8% for premature rupture of membranes (PROM). Other defined reasons 
accounted for smaller proportions. Other than defined reasons accounted for 48.1%.

Figure 4: Reasons for induction of labour, SA, 2014 (n=6,590)

The proportion of women giving birth who had labour augmented was 17.5%. Of the 10,007 women who went 
into spontaneous labour, augmentation was used for 3,579 (35.8%). Methods used in augmentation were artificial 
rupture of membranes (ARM) (72.1%), oxytocics (42.6%) and prostaglandins (1.0%). More than one method may be 
used. It should be noted that prostaglandins are not recommended by the manufacturers as a method of augmenting 
labour. 

Table 14c:  Augmentation of labour after spontaneous onset, women who gave birth, South Australia, 2014

Method of augmentation Number % of women (n=20,448) % of augmentations (n=3,579)

Any augmentation 3,579 17.5  

1 ARM 2,582 12.6 72.1

2 Oxytocics 1,524 7.5 42.6

3 Prostaglandins 37 0.2 1.0

0 10 20 30 40 50 60

Other

Prolonged pregnancy

Chorioamnionitis

Fetal death

Fetal distress

Isoimmunisation

IUGR

Hypertensive disorders

PROM

Diabetes*

Percentage

*includes diabetes mellitus, gestational diabetes and glucose intolerance

Pregnancy Outcome in South Australia 2014 page  33

Mothers and Babies



15a. Presentation and method of birth
Of the women who gave birth, 54.1% had normal spontaneous vaginal births (Table 15a and Figure 5a). Caesarean 
section was performed for 33.9% of women, with 16.6% of women having elective sections; forceps were utilised 
for 5.3%; ventouse for 6.3% and breech birth for the remaining 0.4%. The method of birth given for women who 
had multiple births is that for the first birth. The method of birth by presentation for all births is provided in Table 15b. 
Breech presentation occurred in 4.6% of births and caesarean section was the method of birth for 89.2% of breech 
presentations. Caesarean section was utilised for 90.6% of breech presentations in singletons (Table 15c). 

Table 15a: Method of birth, women who gave birth, South Australia, 2014

Method of birth Number %

Normal spontaneous vaginal 11,071 54.1

Forceps 1,089 5.3

Assisted breech (no forceps) 16 0.1

Caesarean section (elective) 3,399 16.6

Caesarean section (emergency) 3,531 17.3

Ventouse 1,282 6.3

Breech extraction 6 0.0

Breech spontaneous 50 0.2

Assisted breech (with forceps for head) 4 0.0

Total 20,448 100.0

Figure 5a: Method of birth, women who gave birth, South Australia, 2014 (n = 20,448)

Ventouse (6.0%)

Caesarean section (33.8%)
Normal
spontaneous
vaginal (54.2%)

 
 

Breech delivery (0.4%)
Forceps (5.5%)

Pregnancy Outcome in South Australia 2014page 34

Mothers and Babies



Table 15b: Method of birth by presentation, all births, South Australian 2014 (n=20,749)

Method of 
birth

Presentation

TotalVertex Breech Other Unknown

Number % Number % Number % Number % Number %

Normal 
spontaneous 11,053 56.5 0 0.0 53 27.5 12 30.0 11,118 53.6

Forceps 1,093 5.6 0 0.0 4 2.1 1 2.5 1,098 5.3

Assisted breech 
(no forceps) 0 0.0 26 2.7 0 0.0 0 0.0 26 0.1

Elective 
caesarean 2,949 15.1 518 54.2 39 20.2 13 32.5 3,519 17.0

Emergency 
caesarean 3,186 16.3 335 35.0 90 46.6 11 27.5 3,622 17.5

Ventouse 1,279 6.5 0 0.0 4 2.1 2 5.0 1,285 6.2

Breech  
extraction 0 0.0 13 1.4 2 1.0 0 0.0 15 0.1

Breech 
spontaneous 0 0.0 59 6.2 1 0.5 1 2.5 61 0.3

Assisted breech  
(forceps) 0 0.0 5 0.5 0 0.0 0 0.0 5 0.0

Total 19,560 (94.3) 956 (4.6) 193 (0.9) 40 (0.2) 20,749 100.0

Table 15c: Method of birth in breech presentation, by plurality, all births, South Australia, 2014 (n= 956)

Plurality Assisted* breech
Elective 

caesarean
Emergency 
caesarean

Breech 
extraction

Breech 
spontaneous

Assisted Breech 
(forceps) Total

Singleton 16 431 270 5 47 4 773

Twins 10 84 61 7 12 1 175

Triplets 0 3 4 1 0 0 8

Total 26 518 335 13 59 5 956

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

Pregnancy Outcome in South Australia 2014 page  35

Mothers and Babies



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 caesarean sections only) and Figure 5d (emergency 
caesarean sections only). The main reasons given for all caesarean sections were previous caesarean section (37.3%), 
failure to progress/cephalopelvic disproportion (CPD) (26.4%), fetal distress (14.1%) and malpresentation (11.6%).
Maternal choice accounted for 2.4% (up from 1.5%in 2012 when it was first added). The main reasons for elective 
sections were previous caesarean section (65%), malpresentation (13.2%), maternal choice (3.9%) and multiple 
pregnancy (3.3%). The main reasons given for emergency sections were failure to progress or CPD (50.8%), fetal 
distress (27.5%), previous caesarean section (10.6%), malpresentation (10%) and maternal choice (1%). 

Figure 5b: Reason for caesarean section, 2014 (n=6,930) 

Figure 5c: Reason for elective caesarean section, 2014 (n=3,399)

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 

Other 

Maternal choice 

Intrauterine Growth
 Restriction (IUGR)

Multiple pregnancy 

Antepartum
 Haemorrhage (APH)

Pregnancy hypertension/
hypertension 

Malpresentation 

Fetal distress

Previous caesarean 

CPD/Failure to progress 

Percentage 

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 

Other 

Maternal choice 

IUGR 

Multiple pregnancy 

APH 

Pregnancy hypertension/
hypertension

Malpresentation 

Fetal distress 

Previous caesarean 

CPD 

Percentage 

Pregnancy Outcome in South Australia 2014page 36

Mothers and Babies



Figure 5d: Reason for emergency caesarean section, 2014 (n=3,531) 

16. Complications of labour and birth and perineal status after birth
Complications of labour or birth were recorded for 7,706 women who gave birth (37.7%).  Up to four complications 
can be recorded. The reported frequency of some complications is presented in Table 16. Among all 20,448 women 
who gave birth, episiotomy was performed for 2,937 (14.4%). Among the 13,518 women who gave birth vaginally, 
3,582 (26.5%) had an intact perineum after birth, 5,184 (38.3%) had a repair of a perineal tear, of whom 466 (2.3%) 
had a third or a fourth degree tear; 21.7% had an episiotomy. 

Table 16: Frequency of some complications of labour and birth, women who gave birth, South Australia, 2014

Complication of labour Number of women % of women (n=20,448)

None 12,742 62.3

Postpartum Haemorrhage (PPH) - 600-999ml 1,568 7.7

PPH   1,000 ml or more 1,044 5.1

PPH   primary (amount not specified) 12 0.1

Fetal distress 2,230 10.9

Retained placenta 256 1.3

Prolonged labour 143 0.7

Cord prolapse 24 0.1

Wound infection 13 0.1

Third degree tear (391) or fourth degree tear (31) 466 2.3

Failure to progress 2,589 12.7

Other 4,957 24.2

0.0 10.0 20.0 30.0 40.0 50.0 60.0 

Other 

Maternal choice 

IUGR 

Multiple pregnancy 

APH 

Pregnancy hypertension/hypertension 

Malpresentation 

Fetal distress 

Previous caesarean 

CPD/Failure to progress 

Percentage 

Pregnancy Outcome in South Australia 2014 page  37

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17. Fetal monitoring during labour
Cardiotocography (CTG) was performed during labour for 63.1% of women who gave birth. The majority of these 
(49.8% of women) were external CTGs (Table 17a) while a scalp clip was used for 13.3%. 

A fetal scalp pH was taken during labour in 195 women who gave birth (1.0%, Table 17b).

Table 17a: CTG performed during labour, women who gave birth, South Australia, 2014

CTG during labour Number of women % of women (n=20,448)

1 None 7,544 36.9

2 External 10,186 49.8

3 Scalp clip 2,718 13.3

Table 17b: Fetal scalp pH taken during labour, women who gave birth, South Australia, 2014

Fetal scalp pH taken Number of women % of women (n=20,448)

1 No 20,253 99.0

2 Yes 195 1.0

18. Analgesia for labour and anaesthesia for birth
These distributions are provided in Tables 18a and 18b. Epidurals were used for analgesia in labour for 29.2% and 
for anaesthesia for birth for 27.4% of women. The proportion of women who had an epidural for either was 32.6% 
(6,656 women). The proportion of women who had a spinal anaesthetic increased between 1991 and 2014 from 
0.2% to 0.9% for analgesia and from 0.5% to 25% for anaesthesia. General anaesthesia was used for 2.1% of 
births. It was used in 6% of caesarean sections. Approximately 37% of women who gave birth received none of the 
specified methods for analgesia during labour..

Table 18a:  Analgesia for labour,* women who gave birth, South Australia, 2014

Analgesia Number % of women

1 None 7,629 37.3

2 Nitrous oxide and oxygen 8,296 40.6

3 Narcotic (parenteral) 2,914 14.3

4 Epidural (lumbar/caudal) 5,978 29.2

5 Spinal 193 0.9

6 Other 973 4.8

7 Combined spinal-epidural 11 0.1

 * more than one method may be used for each woman

Pregnancy Outcome in South Australia 2014page 38

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Table 18b: Anaesthesia for birth,* women who gave birth, South Australia, 2014

Anaesthesia Number % of women

1 None 7,890 38.6

2 Local anaesthesia 1,440 7.0

3 Pudendal 166 0.8

4 Epidural (lumbar/caudal) 5,610 27.4

5 Spinal 5,114 25.0

6 General anaesthesia 426 2.1

7 Other 229 1.1

8 Combined spinal-epidural 60 0.3

* more than one method may be used for each woman

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

The median duration of stay was two days longer for private patients for vaginal as well as caesarean births (four and 
five days respectively for private patients compared with two and three days respectively for public patients).

Table 19a: Postnatal length of stay by type of patient, women who gave birth in South Australian hospitals, 2014

Postnatal length of 
stay (days)

Public Private Total

Number % Number % Number %

&lt;1 1,098 7.3 35 0.6 1,133 5.6

  1 3,928 26.3 78 1.4 4,006 19.7

  2 3,836 25.7 235 4.4 4,071 20.0

  3 3,573 23.9 693 12.8 4,266 21.0

  4 1,564 10.5 2,084 38.6 3,648 17.9

  5 552 3.7 1,601 29.6 2,153 10.6

  6 204 1.4 503 9.3 707 3.5

  7 or more 189 1.3 173 3.2 362 1.8

Total 14,944 100.0 5,402 100.0 20,346 100.0

Table 19b: Average postnatal length of stay by type of patient &amp; type of birth, women who gave birth in 
South Australian hospitals, 2014

Average 
length of stay

Public Private Total

Vaginal  
(n=10,239)

Caesarean 
(n=4,705)

Total  
(n=14,944)

Vaginal  
(n=3,177)

Caesarean 
(n=2,225)

Total  
(n=5,402)

Vaginal  
(n=13,416)

Caesarean 
(n=6,930)

Total  
(n=20,346)

Mean number 
of days

1.8 3.5 2.3 3.8 5.1 4.3 2.3 4.0 2.8

 ( SD) ( 2.21) ( 1.69) ( 2.21) ( 1.42) ( 1.14) ( 1.45) ( 2.23) ( 1.71) ( 2.22)

Median 
number of days

2.0 3.0 2.0 4.0 5.0 4.0 2.0 4.0 3.0

Pregnancy Outcome in South Australia 2014 page  39

Mothers and Babies



20. Sex of baby
The sex distribution of babies is provided in Table 20; the male: female sex ratio was1.05:1.

Table 20: Sex of baby, all births, South Australia, 2014

Sex of baby Number %

Male 10,626 51.2

Female 10,122 48.8

Indeterminate 1 0.0

Total 20,749 100.0

21. Birthweight and gestation
The birthweight distribution of all births is presented in Table 21. The percentage of low birthweight babies (&lt;2,500g) 
was 7.1%, and that of very low birthweight babies (&lt;1,500g) was 1.6%. The mean birthweight was 3,318g (SD 
610.6g), with birthweights ranging from 122g to 5345g. The proportion of low birthweight babies was 15.4% 
among babies of Aboriginal women compared with 6.9% among babies of non-Aboriginal women. Among liveborn 
babies, and excluding terminations of pregnancy, these proportions were 14.8% and 6.3% respectively.

Table 21:  Birthweight distribution of all births, South Australia, 2014

Birthweight (g) Number of births Percentage of births

&lt;400 60 0.3

400-499 30 0.1

500-749 53 0.3

750-999 53 0.3

1,000-1,499 126 0.6

1,500-1,999 294 1.4

2,000-2,499 867 4.2

2,500-2,999 3,316 16.0

3,000-3,499 7,753 37.4

3,500-3,999 6,091 29.4

4,000-4,499 1,851 8.9

4,500+ 253 1.2

Unknown 2 0.0

Total 20,749 100.0

In 2014, 1,483 babies (7.1%) were of low birthweight and 1,918 (9.2%) were preterm (&lt;37 weeks gestation). The 
proportion of preterm births was 17.8% among babies of Aboriginal women compared with 8.9% among babies of 
non-Aboriginal women. 

Pregnancy Outcome in South Australia 2014page 40

Mothers and Babies



22. Birth injuries
Birth injuries were reported in 123 live births (0.6%). The most common injury reported was cephalhaematoma. 
Fracture and nerve injury occurred less frequently (Table 22).

Table 22: Birth injuries* in 20,604 live births, South Australia, 2014

Birth injury Number of live births % of live births

None 20,481 99.4

Fracture 7 0.0

Dislocation 2 0.0

Nerve Injury 15 0.1

Cephalhaematoma 84 0.4

Other 23 0.1

*more than one injury may be reported for each birth

23. Treatment given in neonatal period
The proportions of live births who received specified treatments in the neonatal period are provided in Table 23, which 
shows that 84.1% of neonates did not receive any of these treatments..

Table 23: Neonatal treatment given, all live births, South Australia, 2014

Neonatal treatment Number % of live births

None of the treatments listed below 17,334 84.1

Oxygen therapy for more than 4 hours 886 4.3

Phototherapy for jaundice 1,238 6.0

Gavage feeding more than once 1,527 7.4

Any intravenous therapy 2,277 11.1

24. Level of care* utilised
Table 24 shows that 84% of neonates utilised Level 1 - 3 care only. Level 4 -5  care was used by 15.9% of neonates, 
Level 6 care at the Women s and Children s Hospital or Flinders Medical Centre by 2.5% and paediatric intensive care 
at the Women s and Children s Hospital by 0.2% of neonates. As would be expected, with decreasing birthweight, an 
increasing percentage of babies required Level 4 -5 and Level 6 care.

Table 24: Level of nursery care* utilised by birthweight, all live births, South Australia, 2014

Level of care utilised

Birthweight (g)

&lt;1,500 (n=210) 1,500-2,499 (n=1,152) 2,500+ (n=19,242) Total (n=20,604)

Number % Number % Number % Number %

Level I - 3 only 24 11.4 246 21.4 17,041 88.6 17,311 84.0

Level 4 - 5 178 84.8 905 78.6 2,191 11.4 3,274 15.9

Level 6 (W&amp;CH &amp; FMC) 164 78.1 168 14.6 179 0.9 511 2.5

Level 6 (W&amp;CH Paediatric 
intensive care) 3 1.4 12 1.0 26 0.1 41 0.2

*Standards for Maternal and Neonatal Services in South Australia 2010

Pregnancy Outcome in South Australia 2014 page  41

Mothers and Babies



25. Length of stay of babies
Table 25 shows the distribution of length of stay of liveborn babies in hospital for preterm (&lt;37 weeks gestation) and 
term births (?37 weeks gestation). The mean duration of stay for all liveborn babies was 4.5 days (SD 10.4) and the 
median duration 3 days. The mean duration was 3.1days (SD 4.9) for term births 19.9 days (SD 26.7) for preterm 
births, while the median durations were 3 and 12 days respectively.

Table 25:  Length of stay of liveborn babies in hospital, South Australia, 2014

Length of stay (days)

Preterm births Term births Total

Number % Number % Number %

&lt;1 29 1.6 1,043 5.6 1,072 5.2

  1 27 1.5 3,708 19.8 3,735 18.2

  2 92 5.1 3,595 19.2 3,687 18.0

  3 92 5.1 3,893 20.8 3,985 19.4

  4 137 7.6 3,356 17.9 3,493 17.0

  5 122 6.8 2,001 10.7 2,123 10.4

  6 114 6.4 608 3.2 722 3.5

  7-13 347 19.4 378 2.0 725 3.5

  14-20 267 14.9 62 0.3 329 1.6

  21-27 180 10.1 25 0.1 205 1.0

  28 or more 384 21.4 42 0.2 426 2.1

Total 1,791 100.0 18,711 100.0 20,502 100.0

26. Congenital anomalies
Among the 20,749 births in 2014 there were 560 births (2.7%) notified with congenital anomalies, compared with an 
average of 2.5% over the past decade; 527 (2.5%) of these births had anomalies notified in the congenital anomalies 
range 74000-75999 of the British Paediatric Association (BPA) Classification of Diseases. This is a 5-digit extension of 
the 4-digit classification of the ICD-9 (International Classification of Diseases. Manual of the International Statistical 
Classification of Diseases, Injuries and Causes of Death, 1975 Revision. Geneva: World Health Organisation, 1977). 
Table 26 includes births with the more readily identifiable defects used for international monitoring (sentinel defects) 
notified to the perinatal statistics collection in 2004-2014.

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

Pregnancy Outcome in South Australia 2014page 42

Mothers and Babies



Table 26: Selected congenital anomalies notified to the perinatal statistics collection 2004-2014, South Australia.

Congenital 
abnormality Year

BPA* CODE 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Number of births = 17,522 18,196 18,803 19,757 19,970 19,901 20,002 20,344 20,666 20,263 20,749

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

74100-74199 Spina bifida 5 5 8 5 4 18 11 6 4 7 6

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

74230-74239 Hydrocephalus 6 9 10 12 11 14 4 9 11 13 12

74900-74909 Cleft palate 10 15 11 12 9 11 12 11 14 12 13

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

17 9 16 30 28 25 18 13 14 14 16

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

2 5 4 12 5 6 3 6 5 7 8

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

6 12 4 7 9 7 9 10 5 8 5

75260-75261 Hypospadias 
and epispadias

41 38 29 41 40 39 44 43 38 44 42

75300-75301 Renal agenesis 
and dysgenesis

4 12 8 8 3 11 8 12 10 7 5

75520-75549 Limb reduction 
defects

8 8 13 18 9 8 13 8 15 17 10

75660-75669 Anomalies of 
diaphragm

4 7 12 7 9 9 6 5 1 8 8

75670-75679 Anomalies of 
abdominal wall

12 9 10 7 9 17 7 15 14 8 17

75800-75809 Down 
syndrome

14 19 17 17 21 22 14 16 19 14 15

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

27. Multiple births
Among women who gave birth there were 287 twin and 7 triplet pregnancies compared with 20,154 singleton 
ones in 2014. Thus there was one twin pregnancy in every 71 pregnancies, one triplet pregnancy in every 2,921 
pregnancies among women who gave birth. Women who gave birth with twins and triplets comprised 1.4% of all 
women who gave birth. The total number of multiple births was 595 (2.9% of total births).

A comparison of multiple births with singletons shows that multiple births were of lower birthweight (with 57.1% 
being of low birthweight compared with 5.7% for singletons, Table 27a), and gestation (with 69.1% being preterm 
births compared with 7.5% for singletons, Table 27b). The proportion of live births in hospital at 28 days was 20.3% 
for multiple births compared with 1.6% for singletons. The perinatal death rate for multiple births was 31.9 compared 
with 8.2 deaths per 1,000 births for singletons, Table 27c).

Pregnancy Outcome in South Australia 2014 page  43

Mothers and Babies



Table 27a: Birthweight by plurality, all births, South Australia, 2014

Birthweight (g)
Singleton births Multiple births

Number % Number %

&lt;400 48 0.2 12 2.0

400-499 28 0.1 2 0.3

500-749 44 0.2 9 1.5

750-999 44 0.2 9 1.5

1,000-1,499 91 0.5 35 5.9

1,500-1,999 201 1.0 93 15.6

2,000-2,499 687 3.4 180 30.3

2,500-2,999 3,110 15.4 206 34.6

3,000-3,499 7,709 38.3 44 7.4

3,500-3,999 6,087 30.2 4 0.7

4,000-4,499 1,851 9.2 0 0.0

4,500+ 253 1.3 0 0.0

Unknown 1 0.0 1 0.2

Total 20,154 100.0 595 100.0

Table 27b: Gestation at birth by plurality all births, South Australia, 2014

Gestation (weeks)
Singleton births Multiple births Total

Number % Number % Number %

&lt;24 97 0.5 12 2.0 109 0.5

24-27 54 0.3 13 2.2 67 0.3

28-31 121 0.6 47 7.9 168 0.8

32-36 1,235 6.1 339 57.0 1,574 7.6

37-41 18,597 92.3 184 30.9 18,781 90.5

42+ 50 0.2 0 0.0 50 0.2

Unknown 0 0.0 0 0.0 0 0.0

Total 20,154 100.0 595 100.0 20,749 100.0

Table 27c: Perinatal outcome by plurality, all births, South Australia, 2014

Perinatal outcome
Singleton births Multiple births Total

Number % Number % Number %

Stillbirth 132 0.7 13 2.2 145 0.7

Discharged within 28 days 19,675 97.6 455 76.5 20,130 97.0

In hospital at 28 days 314 1.6 121 20.3 435 2.1

Neonatal death 33 0.2 6 1.0 39 0.2

Total 20,154 100.0 595 100.0 20,749 100.0

Pregnancy Outcome in South Australia 2014page 44

Mothers and Babies



28. Perinatal mortality
High crude perinatal mortality rates were associated with low and high birthweight births (Table 28a), low gestation 
births (Table 28b) and multiple births (Table 27c).7 The perinatal mortality rate for all births (livebirths of any gestation 
and stillbirths of at least 400g birthweight/20 weeks gestation) in 2014 was 8.9 per 1,000 births. The stillbirth rate 
was 7 per 1,000 births and the neonatal mortality rate was 1.9 per 1,000 live births. 

The relationship between perinatal mortality and birthweight is demonstrated in Table 28a and Figure 6. The highest 
perinatal mortality rate was observed for the lowest birthweight group weighing &lt;500g (1,000 per 1,000). The 
lowest perinatal mortality rate of 0.5 per 1,000 births was observed for the birthweight groups of 3,500-3,999g and 
4,000 4,499g. The perinatal mortality rate for the birthweight group 3,000-3,499 was 1.3 per 1,000 births, and the 
4,500+g birthweight group was 7.9 per 1000 births. The perinatal mortality rate for babies of normal birthweight 
(2,500g or more) was 1.5 per 1,000 births. The decline in perinatal mortality with increasing gestational age is 
demonstrated in Table 28b.

More detail regarding perinatal mortality is available in the  Maternal, Perinatal and Infant Mortality in South Australia  
reports.3

Table 28a: Perinatal mortality by birthweight, all births, South Australia, 2014

Birthweight  
(g)

Total 
births

Live 
births

Stillbirths Neonatal deaths Perinatal deaths

Number
Deaths per 

1,000 births Number

Deaths per 
1,000 live 

births Number
Deaths per 

1,000 births

&lt;400 60 11 49 816.7 11 1,000.0 60 1,000.0

400-499 30 5 25 833.3 5 1,000.0 30 1,000.0

500-749 53 30 23 434.0 9 300.0 32 603.8

750-999 53 43 10 188.7 1 23.3 11 207.5

1,000-1,499 126 121 5 39.7 3 24.8 8 63.5

1,500-1,999 294 288 6 20.4 1 3.5 7 23.8

2,000-2,499 867 864 3 3.5 2 2.3 5 5.8

2,500-2,999 3,316 3,308 8 2.4 5 1.5 13 3.9

3,000-3,499 7,753 7,744 9 1.2 1 0.1 10 1.3

3,500-3,999 6,091 6,089 2 0.3 1 0.2 3 0.5

4,000-4,499 1,851 1,850 1 0.5 0 0.0 1 0.5

4,500+ 253 251 2 7.9 0 0.0 2 7.9

Unknown 2 0 2 1,000.0 0 . 2 1,000.0

Total 20,749 20,604 145 7.0 39 1.9 184 8.9

Figure 6: Perinatal mortality rate by birthweight, all births, South Australia, 2014

0.1

1.0

10.0

100.0

1000.0

&lt;5
00

50
0-

75
0-

10
00

-

15
00

-

20
00

-

25
00

-

30
00

-

35
00

-

40
00

-

45
00

+

Birthweight (g)

Pe
ri

n
at

al
 d

ea
th

s 
p

er
 1

,0
00

 b
ir

th
s

(l
o

g
ar

it
h

m
ic

 s
ca

le
)

Pregnancy Outcome in South Australia 2014 page  45

Mothers and Babies



Table 28b: Perinatal mortality by gestational age at birth, South Australia, 2014

Gestational 
age at birth 
(weeks)

Total 
births

Live 
births

Stillbirths Neonatal deaths Perinatal deaths

Number

Deaths 
per 1,000 

births Number

Deaths per 
1,000 live 

births Number
Deaths per 

1,000 births

&lt;24 109 24 85 779.8 21 875.0 106 972.5

24-27 67 52 15 223.9 5 96.2 20 298.5

28-31 168 159 9 53.6 4 25.2 13 77.4

32-36 1,574 1,558 16 10.2 4 2.6 20 12.7

37-41 18,781 18,761 20 1.1 5 0.3 25 1.3

42+ 50 50 0 0.0 0 0.0 0 0.0

Unknown 0 0 0 . 0 . 0 .

TOTAL 20,749 20,604 145 7.0 39 1.9 184 8.9

The perinatal mortality rates for other specified minimum birthweights or gestational ages (where birthweight was 
unavailable) are provided in Table 28c. The perinatal mortality rate recommended by the World Health Organisation 
(WHO) for use in international comparison refers only to stillbirths of at least 1,000g birthweight (or, if birthweight 
is unavailable, 28 weeks gestation) and to (early) neonatal deaths within the first 7 days of life. This rate was 2.4 per 
1,000 births in 2014, with a stillbirth rate of 1.8 per 1,000 births and an early neonatal mortality rate of 0.4 per 1,000 
live births. The perinatal mortality rate for births to Aboriginal women was 12.5 per 1,000 births in 2014 compared 
with 8.7 per 1,000 births for births to non-Aboriginal women (Table 28d). 

Table 28c: Perinatal mortality, South Australia, 2014 (all births of specified birthweight/gestation)

Specified  
birthweight/ 
gestation

Total 
births

Live 
births

Stillbirths Neonatal deaths Perinatal deaths

Number Number Number

Deaths 
per 1,000 

births Number

Deaths 
per 1,000 
live births Number

Deaths 
per 1,000 

births

?400g/20 weeks* 20,749 20,604 145 7.0 39 1.9 184 8.9

?500g/22 weeks 20,658 20,588 70 3.4 23 1.1 93 4.5

(WHO National Statistics) 17 0.8 87 4.2

?1,000g/28 weeks 20,552 20,515 37 1.8 13 0.6 50 2.4

(WHO International 
Statistics)

9** 0.4 46 2.2

* There were 60 births of birthweight &lt;400g  

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

Pregnancy Outcome in South Australia 2014page 46

Mothers and Babies



Table 28d: Perinatal mortality by race, all births, South Australia, 2014

Race

Total births Stillbirths Neonatal deaths Alive at 28 days Perinatal deaths

Number Number Number Number Number
Deaths per 

1,000 births

Caucasian 15,966 107 29 15,830 136 8.5

Aboriginal 720 5 4 711 9 12.5

Asian 2,678 23 5 2,650 28 10.5

Other 1,385 10 1 1,374 11 7.9

Total 20,749 145 39 20,565 184 8.9

29. Home births
Supplementary Birth Records were received from home birth midwives regarding planned home births for 96 women 
which occurred at home in 2013. There were six unplanned home births in South Australia in 2014 which have been 
excluded from the planned home birth statistics. Four of these six women received no antenatal care. Ascertainment 
of planned home births occurring at home in South Australia for the year 2014 is estimated to be 85.7% (102 out of 
an estimated 119 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 babies born 
before arrival at the hospital into which the woman had been booked). This proportion was slightly increased from 
last year (84.3%). In addition, 17 women who planned to birth at home were transferred to hospital care before 
birth.  Statistics for all 113 planned home births in 2014 are provided in Tables 29-32, by place of birth.

Table 29: Planned home births by age of women, South Australia, 2014

Age (years)

Birthed at home Birthed in hospital Total

Number % Number % Number %

&lt;20 8 8.3 1 5.9 9 8.0

20-24 24 25.0 5 29.4 29 25.7

25-29 33 34.4 10 58.8 43 38.1

30-34 27 28.1 0 0.0 27 23.9

35-39 4 4.2 0 0.0 4 3.5

40-44 0 0.0 1 5.9 1 0.9

Total 96 100.0 17 100.0 113 100.0

Pregnancy Outcome in South Australia 2014 page  47

Mothers and Babies



Table 30: Method of birth in planned home births, South Australia, 2014

Method of birth

Birthed at home Birthed in hospital Total

Number % Number % Number %

Normal spontaneous vaginal 95 99.0 12 70.6 107 94.7

Forceps 0 0.0 1 5.9 1 0.9

Elective caesarean section 0 0.0 0 0.0 0 0.0

Emergency caesarean section 0 0.0 4 23.5 4 3.5

Ventouse 0 0.0 0 0.0 0 0.0

Breech spontaneous 1 1.0 0 0.0 1 0.9

Total 96 100.0 17 100.0 113 100.0

Table 31: Birthweight distribution of planned home births, South Australia, 2014

Birthweight (g)

Birthed at home Birthed in hospital Total

Number % Number % Number %

1,500-1,999 0 0.0 0 0.0 0 0.0

2,000-2,499 0 0.0 1 5.9 1 0.9

2,500-2,999 6 6.3 2 11.8 8 7.1

3,000-3,499 27 28.1 6 35.3 33 29.2

3,500-3,999 43 44.8 6 35.3 49 43.4

4,000-4,499 18 18.8 1 5.9 19 16.8

4,500+ 2 2.1 1 5.9 3 2.7

Total 96 100.0 17 100.0 113 100.0

Table 32: Perinatal outcome in planned home births, South Australia, 2014

Perinatal outcome

Birthed at home Birthed in hospital Total

Number % Number % Number %

Stillbirth - - - - - -

Discharged within 28 days 96 100.0 16 94.1 112 99.1

Discharged within 28 days 0 0.0 1 5.9 1 0.9

Neonatal death - - - - - -

Total 96 100.0 17 100.0 113 100.0

Pregnancy Outcome in South Australia 2014page 48

Mothers and Babies



30. Birthing unit births
Statistics presented for births in birthing units in South Australia (Tables 33-36) relate to the birthing units at the 
Women s and Children s Hospital, the Lyell McEwin Hospital and Flinders Medical Centre. The units at the Women s 
and Children s Hospital and the Lyell McEwin Hospital were established in 1992 and 1993 respectively under the 
Alternative Birthing Services Programme.  In October 1996 the birthing unit at Flinders Medical Centre commenced 
a birthing service.5 These statistics relate to all 2,277 women for whom it was reported that  birthing unit  was 
their intended place of birth. Of these women, 1,232 gave birth in the birthing units while 1,045 women (45.9%) 
gave birth in labour wards. Some of these women were transferred to labour wards because of medical or obstetric 
complications. With the commencement of the Midwifery Group Practice model of care at Women s and Children s 
Hospital in 2004, more of these women who gave birth in labour wards than previously did so because the birthing 
unit was not available at the time. Among the women who gave birth in labour wards, 29.2% had caesarean 
sections and 17.4% had instrumental births. These statistics have also been included in the statistics for the respective 
hospitals. Sixty-three babies (2.8%) were of low birthweight and there were 2 perinatal deaths (perinatal mortality 
rate 0.9 per 1,000 births). 

Table 33: Planned birthing unit births by age of women, South Australia, 2014

Age 

(years)

Birthed in birthing unit Birthed in labour ward Total

Number % Number % Number %

&lt;20 60 4.9 52 5.0 112 4.9

20-24 244 19.8 155 14.8 399 17.5

25-29 425 34.5 359 34.4 784 34.4

30-34 353 28.7 325 31.1 678 29.8

35-39 132 10.7 128 12.2 260 11.4

40-44 18 1.5 26 2.5 44 1.9

45+ - - - - - -

Total 1,232 100.0 1,045 100.0 2,277 100.0

Table 34 Method of birth in planned birthing unit births, South Australia, 2014

Method of birth

Birthed in birthing unit Birthed in labour ward Total

Number % Number % Number %

Normal spontaneous vaginal 1,184 96.1 555 53.1 1,739 76.4

Forceps 10 0.8 99 9.5 109 4.8

Assisted breech (no forceps) 1 0.1 3 0.3 4 0.2

Caesarean section (elective) 0 0.0 36 3.4 36 1.6

Caesarean section (emergency) 0 0.0 269 25.7 269 11.8

Ventouse 36 2.9 81 7.8 117 5.1

Breech spontaneous 1 0.1 0 0.0 1 0.0

Assisted breech (forceps) 0 0.0 2 0.2 2 0.1

Total 1,232 100.0 1,045 100.0 2,277 100.0

Pregnancy Outcome in South Australia 2014 page  49

Mothers and Babies



Table 35: Birthweight distribution of planned birthing unit births, South Australia, 2014

Birthweight (g)

Birthed in birthing unit Birthed in labour ward Total

Number % Number % Number %

&lt;1,500 0 0.0 9 0.9 9 0.4

1,500-1,999 0 0.0 9 0.9 9 0.4

2,000-2,499 9 0.7 36 3.4 45 2.0

2,500-2,999 134 10.9 137 13.1 271 11.9

3,000-3,499 468 38.0 380 36.3 848 37.2

3,500-3,999 430 34.9 336 32.1 766 33.6

4,000-4,499 164 13.3 122 11.6 286 12.5

4,500+ 27 2.2 19 1.8 46 2.0

Total 1,232 100.0 1,048 100.0 2,280 100.0

Table 36: Perinatal outcome in planned birthing unit births, South Australia, 2014

Perinatal outcome

Birthed in birthing unit Birthed in labour ward Total

Number % Number % Number %

Stillbirth 0 0.0 2 0.2 2 0.1

Discharged within 28 days 1,231 99.9 1,033 98.6 2,264 99.3

Prolonged hospitalisation  (in 
hospital at 28 days)

1 0.1 13 1.2 14 0.6

Neonatal death 0 0.0 0 0.0 0 0.0

Total 1,232 100.0 1,048 100.0 2,280 100.0

Pregnancy Outcome in South Australia 2014page 50

Mothers and Babies



III. Terminations of Pregnancy

1. Numbers and rates
There were 4,650 terminations of pregnancy notified in South Australia in 2014, 31 fewer than in 2013. There were 
13.8 terminations of pregnancy per 1,000 women aged 15-44 years. Following the introduction of specific legislation 
in 1970, the pregnancy termination rate rose to a peak of 13.9 in 1980, followed by a period of relative stability in the 
1980s, with another increase commencing in 1991 which reached a peak of 17.9 in 1999. The rate declined to 15.3 
in 2005; remained relatively stable until 2011, and has since has continued to decline (Table 1 and Figure 1). 

Table 37: Number* of pregnancy terminations, and rate per 1,000 women aged 15-44 years,  
South Australia, 1970-2014

Year Number Rate Year Number Rate

1970 1,440 6.0 1993 4,959 15.0

1971 2,409 9.6 1994 5,140 15.7

1972 2,692 10.6 1995 5,475 16.9

1973 2,847 11.1 1996 5,545 17.2

1974 2,867 10.9 1997 5,609 17.5

1975 3,000 11.1 1998 5,488 17.2

1976 3,289 11.9 1999 5,679 17.9

1977 3,494 12.4 2000 5,580 17.6

1978 3,895 13.6 2001 5,579 17.7

1979 3,880 13.3 2002 5,467 17.5

1980 4,081 13.9 2003 5,216 16.7

1981 4,096 13.7 2004 4,931 15.9

1982 4,061 13.4 2005 4,715 15.3

1983 4,036 13.1 2006 4,889 15.5

1984 4,091 13.1 2007 4,885 15.4

1985 4,079 12.9 2008 5,101 16.0

1986 4,327 13.5 2009 5,057 15.6

1987 4,229 13.1 2010 5,048 15.5

1988 4,263 13.0 2011 5,010 15.5

1989 4,342 13.2 2012 4,765 14.7

1990 4,463 13.4 2013 4,681 14.4

1991 4,496 14.1 2014 4,650 13.8

1992 4,717 14.2

*The corrected total numbers of pregnancy terminations notified for the years 1970 - 2013 are shown in Table 37

Figure 7: Pregnancy termination rate per 1,000 women aged 15-44 years, South Australia, 1970-2014

0 

4 

8 

12 

16 

20 

19
70

 
19

71
 

19
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Pregnancy Outcome in South Australia 2014 page  51

Terminations of Pregnancy



2. Age of women
The age distribution of women who had pregnancies terminated is shown in Table 38. Among the five- year age 
groups (Table 39), the highest pregnancy termination rate was among women aged 20-24 years (21.4 per 1,000 
women), followed by women aged 25-29 years (19.3 per 1,000 women). Pregnancy termination rates continued to 
fall for teenage women, from 12.2 per 1,000 women in 2013 to 10.3 per 1,000 women aged 15-19 years in 2014. 
The teenage pregnancy rate (including live births and induced abortions) continued to decline, and in 2014 was the 
lowest on record for the state at 22.1 per 1,000 women aged 15-19 years compared with 25.3 in 2013. The  abortion 
proportion  (induced abortion as a proportion of induced abortions and live births) was 0.18. It was highest among 
teenagers (0.47), and was also high among women aged 20-24 years (0.31) and older women aged over 45 years 
(0.23). This indicated that about 47% of known teenage pregnancies were terminated. This proportion was highest 
for younger teenagers (0.80 for those aged &lt;15 years).

Table 38: Terminations of pregnancy by age, South Australia, 2014

Age (years) Number
% of terminations  

under 20 years % of all terminations

11 0 0.0 0.0

12 0 0.0 0.0

13 2 0.4 0.0

14 6 1.1 0.1

15 24 4.3 0.5

16 60 10.8 1.3

17 97 17.5 2.1

18 157 28.4 3.4

19 207 37.4 4.5

Sub-total 553 100.0 11.9

Under 15 8 0.2

15-19 545 11.7

20 24 1,256 27.0

25 29 1,135 24.4

30 34 902 19.4

35 39 561 12.1

40 44 228 4.9

45 and over 15 0.3

Total 4,650  100.0

The age distribution of pregnancy terminations and live births by age in South Australia in 2014 (Table 39 and Figure 
8a) demonstrated that women aged 20-24 years had the highest rate of induced abortions (21.4 per 1,000 women), 
while women aged 30-34 years had the highest fertility (live birth) rate of 125.7 per 1,000 women. Teenagers 
accounted for 11.9% of women who had pregnancies terminated and 3.1% of women who had live births in  
South Australia in 2012. The teenage pregnancy rate continued to decline and was associated with a decline in both 
the teenage birth and teenage pregnancy termination rate (Figure 8b). The teenage pregnancy rate in 2014 was 22. 
1 per 1,000 women aged 15-19 years, and was the lowest rate recorded since 1970.

Pregnancy Outcome in South Australia 2014page 52

Terminations of Pregnancy



Table 39: Termination of pregnancy and live birth rates and termination of pregnancy proportions by age, 
South Australia, 2014

Age 
(years)

Number  
of 

termination 
of pregnancy

Estimated 
resident female 

population

August 4 2014*

Termination 
of pregnancy 

rate per 
1,000 women

Number of 
live births#

Fertility 
rate

per 1,000 
women

Termination 
of 

pregnancy  
+ live births

Abortion 
proportion

&lt;15 8           na na 2 na 10 0.80

15-19 545 53,613 10.3 630  10.8 1175 0.46

20-24 1,256 58,816 21.4 2,771 47.1 4,027 0.31

25-29 1,135 58,902 19.3 5,898 100.1 7,033 0.16

30-34 902 56,023 16.1 7,042 125.7 7,944 0.11

35-39 561 51,536 10.9 3,453 67.0 4,014 0.14

40-44 228 56,995  4.3 760  14.1 988 0.23

45+ 15 na na 44 na 59 0.25

Total 4,650 335,885 13.8 20,600 60.4 25,250 0.18

*Australian Bureau of Statistics. Population Estimates by Age and Sex, South Australia 2014. Canberra: ABS, 2014 (Catalogue No 3235.0).

#Terminations of pregnancy are excluded from the numbers of live births. 

 The termination of pregnancy and live birth rates for women aged 15-19 years include terminations and live births at younger ages, and the rates for 
women aged 40-44 years include terminations and live births at older ages, while the total rates include all terminations and live births.

Figure 8a: Termination of pregnancy and live births by age, South Australia, 2014

0% 

20% 

40% 

60% 

80% 

100% 

Abortions Live births Abortions &amp; Live births 

Pe
rc

en
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e 

o
f 

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Age (years) 

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

n=4,6501 n=20,600 n=25,250

Pregnancy Outcome in South Australia 2014 page  53

Terminations of Pregnancy



Figure 8b: Teenage pregnancy, termination of pregnancy and birth rates, South Australia, 1970-2014

0 

10 

20 

30 

40 

50 

60 
19

70
 

19
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Abortion rate* Birth rate* Pregnancy rate* 

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

3. Place of residence and place where termination performed
The proportion of pregnancy terminations to country residents (18.9%) was similar to previous years. As in previous 
years, the proportion of pregnancy terminations performed in country hospitals was relatively lower (1.6%), indicating 
that the majority of country residents had their terminations in metropolitan hospitals (Table 40). 

Table 40: Terminations by place of residence, South Australia, 2014

Residence of women Number %

Metropolitan 3,754 81.1

Country 877 18.9

Total 4,631 100.0

As in previous years, the vast majority of terminations (97.5%) were performed in metropolitan public hospitals, 
including 57.4% (2,603) at the Pregnancy Advisory Centre (Table 41). 

Table 41: Terminations by hospital category, South Australia, 2014

Hospital where termination performed Number %

Metropolitan public 4,533 97.5

Metropolitan private 43 0.9

Country 74 1.6

Total 4,650 100.0

Doctors in family advisory clinics in teaching hospitals and the Pregnancy Advisory Centre performed 76.9% of the 
terminations. Obstetricians and trainee obstetricians performed 22.3%, while general practitioners performed 0.8% 
(Table 42).

Pregnancy Outcome in South Australia 2014page 54

Terminations of Pregnancy



Table 42:  Terminations by category of doctor, South Australia, 2014

Category of doctor performing termination Number %

Medical practitioner in family advisory clinic 3,578 76.9

Obstetrician/gynaecologist 759 16.3

Trainee obstetrician/gynaecologist 277 6.0

General practitioner 36 0.8

Total 4,650 100.0

4. The reason for termination
The pattern of reasons for termination of pregnancy remained similar to previous years, with 95.4% performed for 
the woman s mental health, 3.7% for serious handicap of the fetus and 0.7% for specified medical conditions. Of 
the 174 terminations for fetal reasons, 69 were for chromosomal abnormalities and 103 for other fetal abnormalities 
detected or suspected prenatally. Two were performed for exposure during pregnancy to drugs, which may cause fetal 
abnormalities (Table 43). 

Table 43:  Reason for termination for fetal reasons, South Australia, 2014

Reason for termination Number %

Identified chromosomal abnormality 69 39.7

Other identified fetal abnormality 103 59.2

Possibility of damage from drugs 2 1.1

Total 174 100.0

5. Gestation, method and complications
The majority of terminations (91.0%) were performed within the first 14 weeks of pregnancy and most frequently (in 
67.2% of cases) by vacuum aspiration/dilatation and curettage. There were 107 terminations performed at 20 weeks 
gestation or later: 48.6% of these were performed for fetal reasons. 

Tables 44a and 44b report complications by the number of women undergoing termination procedures (4,650), which 
included four failed procedures - three medical and one surgical, with each then progressing to a successful surgical 
procedure. 

There were 62 (2.2%) women who experienced complications related to a pregnancy termination. Twenty (32.3%) 
of these were reported on the notification form, and 42 (67.7%)  were identified through validation with hospital 
admission statistics from the South Australian hospital morbidity collection, using codes for pregnancy termination for 
women admitted in to hospital. The notification form tends to identify more immediate complications.

The main complication reported was retained products of conception (41 cases). Of the 33 women with complications 
reported following termination with mifepristone +/- misoprostol, 28 (84.8%) were due to retained products. 

Pregnancy Outcome in South Australia 2014 page  55

Terminations of Pregnancy



Table 44a: Complications of termination procedures, South Australia, 2014

Complication
Number of 

complications % of complications
% of all termination 

procedures

Retained products of conception 41 66.1 1.4

Uterine infection 6 9.7 0.2

Bleeding 1 1.6 0.0

Sepsis 1 1.6 0.0

Haemorrhage post-operative 4 6.5 0.1

Haemorrhage intra-operative 1 1.6 0.0

Failed procedure 4 6.5 0.1

Other 4 6.5 0.1

Total 62 100.0 2.2

Table 44b: Complications by method of termination procedure, South Australia, 2014

Method of termination
Number of women  
with complications

Number of  
termination procedures

% of termination 
procedure with 

complications by method

Mifepristone +/- Misoprostol 33 1,090 3.0

Vacuum aspiration 19 3,125 0.6

Dilatation and curettage 5 376 1.3

Vaginal prostaglandin 
eg Cervagem

2 31 6.5

Dilatation and evacuation 5 376 1.3

Misoprostol 3 24 12.5

Hysterotomy 0 2 0.0

Other 0 2 0.0

Total 62 4,650 1.3

Pregnancy Outcome in South Australia 2014page 56

Terminations of Pregnancy



6. Previous terminations. Total termination of pregnancy rate and total first 
termination of pregnancy rate
Of the 4,650 women who had terminations, 1,676 (36.0%) had undergone a previous termination (Table 45a). 
Among the teenagers 13.4% had a previous termination; 30.3% of women aged 20-24 years and 44.2% of women 
aged 35-39 years had undergone a previous termination. 

The total induced abortion rate (TAR) is the sum of pregnancy termination rates for each of the five-year age groups 
multiplied by five. This can be calculated using the rates in Table 39 and in 2014 was 410.9 per 1,000 women aged 
15-44 (Table 45b). This represents the number of induced abortions 1,000 women would have during their lifetime if 
they experienced the induced abortion rates of the different age groups for 2014.

A woman may have more than one termination of pregnancy in her lifetime, and to estimate how prevalent 
termination of pregnancy is at these age-specific induced abortion rates, a total first induced abortion rate (TFAR, 
Table 45c) may be calculated after excluding women with repeat terminations. The TFAR for 2014 was 262.9 per 
1,000 women aged 15-44 years. This suggests that 26.3% of women would have at least one termination of 
pregnancy in their lifetime if they experienced the termination of pregnancy rates of the different age groups for 
2014.

Table 45a: Women with previous terminations by age, South Australia, 2014

Age (years) Number % of age group % of all terminations

&lt; 15 0 0.0 0.0

15 - 19 73 13.4 1.6

20 - 24 381 30.3 8.2

25 - 29 462 40.7 9.9

30 - 34 401 44.5 8.6

35 - 39 248 44.2 5.3

40+ 111 45.7 2.4

Total 1,676 36.0 36.0

Further details of termination of pregnancy in South Australia in 2014 may be obtained from the Annual Report of 
the South Australian Abortion Reporting Committee   for the year 2014.6

Pregnancy Outcome in South Australia 2014 page  57

Terminations of Pregnancy



Table 45b: Calculation of total induced abortion rate (TAR), South Australia, 2014*

Age (years)
Number of women  

who had terminations
Estimated female resident  

population 30 June 2014
Termination of pregnancy 

rate per 1,000 women

15-19* 553 53,613 10.3

20-24 1,256 58,816 21.4

25-29 1,135 58,902 19.3

30-34 902 56,023 16.1

35-39 561 51,536 10.9

40-44* 243 56,995 4.3

Total 4,650 335,885 13.8

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

Total induced abortion rate (TAR) = sum of termination of pregnancy rates for 5-year age groups x 5 = 82.2 x 5 = 410.9 per 1,000 women aged 
15-44 years.

Table 45c: Calculation of total first induced abortion rate (TFAR), South Australia, 2014

Age 
(years)

Number of 
women who had 

terminations

(A)

Number of women 
who had previous 

terminations

(B)

Number of women 
who had first 

termination

(A)   (B)

Estimated 
female resident 

population 
30 June 2014*

First termination 
of pregnancy 

rate per 1,000 
women

15-19 553 73 480 53,613 9.0

20-24 1,256 381 875 58,816 14.9

25-29 1,135 462 673 58,902 11.4

30-34 902 401 501 56,023 8.9

35-39 561 248 313 51,536 6.1

40-44 243 111 132 56,995 2.3

Total 4,650 1,676 2,974 335,885 8.9

* Australian Bureau of Statistics. Population Estimates by Age and Sex, South Australia 30 June 2014. Canberra: ABS, 2014(Catalogue No 3235.0).  

 In these calculations, termination of pregnancy for women under 15 years are included in the age group 15-19 years and termination of pregnancy 
 for women aged 45 years or more are included in the age group 40-44 years.

Total induced abortion rate (TFAR) = sum of first termination of pregnancy rates for 5-year age groups x 5 = 52.6 x 5 = 262.9 per 1,000 women 
aged 15-44 yrs. 

Pregnancy Outcome in South Australia 2014page 58

Terminations of Pregnancy



IV. Obstetric Profiles by Hospital Category
Obstetric profiles for the three major metropolitan public hospitals and three hospital categories for 2014 are provided 
in Table 46 and Figures 9-28. They were also reported for hospital categories and individual hospitals in the Pregnancy 
and Neonatal Care Bulletins.

These hospital categories as determined by their Perinatal Service Delineation, defined in the Standards for Maternal 
and Neonatal Services in South Australia, and are provided in parentheses:

1. The Women s &amp; Children s Hospital (5:6)

2. Flinders Medical Centre (6:6)

3. The  Lyell McEwin Hospital (6:5)

4. metropolitan private hospitals (4:4 to 6:5)

5. two Level 4:4 country hospitals (Mount Gambier and Port Augusta)

6.   other country hospitals (3:3). 

One mother who gave birth at the Queen Elizabeth has been excluded from these hospital category statistics.  
A list of maternal and baby factors identified either as risk factors for poor perinatal outcome in earlier analyses,  
7 or of general interest, is provided with  means  for all state hospital births as well as proportions for the six  
hospital categories.

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

x100
    Total number of women who gave birth in state hospitals

    Number of Aboriginal  women who gave birth in state hospitals

Where indicated (+) in Table 46, it is the mean (number of women who gave birth, or births) for the 22 hospitals 
or groups of hospitals for which obstetric profiles have been provided, and which have also been included in the 
provision of the 10th and 90th percentile values. These are as follows:

  1. Women s &amp; Children s Hospital

  2. Flinders Medical Centre

  3. Lyell McEwin Hospital

  4. Ashford Hospital 

  5. Burnside War Memorial Hospital Inc

  6. Calvary Healthcare Adelaide

  7. Flinders Private Hospital

  8. North Eastern Community Hospital

  9. Mount Gambier &amp; District Health Service Inc

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

11. Barossa Health (Tanunda Centre)

12. Gawler Health Service

13. Mount Barker District Soldiers  Memorial Hospital Inc

14. Murray Bridge Soldiers  Memorial Hospital Inc

15. Naracoorte Health Service Inc

16. Northern Yorke Peninsula Regional Health Service (Wallaroo)

17. Port Lincoln Health Service Inc

18. Port Pirie Regional Health Service Inc

Pregnancy Outcome in South Australia 2014 page  59

Obstetric Profiles by Hospital Category



19. Riverland General Hospital (Berri)

20.      South Coast District Hospital Inc (Victor Harbor)

21. The Whyalla Hospital &amp; Health Services Inc

22. Country hospitals with &lt;100 births per year

The 10th percentile is the proportion below which 10% of the 22 hospital proportions, i.e. the two lowest hospital 
proportions, would be found if the 22 proportions were ranked from highest to lowest. The 90th percentile is the 
proportion above which 10% of the 22 hospital proportions, i.e. the two highest proportions, would be found if the 
22 proportions were ranked from highest to lowest. As the two Level III hospitals which account for 40.6% 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 20 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 three major metropolitan public hospitals and three hospital 
categories. 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,8 the latter with exclusion of 
perinatal deaths from congenital abnormalities3 and terminations of pregnancy. For country hospitals with less than 
100 births per year, a group report has been provided.

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

Pregnancy Outcome in South Australia 2014page 60

Obstetric Profiles by Hospital Category



Table 46:  Obstetric profiles by hospital category, South Australia, 2014: live births and stillbirths of &gt;=400g 
or &gt;=20 weeks gestation#

Factors

All state hospitals Metropolitan hospitals Country hospitals

Mean 10th percentile
90th 

percentile W&amp;CH FMC LMH Private
Level 

4:4 Other

Maternal factors

Women (n= 20,345) 925+ 120 3,486 4,734 3,486 3,594 4,594 936 3,001

% Aboriginal women 3.5 0.0 9.5 4.2 2.9 4.0 0.2 12.6 4.8

% Antenatal visits &lt;7* 9.5 0.8 13.1 15.5 12.1 13.1 1.2 7.9 6.0

% Teenage women 3.1 0.0 7.5 2.7 2.7 6.0 0.1 5.0 4.9

% Women ?35 years 20.5 12.2 32.1 21.7 18.6 13.7 31.6 12.7 14.7

% Single women 8.9 1.9 18.1 11.8 8.8 11.7 1.8 13.8 10.5

% 4+ prior live births 3.3 0.4 5.8 3.7 2.7 6.4 0.5 5.7 3.6

% 1+ prior perinatal deaths 1.3 0.2 1.6 2.1 1.6 1.3 0.8 1.4 0.8

% Obstetric complications 39.6 23.2 42.7 41.6 54.7 45.4 29.7 36.9 27.8

% Labour complications 37.9 24.0 42.9 46.2 50.6 37.6 25.8 26.5 32.0

% Induction 32.4 23.2 36.7 34.3 32.6 30.9 35.2 29.2 27.5

% Emergency caesarean 17.4 14.1 20.2 16.3 20.2 17.8 16.6 16.3 16.7

% Elective caesarean 16.7 8.8 24.9 13.3 15.8 14.1 25.3 17.1 13.1

% Total caesarean 34.1 23.8 41.9 29.6 36.0 31.8 41.9 33.4 29.7

% Ultrasound 
examination* 97.5 92.0 98.9 98.8 98.9 98.0 95.9 97.4 95.9

% Amniocentesis* 2.5 0.6 2.9 4.3 2.1 2.7 1.7 0.7 1.7

% Episiotomy 14.4 4.4 18.6 16.5 14.3 14.6 17.8 5.7 8.7

% Repair of perineal tear 25.5 17.1 32.9 32.6 22.7 20.1 26.0 18.4 25.2

% Epidural analgesia 29.4 13.0 45.3 27.7 25.9 28.5 43.4 16.5 19.7

% Spinal analgesia 0.9 0.2 2.3 0.0 0.9 1.6 0.9 1.6 1.5

% Private patients 26.6 0.9 100.0 7.5 0.9 0.6 100.0 13.4 9.2

% Primiparous women 41.9 32.4 46.5 43.8 44.1 38.6 45.7 33.3 37.0

% Previous caesarean 17.8 14.7 24.8 16.3 17.9 17.5 20.4 19.4 16.3

% PPH 12.9 3.0 15.6 20.4 14.5 14.8 5.0 7.8 10.5

Baby factors 

Births (n= 20,148) 938 120 3,538 4,863 3,538 3,632 4,659 951 3,003

% Birthweight &lt;2,500g 7.2 1.1 7.1 13.1 8.3 6.6 4.0 6.2 2.2

% Gestational age  
&lt;37 weeks at birth 9.3 0.5 11.4 14.8 11.4 8.9 7.0 10.5 1.4

% Prolonged 
hospitalisation (&gt;27 days) 2.1 0.0 2.6 4.5 3.4 0.7 1.1 0.6 0.4

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

2.5 0.0 2.4 5.4 4.4 1.1 0.7 1.1 0.8

% Birth defect 2.7 1.0 2.9 5.0 1.9 3.0 1.5 2.2 1.8

* adjusted for missing values

+ mean number of women who gave birth, or mean number of births for the 22 hospitals or groups of hospitals

# 1 mother who gave birth at the TQEH has been excluded from this table 

Pregnancy Outcome in South Australia 2014 page  61

Obstetric Profiles by Hospital Category



Figure 9: Percentage of Aboriginal women by hospital category

0 
2 
4 
6 
8 

10 
12 
14 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 

Mean 

10th percentile 

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

0.0 
2.0 
4.0 
6.0 
8.0 

10.0 
12.0 
14.0 
16.0 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 

Mean 

10th percentile 

Figure 11: Percentage of teenage women by hospital category

0.0 

1.0 

2.0 

3.0 
4.0 

6.0
5.0

7.0
8.0

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 

Mean 

10th percentile 

Pregnancy Outcome in South Australia 2014page 62

Obstetric Profiles by Hospital Category



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

0.0 
5.0 

10.0 
15.0 
20.0 
25.0 
30.0 
35.0 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 

Mean 

10th percentile 

Figure 13: Percentage of single women by hospital category

0.0 
2.0 
4.0 
6.0 
8.0 

10.0 
12.0 
14.0 
16.0 
18.0 
20.0 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 

Mean 

10th percentile 

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

0.0 

1.0 

2.0 

3.0 

4.0 

5.0 

6.0 

7.0 

8.0 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 

Mean 

10th percentile 

Pregnancy Outcome in South Australia 2014 page  63

Obstetric Profiles by Hospital Category



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

0.0 

0.5 

1.0 

1.5 

2.0 

2.5 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 

Mean 

10th percentile 

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

0.0 

10.0 

20.0 

30.0 

40.0 

50.0 

60.0 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

10th percentile 

90th percentile 
Mean 

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

0.0 

10.0 

20.0 

30.0 

40.0 

50.0 

60.0 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

10th percentile 

90th percentile 
Mean 

Pregnancy Outcome in South Australia 2014page 64

Obstetric Profiles by Hospital Category



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

0.0 

10.0 

20.0 

30.0 

40.0 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 

Mean 

10th percentile 

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

0.0 

10.0 

20.0 

30.0 

40.0 

50.0 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 

Mean 

10th percentile 

Figure 20: Percentage of breech births by hospital category

0 
0.1 
0.2 
0.3 
0.4 
0.5 
0.6 
0.7 
0.8 
0.9 

1 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 

Mean 

10th percentile 

Pregnancy Outcome in South Australia 2014 page  65

Obstetric Profiles by Hospital Category



Figure 21: Percentage of emergency caesarean sections by hospital category

0.0 

5.0 

10.0 

15.0 

20.0 

25.0 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 
Mean 

10th percentile 

Figure 22: Percentage of elective caesarean sections by hospital category

0.0 

5.0 

10.0 

15.0 

20.0 

25.0 

30.0 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 

Mean 

10th percentile 

Figure 23: Percentage of total caesarean sections by hospital category

0.0 
5.0 

10.0 
15.0 
20.0 
25.0 
30.0 
35.0 
40.0 
45.0 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 

Mean 

10th percentile 

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

0.0 
2.0 

4.0 
6.0 

8.0 

10.0 
12.0 
14.0 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 
Mean 
 

10th percentile 

Pregnancy Outcome in South Australia 2014page 66

Obstetric Profiles by Hospital Category



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

0.0 
2.0 

4.0 

6.0 
8.0 

10.0 

12.0 
14.0 

16.0 

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

90th percentile 
Mean 

10th percentile 

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

0 

1 

2 
2.5

1.5

0.5

2 

3.5
4 

4.5 
5

1 2 3 4 5 6 

Pe
rc

en
ta

g
e 

Hospital category 

10th percentile 

 
90th percentile 
Mean 

 

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

0

1

2

3

4

5

6

1 2 3 4 5 6

Hospital category

Pe
rc

en
ta

g
e

Mean

10th percentile

90th percentile

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

1 2 3 4 5 6

Hospital category

0

2
1

3
4
5
6

Pe
rc

en
ta

g
e

10th percentile

90th percentile
Mean

Pregnancy Outcome in South Australia 2014 page  67

Obstetric Profiles by Hospital Category



V. Clinical and Maternity Performance Indicators

1. Clinical indicators

Ten national core maternity indicators have been developed to examine trends in maternity interventions and 
outcomes and the quality of maternity services in the years after the introduction of the National Maternity Services 
Plan.9 This report presents these indicators  with 95% Confidence Intervals (CI) for South Australian births in 
2014. They were also reported for individual hospitals in the Pregnancy and Neonatal Care Bulletin 2014. Indicator 
specifications are in accordance with the 2014 National Core Maternity Indicators report.10

For the purpose of Indicators 5, 6 and 8  selected primiparae  was defined as:

 &gt; a woman who was 20-34 years of age at the time of giving birth

 &gt; giving birth for the first time at ?20 weeks of gestation

 &gt; singleton pregnancy

 &gt; cephalic presentation

 &gt; at 37 to 41 weeks gestation.

INDICATOR 1: Smoking in pregnancy 

Description: This indicator has two parts: (a) among all women who gave birth, the proportion who reported smoking 
tobacco at any time within the first 20 weeks of pregnancy; and (b) among women who reported smoking, the 
proportion who reported smoking after 20 weeks of pregnancy.

Purpose: This indicator is used to monitor public health and assess the effectiveness of smoking cessation advice in the 
antenatal period in the antenatal period. 

 &gt; Clinical indicator 1a: Total number of women smoking in first 20 weeks of pregnancy.

Numerator: The number of women who gave birth and reported smoking tobacco in the first 20 weeks of pregnancy 
(n=2,634).

Denominator:  The total number of women who gave birth (n=20,448).

Clinical indicator 1a = 
 2,634 x 100

20,448
=12.9%   (95% CI 12.4% - 13.3%).).

 &gt; Clinical indicator 1b: Proportion of women who smoked in first 20 weeks of pregnancy and continued to 
smoke in the second 20 weeks of pregnancy. 

Numerator:  The number of women who gave birth and reported smoking tobacco in the second 20 weeks of 
pregnancy (n= 1,826).

Denominator:  The number of women who gave birth who reported smoking tobacco at any time in the pregnancy 
(n= 2,634).

Clinical indicator 1b = 
  1,826x 100

2,634
= 69.3% (95% CI 67.5%   71.1%).  

Pregnancy Outcome in South Australia 2014page 68

Clinical and Maternity Performance Indicators



INDICATOR 2: Antenatal care in the first trimester for all women giving birth

Description: Among all women who gave birth, the proportion who commenced antenatal care in the first trimester 
(before 14 weeks gestation).

Purpose: This indicator is used to assess the accessibility of antenatal services.

 &gt; Clinical indicator 2: Antenatal care in the first trimester for all women giving birth

Numerator:  The number of women who had their first antenatal visit before 14 weeks gestation and went on to give 
birth (n=15,239).

Denominator:  The number of all women who gave birth (n=20,448).

Clinical indicator 2 =
20,448

15,239x 100
= 74.5%  (95% CI 73.9% - 75.1%).

INDICATOR 3: Episiotomy for women having their first baby and giving birth vaginally

Description: This indicator has two parts among women who had their first baby: (a) the proportion who received an 
episiotomy while giving birth vaginally without instruments; and (b) the proportion who received an episiotomy during 
an instrumental vaginal birth.

Purpose: This indicator is used to benchmark practice. 

 &gt; Clinical indicator 3a: Total number of women having their first baby who gave birth vaginally without 
instruments and had an episiotomy

Numerator: The number of women having their first baby who had an episiotomy while giving birth vaginally without 
instruments (n= 839)

Denominator: The number of women having their first baby who gave birth vaginally without instruments (n=3,662)

Clinical indicator 3a = 

 &gt; Clinical indicator 3b: Total number of women having their first baby who gave birth vaginally with 
instrumental assistance and had an episiotomy

Numerator: The number of women having their first baby who had an episiotomy during a vaginal birth with 
instruments (n=1,315)

Denominator: The number of women having their first baby who gave birth vaginally with instruments (n=1,861)

Clinical indicator 3b =

839 x 100
3,662

1,315 x 100
1,861

 = 22.9% (95% CI 21.6% - 24.3%).

 = 70.7% (95% CI 68.6% - 72.7%).

Pregnancy Outcome in South Australia 2014 page  69

Clinical and Maternity Performance Indicators



INDICATOR 4: Apgar score of less than 7 at 5 minutes for births at or after term

Description: The proportion of liveborn term infants with an Apgar score of less than 7 at 5 minutes.

Purpose: This indicator of the condition of the baby after birth provides an outcome measure of intrapartum care and 
resuscitation of the newborn.

 &gt; Clinical indicator 4: Apgar score of less than 7 at 5 minutes for births at or after term

Numerator: The number of babies born alive at term with an Apgar score less than 7 at 5 minutes (n=202).

Denominator: The number of live babies born at term (n=18,811).

Clinical indicator 4 =   = 1.1% (95% CI 0.9% - 1.2%).

INDICATOR 5: Induction of labour for selected primiparae

Description: The proportion of all selected primiparae, whose labour was induced.

Purpose: This indicator is used to benchmark practice.

 &gt; Clinical indicator 5: Induction of labour for selected women giving birth for the first time

Numerator: The number of selected primiparae who had labour induced (n=2,444).

Denominator:  All selected women giving birth for the first time (n=5,931).

Clinical indicator 5 =       = 41.2% (95% CI 40.0% - 42.5%).).

INDICATOR 6: Caesarean section for selected primiparae

Description: The proportion of all selected primiparae who gave birth by caesarean section.

Purpose: This indicator is used to benchmark practice.

 &gt; Clinical indicator 6: Caesarean section for selected primiparae

Numerator: The number of selected primiparae who gave birth by caesarean section (n=1,785).

Denominator: All selected primiparae (n=5,931).

Clinical indicator 6 = = 30.1% (95% CI 28.9% - 31.3%).).

INDICATOR 7: Normal (non-instrumental) vaginal birth for selected primiparae

Description: The proportion of all selected primiparae, who had a normal (non-instrumental) vaginal birth.

Purpose: This indicator is used to benchmark practice.

 &gt; Clinical indicator 7: Normal (non-instrumental) vaginal birth for selected primiparae

Numerator: The number of selected primiparae who had a normal (non-instrumental) vaginal birth (n=2,691).

Denominator: All selected primiparae (n=5,931).

Clinical indicator 7 =    = 45.4% (95% CI 44.1% - 46.6%).

202 x 100
18,811

2,444 x 100
5,931

1,785 x 100
5,931

2,691x 100
5,931

Pregnancy Outcome in South Australia 2014page 70

Clinical and Maternity Performance Indicators



INDICATOR 8: Instrumental vaginal birth for selected primiparae

Description: The proportion of all selected primiparae, who had a vaginal birth with the assistance of instruments.

Purpose: This indicator is used to benchmark practice.

 &gt; Clinical indicator 8: Instrumental vaginal birth for selected primiparae

Numerator: The number of selected primiparae who had a vaginal birth with the assistance of instruments (n=1,455).

Denominator: All selected primiparae (n=5,931).

Clinical indicator 8 =   = 24.5% (95% CI 23.5% - 25.6%).

INDICATOR 9: General anaesthetic for women giving birth by caesarean section

Description: The proportion of women who gave birth by caesarean section who received a general anaesthetic.

Purpose: This indicator is used to benchmark anaesthetic care in association with caesarean section.

 &gt; Clinical indicator 9: General anaesthetic for women giving birth by caesarean section

Numerator: The number of women who gave birth by caesarean section and had a general anaesthetic (n=419).

Denominator: The total number of women who gave birth by caesarean section (n=6,930).

Clinical indicator 9 =   = 6.0% (95% CI 5.5% - 6.6%).

INDICATOR 10: Small babies among births at or after 40 weeks gestation

Description: The proportion of babies born at or after 40 weeks gestation who weighed less than 2,750 grams at 
birth.

Purpose: This indicator aims to identify intrauterine growth restriction for babies born at or after 40 weeks gestation. 
This indicator is used to benchmark practice.

 &gt; Clinical indicator 10.1: Small babies among births at or after 40 weeks gestation

Numerator: The number of babies born at or after 40 weeks gestation who weighed less than 2,750 grams at birth 
(n=86).

Denominator: The total number of babies born at or after 40 weeks (n=7,048).

Clinical indicator 10 =   = 1.2% (95% CI 1.0% - 1.5%).

1,455 x 100
5,931

419 x 100
6,930

86 x 100
7,048

Pregnancy Outcome in South Australia 2014 page  71

Clinical and Maternity Performance Indicators



2. Maternity performance indicators, hospitals with at least 550 births per year

Six clinical indicators are presented below. Five are selected from The Australian Council on Healthcare Standards 
( ACHS  Clinical Indicator Users  Manual Version 2010 ) and are presented for hospitals with at least 550 births per 
year. Additionally, the sixth indicator presents the standardized perinatal mortality ratio.

These six indicators are as follows:

1. Proportion of selected primiparae who underwent induction of labour.

This was as defined for Clinical indicator 5 and was 41.2% for the state in 2014 (and 41.3% for state hospitals) in 2014.

2. Caesarean section rate for selected primiparae.

This was as defined for Clinical indicator 6 and was 30.1% for the state (and 30.2 for state hospitals) for 2014.

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

Numerator: Total number of women giving birth vaginally following a previous primary caesarean section (n=401).

Denominator:  Total number of women giving birth who have had a previous primary caesarean section and NO 
intervening pregnancies greater than 20 weeks gestation (n=2,533).

This was as defined as above and was 15.9% for the state (and 15.8% for state hospitals) in 2014.

4. Proportion of selected primiparae with an intact perineum following vaginal birth.

Numerator: Total number of selected primiparae with an intact perineum (n=364)

Denominator:  Total number of selected primiparae giving birth vaginally (n=4,133)

This was as defined as above and was 8.9% for the state (and 8.8% for state hospitals) in 2014.

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

Numerator: The number of term babies (37 weeks gestation or later) transferred/admitted to a neonatal intensive care 
unit for reasons other than congenital abnormality (n=103).

Denominator: The total number of term live babies born (n=18,711).

This was as defined as above and was 0.5% for the state (and 0.6% for state hospitals) in 2014.

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

This is as defined8 in the Pregnancy and Neonatal Care Bulletin 2014. It adjusts for the difference between the 
distribution of births by birthweight between the hospital and state hospital births. As perinatal mortality is much 
higher in babies of low birthweight, this adjustment ensures that a hospital is directly comparable with other hospitals 
and state hospitals as a whole if it has a higher proportion of low birthweight babies than state hospital births.

SPMR = 
Expected number of deaths

Observed number of deaths 
 X 100

To obtain the expected number of deaths for a hospital, the state hospital perinatal mortality rate for 2014 for each 
of the birthweight groups in Table 28a is applied to the number of births in each corresponding birthweight group 
for the hospital. This gives an expected number of deaths in each birthweight group.  These expected deaths are then 
totalled to give a total number of expected deaths for the hospital.

SPMRs provided in this report for comparison between sites exclude deaths attributed to congenital abnormalities (as 
determined by the Maternal, Perinatal and Infant Mortality Committee3), which are the least preventable, as well as 
terminations of pregnancy. An SPMR above 100 means that after adjustment for birthweight differences and deaths 
attributed to congenital abnormalities and terminations of pregnancy, perinatal mortality for that hospital is higher 
than that for state hospital births e.g. an adjusted SPMR of 120 means that it is 20% higher.

Pregnancy Outcome in South Australia 2014page 72

Clinical and Maternity Performance Indicators



A 95% confidence interval (CI) which includes the value 100 in its range means that the hospital s perinatal mortality 
is not (statistically) significantly different from that for state hospital births for that year. The SPMRs and 95%CIs for 
individual hospitals and categories of hospitals have been programmed using indirect standardization methods.8

Statistics for the six maternity performance indicators for 2014 are provided in Figures 29a   29f for the eight 
hospitals, A   H, with at least 550 births in 2014.  SPMRs for the preceding five years combined, 2010-2014, are 
provided in Figure 29g. Metropolitan teaching hospitals and Mount Gambier Hospital have been named with their 
permission and are as follows:

A.  Women s and Children s

B.  Flinders Medical Centre

C.  Lyell McEwin Hospital

D.  Mt Gambier Hospital

  

Figure 29a: Induction of labour proportion for selected primiparae, SA hospitals  
with &gt;=550 births per year, 2014

0 

10 

20 

30 

40 

50 

A B C D E F G H I 

%
 

Hospital 

Induction of labour %  *SA hospitals = 41.3% 

Figure 29b: Caesarean section rate for selected primiparae, SA hospitals with &gt;=550 births per year, 2014

0 

10 

20 

30 

40 

50 

60 

A B C D E F G H I 

%
 

Hospital 

Caesarean section % *SA hospitals = 30.2% 

Pregnancy Outcome in South Australia 2014 page  73

Clinical and Maternity Performance Indicators



Figure 29c: VBAC: Proportion of women who had a vaginal birth following a previous primary (first) 
caesarean section &amp; no intervening births, SA hospitals with &gt;=550 births per year, 2014

0 

10 

20 

30 

40 

A B C D E F G H 

%
 

Hospital 

VBAC % *SA hospitals = 15.8% 

Figure 29d: Proportion of selected primiparae with an intact perineum after a vaginal birth, SA hospitals 
with &gt;=550 births per year, 2014

0 

10 

20 

30 

40 

A B C D E F G H 

%
 

Hospital 
Primip no repair %  *SA Hospitals = 8.8% 

Figure 29e: TERM NICU: proportion of term babies admitted to NICU for reasons other than congenital 
abnormality, SA hospitals with &gt;=550 births per year, 2014

0.0 

0.2 

0.4 

0.6 

0.8 

1.0 

1.2 

1.4 

A B C D E F G H 

%
 

Hospital 

Term NICU %  *SA hospitals = 0.6% 

Pregnancy Outcome in South Australia 2014page 74

Clinical and Maternity Performance Indicators



Figure 29f: SPMR (Standardized Perinatal Mortality Ratio) for all births, SA hospitals with &gt;=550 births per 
year, 2014

0 

50 

100 

150 

200 

250 

300 

350

A B C D E F G H 

Hospital 

SPMR *SA hospitals  

Figure 29g: SPMR (Standardized Perinatal Mortality Ratio) for all births, SA hospitals with &gt;=550 births per 
year, 2010-2014

0

50

100

150

200

250

A B C D E F G H

Hospital

SPMR *SA hospitals

Pregnancy Outcome in South Australia 2014 page  75

Clinical and Maternity Performance Indicators



VI. Trends in Perinatal Statistics in South Australia, 1981-2014
Perinatal statistics are presented in Tables 47 and 48 for both socio-demographic and obstetric aspects for each 
year from 2005-2014, as well as for 1981, when the perinatal data collection was commenced. Some features are 
illustrated in Fig 30.1   30.8 for the years 1985-2014. The trends noted between 1981 and 2014 are as follows:

1 The total fertility rate was 1.83 live births per woman, following a steady increase from 1.71 in 2000 to 1.91 live 
births per woman in 2008, 2009 and 2012.

 The total fertility rate was 1.83 live births per woman, following a steady increase from 1.71 in 2000 to 1.91 live 
births per woman in 2008, 2009 and 2012.

2 The increase in the proportion of Asian women from 1.8% in 1981 to 12.9% in 2014 and of Aboriginal women 
from 1.5% in 1981 to 3.6% in 2013 (it was 3.5% in 2014).

3 The decrease in the proportion of teenage women giving birth from 7.8% in 1981 to 3.1% in 2014. Over the 
past decade, there has been a general decline in both the teenage birth and abortion rate. The teenage pregnancy 
rate in 2014 of 22.1per 1,000 women was the lowest recorded since 1970, when abortion statistics were first 
collected, enabling calculation of a pregnancy rate.

4 The increase in the age of women giving birth. The proportion of women who gave birth who were 35 years or 
older increased from 4.6% in 1981 to 20.6% in 2014, following a peak of 21.1% in 2008 and 2009. Amongst 
primiparous women the proportion in 1981 was 1.2%, and in 2014 it was 12.9%. The mean age among women 
giving birth increased from 26.55 years in 1981 to peak in 2012 at 30.21 years; in 2014 it was 29.8 years. The 
mean age among primiparous women which went from 24.42 years in 1981 and peaked in 2012 at 28.44 years 
remained steady at 28.37 years in 2014.

5 The proportion of single women giving birth peaked in 1996 at 14.9%, since which time there has been a gradual 
decrease and was 8.9% in 2014.

6 The proportion of births in country hospitals has gradually declined from 27.8 in 1981 to 24.9% in 1997 and was 
19.3% in 2014.  The proportion of births in teaching hospitals gradually increased to 57.8% in 2014 following 
a low of 47.2% in 1991.  In 2014 metropolitan private hospitals accounted for 22.5% of births.  The number of 
births in birthing units in teaching hospitals increased from 125 (0.6%) in 1992 to 1,232 (5.9%) in 2014. Home 
births increased from 44 (0.2%) in 1997 to 144 (0.7%) in 2010.The decrease in the reporting of homebirths 
noted in 2011 (64.4%) and 2012 (66.2%) has improved with 102 (85.7%) of an estimated 119 homebirths being 
reported to the unit.

7 The proportion of multiple births peaked at 3.6% of all births in 2002 and 2003, and in 2014 this proportion was 
2.9% of all births.

8 The induction rate increased from 22.1% in 1981 to 32.2% in 2014. Forty-eight percent of inductions in 2014 
were performed for other than defined indications.

9 The fall in the proportion of normal spontaneous vaginal births (from 66.1% in 1981 to 54.1% in 2014, breech 
births (from 1.1% to 0.4%) and forceps births (from 15.2% to 5.3%). The proportion delivered by ventouse 
increased from 0.7% to 6.9% in 2010, and was 6.3% in 2014, and by caesarean section, from 16.9% in 1981 to 
33.9% in 2014. 

10 The gradual increase in the proportion of low birthweight births (&lt;2,500 grams) from 5.8% in 1981 to 7.7% in 
2013 (it was 7.1%in 2014). Amongst liveborn babies, the proportion of low birthweight births was 6.6% in 2014, 
compared with 6.0% in 1991. The proportion of preterm births also increased from 5.5% in 1981 to 9.2% in 
2014. 

11 The proportion of births with congenital abnormalities identified before discharge from hospital after birth has 
been relatively stable at 2.3%-2.8% during the last decade and was 2.7% in 2014.

12 The increase in the proportion of babies utilising Level II care from 6.7% in 1982 to 16.5% in 2013 (it was 15.9 
in 2014). The proportion of babies utilising neonatal intensive care has decreased from 3.3% in 1981 to 2.5% 
in 2014, while the proportion using paediatric intensive care remained at 0.2%. The proportion in hospital at 28 
days has been between 2.0% and 2.4% since 2005 (2.1% in 2014). 

Pregnancy Outcome in South Australia 2014page 76

Trends in Perinatal Statistics in South Australia, 1981-2014



14 The considerable fall in the perinatal mortality rate, despite the increasing proportion of preterm births. The 
perinatal mortality rate for national statistics (for babies of at least 500g birthweight or 22 weeks gestation 
if birthweight unavailable) has fallen from 11.6 in 1981 to 4.6 per 1,000 births in 2014, while the rate for 
international statistics (for births of 1,000g or 28 weeks if birthweight unavailable) has fallen from 7.2 to 2.4 per 
1,000 births during the same period. The fall in this neonatal mortality rate (for early neonatal deaths) has been 
particularly outstanding, reaching 0.4 per 1000 live births in 2014, the lowest recorded in the state. The fall in 
perinatal mortality is reflected in the standardized perinatal mortality ratio which has been calculated in Table 48 
for each year utilising perinatal mortality rates for 500g birthweight groups for the years 1981-1989 combined as 
the standard. It was 60.0 in 2014 compared with 117.6 in 1981. 

Table 47: Socio-demographic aspects of perinatal statistics, South Australia, 1981 and 2005-2014

Characteristic
Year

1981 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

1 Total births 19,052 18,196 18,803 19,757 19,970 19,901 20,002 20,344 20,666 20,263 20,749

2 Live births 18,905 18,067 18,663 19,624 19,819 19,761 19,883 20,194 20,528 20,125 20,604

3 Women who 
gave birth 18,857 17,897 18,519 19,471 19,672 19,604 19,667 20,043 20,338 19,925 20,448

4 Total fertility 
rate per 
woman

1.75 1.82 1.82 1.91 1.91 1.87 1.84 1.89 1.91 1.85 1.83

5 Place of birth (%)
 Teaching hospital 52.2% 51.6% 52.1% 52.6% 53.2% 53.7% 54.3% 55.5% 56.8% 57.3% 57.8%

 Private hospital 19.7% 26.5% 26.7% 26.6% 26.5% 25.7% 25.6% 24.1% 23.3% 22.8% 22.5%

 Country hospital 27.8% 21.6% 20.8% 20.2% 20.3% 19.9% 19.3% 19.9% 19.4% 19.3% 19.3%

 Domiciliary* 0.3% 0.3% 0.5% 0.5% 0.5% 0.7% 0.7% 0.5% 0.5% 0.6% 0.5%

(65) (63) (87) (107) (101) (134) (144) (96) (95) (114) (102)

6 Race (%)
 Aboriginal 1.5% 2.7% 3.0% 3.0% 3.2% 3.1% 3.2% 3.5% 3.3% 3.6% 3.5%

(Women who  
gave birth) (277) (487) (548) (578) (624) (607) (625) (693) (662) (717) (712)

(Births to 
Aboriginal 
mothers)

(280) (492) (559) (590) (637) (618) (630) (703) (669) (729) (720)

(Babies identified 
as Aboriginal) (904) (952) (947)

 Asian 1.8% 5.3% 5.1% 6.2% 7.0% 8.1% 9.6% 11.1% 12.1% 12.0% 12.9%

7 Age

 Mean age (years) 26.55 29.86 30.01 30.05 30.11 30.14 30.14 29.69 30.21 29.8 30.0

 Teenage  (%) 7.8% 5.2% 4.8% 4.6% 4.5% 4.1% 4.0% 4.0% 3.9% 3.3% 3.1%

?35 years  (%) 4.6% 18.7% 20.4% 20.2% 21.1% 21.1% 20.5% 20.6% 20.4% 19.8% 20.6%

8 Marital status (%)
 Never married 7.6% 12.5% 11.7% 11.0% 10.7% 10.0% 9.6% 9.2% 9.2% 8.8% 7.8%

Widowed/ 
divorced/  
separated (%)

2.0% 1.3% 1.3% 1.4% 1.2% 1.2% 1.3% 1.0% 1.3% 1.3% 1.1%

(Single) (9.6%) (13.8%) (13.0%) (12.5%) (11.9%) (11.2%) (10.9%) (10.2%) (10.5%) (10.1%) (8.9%)

9 Primiparae

 Mean age (years) 24.42 28.02 28.20 28.30 28.24 28.27 28.34 27.92 28.44 28.20 28.4

 Teenage 15.4% 10.1% 9.5% 8.9% 8.8% 8.4% 7.8% 7.8% 7.8% 6.7% 6.3%

?35 years 1.2% 11.4% 12.6% 12.5% 12.7% 12.8% 12.2% 12.0% 11.8% 12.4% 12.9%

*includes unplanned home births

Pregnancy Outcome in South Australia 2014 page  77

Trends in Perinatal Statistics in South Australia, 1981-2014



Table 48: Obstetric aspects of perinatal statistics, South Australia, 1981 and 2005   2014

Characteristic
Year

1981 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

1 Plurality

Multiple births 
(%) 2.0% 3.3% 3.0% 2.9% 3.0% 3.0% 3.3% 2.9% 3.2% 3.3% 2.9%

Twins (363) (570) (552) (544) (592) (578) (644) (586) (636) (640) (574)

Triplets (21) (21) (12) (21) (3) (12) (15) (12) (15) (27) (21)

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

2 Induction of labour (%) 22.1% 28.3% 28.9% 29.8% 28.6% 29.4% 29.6% 31.2% 30.9% 32.5% 32.2%

3 Method of birth

Normal 
spontaneous 66.1% 55.8% 56.0% 56.0% 56.0% 55.4% 55.2% 54.7% 54.2% 53.9% 54.1%

Elective caesarean 8.2% 14.6% 15.5% 15.3% 15.4% 15.7% 15.5% 15.8% 15.9% 16.2% 16.6%

Emerg caesarean 8.7% 17.6% 17.4% 17.1% 16.8% 16.7% 16.7% 17.3% 17.9% 17.8% 17.3%

Forceps 15.2% 4.2% 3.7% 4.1% 4.2% 4.6% 5.4% 5.7% 5.5% 5.6% 5.3%

Breech 1.1% 0.4% 0.4% 0.4% 0.5% 0.4% 0.3% 0.5% 0.4% 0.5% 0.4%

Ventouse 0.7% 7.3% 7.0% 7.1% 7.1% 7.2% 6.9% 5.9% 6.0% 5.9% 6.3%

Total caesarean (16.9%) (32.3%) (32.9%) (32.3%) (32.2%) (32.4%) (32.2%) (33.2%) (33.8%) (34.0%) (33.9%)

4 Birthweight &lt;2,500g 5.8% 7.6% 7.0% 6.9% 7.0% 7.3% 7.2% 7.5% 7.7% 7.7% 7.1%

Singletons 4.9% 5.9% 5.5% 5.5% 5.5% 5.7% 5.6% 6.2% 6.1% 5.8% 5.7%

Multiples 52.1% 57.7% 53.4% 53.6% 53.4% 59.8% 54.1% 51.9% 56.8% 63.0% 57.2%

5 Gestational age &lt;37 weeks 5.5% 9.0% 8.2% 8.5% 8.6% 9.0% 8.9% 9.2% 9.4% 9.8% 9.2%

Singletons 4.8% 7.3% 6.8% 7.1% 7.0% 7.2% 7.2% 7.5% 7.6% 7.7% 7.5%

Multiples 41.1% 58.4% 54.4% 57.2% 59.3% 67.5% 58.4% 61.5% 64.7% 70.6% 69.2%

6 Congenital abnormalities 3.4% 2.5% 2.3% 2.6% 2.7% 2.7% 2.8% 3.0% 2.7% 2.8% 2.7%

7 Level II care Na 16.2% 15.3% 16.1% 15.4% 15.3% 16.0% 16.2% 16.7% 16.5% 15.9%

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

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

10
Hospitalisation 
for 28 days or 
more

4.2% 2.4% 2.0% 2.1% 2.2% 2.2% 2.0% 2.2% 2.4% 2.4% 2.1%

11 Neonatal deaths 96 63 38 55 51 49 44 44 46 45          39

12 Stillbirths 147 129 140 132 151 140 119 150 138 138 145

13 Perinatal deaths 243 192 178 188+ 202 189 163 194 184 183 184

14 Perinatal mortality rate per 1,000 births

?400g/20 weeks 12.8 10.6 9.5 9.5 10.1 9.5 8.1 7.4 8.9 6.6 8.9

?500g/22 weeks* 11.6 6.2 4.9 5.2 5.3 4.9 4.4 5.3 4.1 5.2 4.6

?1,000g/28 
weeks* 7.2 3.7 3.1 2.6 3.4 3.5 3.2 3.2 2.1 2.8 2.4

15
Standardized 
perinatal 
mortality ratio

117.6 66.5 63.0 65.1 67.3 65.2 57.6 62.9 57.6 59.4 60.0

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

Pregnancy Outcome in South Australia 2014page 78

Trends in Perinatal Statistics in South Australia, 1981-2014



Trends in Perinatal Statistics in South Australia (SA), 1985   2014

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

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Pregnancy Outcome in South Australia 2014 page  79

Trends in Perinatal Statistics in South Australia, 1981-2014



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

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Figure 30.5: Percentage of women never married and with no de facto partner among women giving birth 
in SA

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Figure 30.6: Percentage of multiple births among births in SA

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Pregnancy Outcome in South Australia 2014page 80

Trends in Perinatal Statistics in South Australia, 1981-2014



Figure 30.7 Percentage of low birthweight babies among births in SA

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Figure 30.8: SA standardised perinatal mortality ratio (SPMR)

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Pregnancy Outcome in South Australia 2014 page  81

Trends in Perinatal Statistics in South Australia, 1981-2014



VII. Summary Statistics for 2014
These statistics refer to all live births as well as stillbirths of at least 400g birthweight or 20 weeks gestation.  
Fifty babies of less than 400g birthweight have been included.

1. Number of births

Reported number of births (from monthly notifications): 20,749

Notified births with Supplementary Birth Records (SBRs): 20,749

Notified women who gave birth with SBRs: 20,448

Crude birth rate: 12.2 live births per 1,000 population.  

Total fertility rate: 1.83 live births per woman

2. Place of birth

Home births:102 home births in all (0.5%), of which 96 were planned home births (0.5% of births in the state). 

Metropolitan teaching hospitals: 12,034 (57.9%)

Metropolitan private hospitals: 4,659 (22.5%)

Country hospitals: 3,954 (19.1%)

3. Sex

Males 10,626, Females 10,122. Male: Female sex ratio = 1.05:1

4. Plurality and condition at birth

Condition at birth

Plurality

TotalSingleton Twins Triplets

Live birth 20,022 561 21 20,604

Stillbirth 132 13 0 145

Total 20,154 574 21 20,749

5. Race of women

Race Number of women %

Caucasian 15,717 76.9

Aboriginal 712 3.5

Asian 2,655 13.0

Other 1,364 6.7

Total 20,448 100.0

Pregnancy Outcome in South Australia 2014page 82

Summary Statistics for 2014



6. Obstetric interventions in 20,448 women who gave birth

Induction of labour was performed for 6,589 women (32.2%) and labour was augmented for another 3,579 women 
(17.5%) who gave birth.

Forceps were utilised for 1,093 women (5.3%), ventouse in 1,282 (6.3%) and episiotomy was performed for 2,937 
women who gave birth (14.4%, or 26.5% of women who gave birth vaginally).

Caesarean section was performed in 6,930 women who gave birth (33.9%), of which 3,399 (16.6%) were elective, 
and 3,531 (17.3%) emergency operations.

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

Number of singleton births of low birthweight =1,143 (5.7% of singleton births).

Number of multiple births of low birthweight =340 (57.2% of multiple births).

Number of all births of low birthweight =1,483 (7.1% of all births).

8. Congenital anomalies

Births notified with congenital anomalies: 560 (2.7%).

9. Perinatal mortality rates (numbers of deaths in parentheses)

Birthweight/Gestation Stillbirth rate per 1,000 births
Neonatal death rate per 

1,000 live births
Perinatal mortality rate 

per 1,000 births

1 ?400g/20 weeks (145)    7.0 (39)    1.9 (184)    8.9

2 ?500g/22 weeks if birthweight 
unavailable

(WHO National Statistics*)
(70)    3.4 (17)    0.8* (87)    4.2*

3 ?1,000g/28 weeks if birthweight 
unavailable

(WHO International/ Standard 
Statistics*)

(37)    1.8 (9)    0.4* (46)     2.2*

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

10. Terminations of pregnancy

Total number of induced abortions notified: 4,650

Induced abortion rate per 1,000 women (15-44 years): 13.8

Total induced abortion rate (life-time) per 1,000 women (15-44 years): 410.9 

Total first induced abortion rate (life-time) per 1,000 women (15-44 years): 262.9

Induced abortion proportion: 0.18

Pregnancy Outcome in South Australia 2014 page  83

Summary Statistics for 2014



References
1. Scheil W, Scott J, Chan A. South Australian Perinatal Statistics Collection. Guidelines for the Supplementary Birth 

Record. Adelaide: Pregnancy Outcome Unit , South Australian Department of Health, 2012.

2. The South Australian Birth Defects Register. 2012 Annual Report. Adelaide: Women s and Children s Hospital, 
Children, Youth and Women s Health Service, 2015.

3. Maternal, Perinatal and Infant Mortality Committee. Maternal, Perinatal and Infant Mortality in South Australia 
2014. Adelaide: SA Health, Government of South Australia, 2016.

4. Statewide Service Strategy Division. Standards for Maternal and Neonatal Services in SA 2010. Adelaide: 
Department of Health, 2010.

5. South Australian Health Commission. Report of the South Australian Birthing Services Working Group. Adelaide: 
Social Health and Policy Development Branch, South Australian Health Commission, 1994.

6. South Australian Abortion Reporting Committee. Annual Report - For the Year 2014. Adelaide:  SA Health, 
Government of South Australia, 2016.

7. South Australian Health Commission Epidemiology Branch. Risk factors for adverse perinatal outcome: 
determination from a perinatal statistics collection. Adelaide: South Australian Health Commission, December 
1986.

8. Mallett R, Knox EG. Standardized perinatal mortality ratios: technique, utility and interpretation. Community 
Med 1979; 1: 6-13.

9. AHMC (Australian Health Ministers  Conference) 2011. National Maternity Services Plan. Canberra: Australian 
Government Department of Health and Ageing.

10. AIHW National Perinatal Epidemiology and Statistics Unit and AIHW 2013. National core maternity indicators. 
Cat. no. PER 58. Canberra: AIHW.

Pregnancy Outcome in South Australia 2014page 84

References



Publications
The following is a list of publications from 1985 from the Pregnancy Outcome Unit or which utilised data from the Unit.

Annual Reports
1. Pregnancy Outcome in South Australia (from 1985), website: www.sahealth.sa.gov.au

2. Maternal, Perinatal and Infant Mortality in South Australia. Annual Report of the Maternal, Perinatal &amp; Infant 
Mortality Committee (from 1985), website: www.sahealth.sa.gov.au

3. Committee appointed to examine and report on abortions notified in South Australia Annual Report  (from 1985 
to 2002). South Australian Abortion Reporting Committee Annual Report (from 2003).

4. Pregnancy and Neonatal Care Bulletin (from 1985): for individual hospitals.

The Unit provides birth defects data to the South Australian Birth Defects Register at the Women s and Children s 
Hospital and perinatal and birth defects data to the Australian Institute of Health and Welfare National Perinatal 
Statistics Unit in Sydney for their reports.

These reports are as follows:

1.  The South Australian Birth Defects Register Annual Report (from 1986).

 South Australian Birth Defects Register, Public Health Research Unit, Women s and Children s Hospital, 
Children, Youth and Women s Health  Service, 72 King William Road, North Adelaide, South Australia 5006. 

 Telephone (08) 81616518  
Website: www.wch.sa.gov.au/services/az/other/phru/birthdefect.html

2. Australia s Mothers and Babies (from 1991) and 

3. Congenital anomalies in Australia  (from 1981) 

 AIHW National Perinatal Statistics Unit, Sydney Children s Hospital, Level 2, McNevin Dickson Building, 
Randwick Hospital Campus, Randwick NSW 2031. 

 Telephone (02) 9382 1014   
Website: www. npsu.unsw.edu.au 

Other reports/papers
1. Birth defects

1. Jonas O, Stern LM, Macharper T. A South Australian Study of Pregnancy and Birth Risk Factors associated 
with Cerebral Palsy. Int J Rehab Research 1989; 12 (2): 159-166.

2. Chan A, Robertson EF, Haan EA, Keane RJ, Ranieri E, Carney A. Prevalence of neural tube defects in South 
Australia, 1966   91: effectiveness and impact of prenatal diagnosis. BMJ 1993; 307: 703-6.

3. Bower C, Norwood F, Knowles S, Chambers H, Haan E, Chan A. Amniotic band syndrome: a population-
based study in two Australian States. Paediatr Perinat Epidemiol 1993; 7: 395-403.

4. Chan A, Robertson E, Haan E, Ranieri E, Keane R. The sensitivity of ultrasound and serum alpha-fetoprotein 
in population-based antenatal screening for neural tube defects in South Australia 1986-1991. Br J Obstet 
Gynaecol 1995; 102 :370-376.

5. Chan A, Keane RJ, Hanna M, Abbott M. Terminations of pregnancy for exposure to oral retinoids in South 
Australia, 1985-1993. Aust NZ J Obstet Gynaecol. 1995; 35 : 422-426.

6. Byron-Scott R, Chan A, Haan EA, Bower C, Scott H, Clark K. A population-based study of abdominal wall 
defects in South Australia and Western Australia. Proceedings, 14th Annual  Congress Australian Perinatal 
Society, Adelaide, March 1996, P82.

7. Chan A, Hanna M, Abbott M, Keane RJ. Oral retinoids and pregnancy. MJA 1996;165: 164-167.

Pregnancy Outcome in South Australia 2014 page  85

Publications



8. Chan A, McCaul KA, Cundy P, Haan EA, Byron-Scott R. Perinatal risk factors for developmental dysplasia of 
the hip. Arch Dis Child 1997; 76 : F94   F100.

9. Yiv BC, Saidin R, Cundy PJ, Tgetgel JD, Aguilar J, McCaul KA, Keane RJ, Chan A, Scott H. Developmental 
dysplasia of the hip in South Australia in 1991: Prevalence and risk factors. J. Paediatr Child Health 1997; 
33: 151-6.

10. Cheffins T, Chan A, Keane RJ. The effects of rubella immunisation in South Australia. Proceedings, Rights to 
Health 29th Annual Conference, Public Health Association of Australia Inc., Melbourne, 5-8 October 1997.

11. Byron-Scott R, Haan E, Chan A, Bower C, Scott H, Clark K. A population-based study of abdominal wall 
defects in South Australia and Western Australia. Paediatr Perinat Epidemiol. 1998; 12: 136-151.

12. Cheffins T,  Chan A, Keane RJ, Hann EA, Hall R. The impact of rubella immunisation on the incidence of 
rubella, congenital rubella syndrome and rubella-related terminations of pregnancy in South Australia. Br J 
Obstet Gynaecol 1998; 105: 998-1004.

13. Chan A, McCaul K, Keane RJ, Haan EA. Effect of parity, gravidity, previous miscarriage, and age on the risk 
of Down s syndrome : population-based study. BMJ 1998; 317: 923-4.

14. Byron-Scott R. et al. A validation study of congenital heart defects in South Australia. Proceedings, 
Australian Birth Defects Society. Annual Scientific Meeting. Sydney 1998.

15. Byron-Scott R. et al. A comparison of selected birth defects in Aboriginal and non-Aboriginal babies in 
South Australia. Proceedings, Australian Birth Defects Society. Annual Scientific Meeting, Sydney 1998.

16. Byron-Scott R. Richardson M, Hiller J, Chan A, Haan E, Knight B, Adams P. The prevalence and validation 
of congenital heart defects in South Australia, 1986-94. Proceedings of the 3rd Annual Congress of the 
Perinatal Society of Australia and New Zealand, Melbourne, 1999. P153.

17. Chan A, Cundy PJ, Foster BK, Keane RJ, Byron-Scott R. Late diagnosis of congenital dislocation of the hip 
and presence of a screening programme. South Australian population-based study. Lancet 1999;354:1514-
17.

18. Chan A, Cundy PJ, Foster BK, Keane RJ, Byron-Scott R. Screening for congenital dislocation of the hip 
(letter). Lancet 2000;355:232-33.

19. Chan A, Pickering J, Haan EA, Netting M, Burford A, Johnson A, Keane RJ.  Folate before pregnancy : the 
impact of a South Australian health promotion campaign on women and health professionals. Western 
Australian Birth Defects Registry Twentieth Anniversary Scientific Symposium April 27-28, 2000. Perth, 
Western Australia. Teratology 2000;62: 365.

20. Cheffins T, Chan A, Haan EA, Ranieri E, Ryall RG, Keane RJ, Byron-Scott R, Scott H, Gjerde EM, Nguyen 
A-M, Ford JH, Sykes S. The impact of maternal serum screening on the birth  revalence of Down s syndrome 
and the use of amniocentesis and chorionic villus sampling in South Australia. Br J Obstet Gynaecol 
2000;107:1453-9.

21. Chan A, Pickering J, Haan EA, Netting M, Burford A, Johnson A, Keane RJ.  Folate before pregnancy :the 
impact on women and health professionals of a population-based health promotion campaign in South 
Australia. MJA 2001; 174:631-636.

22. Chan A, Foster BK, Cundy PJ. Invited commentary. Problems in the diagnosis of neonatal hip instablity. Acta 
Paediatr 2001;90:836-9.

23. Metz MP, Ranieri E, Gerace RL, Priest KR, Luke CG, Chan A. Newborn screening in South Australia: is it 
universal? MJA 2003;179:412-415.

24. Chan A. Invited commentary: Parity and the risk of Down syndrome   caution in interpretation. Am J 
Epidemiol 2003;158:509-511.

25. Gibson CS, MacLennan AH, Hague WM, Rudzki Z, Sharpe P, Chan A, Dekker GA. Fetal thrombophilic 
polymorphisms are not a risk factor for cerebral palsy. Perinatal Society of Australia and New Zealand 8th 
Annual Congress, Convention Centre, Darling Harbour, Sydney, Australia, 15th-18th March 2004, A41.

Pregnancy Outcome in South Australia 2014page 86

Publications



26. Gibson CS, MacLennan AH, Rudzki Z, Hague WM, Haan EA, Sharpe P, Priest K, Chan A, Dekker GA for the 
South Australian Cerebral Palsy Research Group. The prevalence of inherited thrombophilias in a Caucasian 
Australian population. Pathology  2005;37:160-163.

27. Byron-Scott R, Sharpe P, Hasler C, Cundy P, Hirte C, Chan A, Scott H, Baghurst PB, Haan E. A South 
Australian population-based study of congenital talipes equivarus. Paediatr Perinat Epidemiol  2005;19:227-
237.

28. Gibson CS, MacLennan AH, Hague WM, Haan E, Priest K, Chan A, Dekker GA  for the South Australian 
Cerebral Palsy Research Group. Associations between inherited thrombophilias, gestational age and 
cerebral palsy. Am J Obstet Gynecol 2005;193:1437.e1-1437.e12.

29. Sharpe PB, Chan A, Haan EA, Hiller JE. Maternal diabetes and congenital anomalies in South Australia 
1986-2000: a population-based cohort study. Birth Defects Research Part A  Clin Mol Teratol 2005:73;605-
611.

30. Gibson CS, MacLennan AH, Goldwater PN, Haan EA, Priest K, Dekker GA for the South Australian Cerebral 
Palsy Research Group. Neurotropic viruses and cerebral palsy: a population bases case-control study. BMJ 
,doi:10.1136/bmj.38668.616806.3A (published 6 January 2006).

31. Sharpe PB, Mulpuri K, Chan A, Cundy P. Differences in risk factors between early and late diagnosed DDH. 
Arch Dis Child 2006;91:F158-162.

32. Gibson CS, MacLennan AH, Goldwater PN, Haan EA, Priest K, Dekker GA for the South Australian Cerebral 
Palsy Research Group. The association between inherited cytokine polymorphisms and cerebral palsy. Am J 
Obstet Gynecol 2006;194: 674.e1-674.e11.

33. Gibson CS, MacLennan AH, Janssen NG, Kist WJ, Hague WM, Haan EA, Goldwater PN, Priest K, Dekker GA 
for the South Australian Cerebral Palsy Research Group. Associations between fetal inherited thrombophilia 
and adverse pregnancy outcomes. Am J Obstet Gynecol  2006; 194: 947.e1-947.e10.

34. Gibson CS, MacLennan AH, Dekker GA, Goldwater PN, Dambrosia JM, Munroe DJ, Tsang S,  Stewart C, 
Nelson KB. Genetic polymorphisms and spontaneous preterm birth. Obstet Gynecol 2007;109:384-391.

35. Muller PR, Cocciolone R, Haan EA, Wilkinson C, Scott H, Sage L, Bird R, Hutchinson R, Chan A. Trends in 
state/population-based Down syndrome screening and invasive prenatal testing with the introduction of 
first-trimester combined Down syndrome screening, South Australia, 1995-2005. Am J Obstet Gynecol 
2007;196:315.e1-315.e7.

36. Gibson CS, MacLennan AH, Goldwater PN, Haan EA, Priest K, Dekker GA for the South Australian Cerebral 
Palsy Research Group. Mannose-binding lectin haplotypes may be associated with cerebral palsy only after 
perinatal viral exposure. Am J Obstet Gynecol 2008;198:509.e1-509.e8.

37. Khoo NS, van Essen P, Richardson M, Robertson T. Effectiveness of prenatal diagnosis of congenital heart 
defects in South Australia: a population analysis 1999-2003. Aust NZ J Obstet Gynaecol 2008;48:559-563.

38. Chan AC, van Essen P, Scott H, Haan EA, Sage L, Scott J, Gill TK, Nguyen A-M T. Folate awareness and the 
prevalence of neural tube defects in South Australia, 1966-2007. MJA 2008;189: 566-569.

39. Djukic M, Gibson CS, MacLennan AH, Goldwater PN, Haan EA, McMichael G et al. Genetic susceptibility to 
viral exposure may increase the risk of cerebral palsy. Aust NZ J Obstet Gynaecol 2009: 49:247-253.

40. De Souza, Halliday J, Chan A, Bower C, Morris JK. Recurrence risks for trisomies 13,18, and 21. Am J Med 
Genet Part A 149A:2716 2722.

41. Davies MJ, Moore VM, Willson KJ, Van Essen P, Priest K, Scott H, et al. Reproductive technologies and the 
risk of birth defects. N Engl J Med. 2012 May 10;366(19):1803-13. PubMed PMID: 22559061.

42. Flood L, Scheil W, Nguyen A, Sage L, Scott J. An increase in neural tube defect notifications, South 
Australia, 2009 2010. Western Pacific Surveillance and Response Journal, 2013, 4 (2). doi:10.5365/
wpsar.2012.3.3.006.

43. Gibson CS, Scott H, Haan E, Scheil W. Age Range for Inclusion Affects Ascertainment by Birth Defects 
Registers. Birth Defects Research (Part A) 00:000 000, 2016.

Pregnancy Outcome in South Australia 2014 page  87

Publications



44. Davies MJ, Rumbold AR, Whitrow MJ, Willson KJ, Scheil WK, Mol BW, &amp; Moore VM. Spontaneous loss of a 
co-twin and the risk of birth defects after assisted conception. Journal of Developmental Origins of Health 
and Disease, 2016, 1-7. doi:10.1017/S2040174416000301.

45. Studer K, Williams N, Antoniou G, Gibson C, Scott H, Scheil WK,  Cundy PJ. Increase in late diagnosed 
developmental dysplasia of the hip in South Australia: Risk factors, proposed solutions. Medical Journal of 
Australia, 2016, 204(6), 240.e1-240.e6. doi:10.5694/mja15.01082.

46. Constantine S, David D, Anderson P. The use of obstetric ultrasound in the antenatal diagnosis of 
craniosynostosis: We need to do better. Australasian Society for Ultrasound in Medicine AJUM April 2016 0 
(0) 1.

2. Termination of pregnancy

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

2. Chan A, Taylor A. Medical Termination of Pregnancy in South Australia - The First 20 Years 1970-1989. 
Adelaide: Pregnancy Outcome Unit, South Australian Health Commission, December 1991.

3. Chan A, McColl M, Versteeg J, Gameau B, Scanlan C, Pridmore B. A South Australian Study on 
Contraception and Abortion. Public and Environmental Health Service, South Australian Health Commission 
and Department of Obstetrics and Gynaecology, The Queen Elizabeth Hospital, Adelaide, March 1994.

4. Hart G, Macharper T. Clinical aspects of induced abortion in South Australia from 1970-1984. Aust. NZ J 
Obstet Gynaecol 1986; 26: 219-224.

5. Hart G, Macharper T. Induced abortion trends in South Australia. Am J Public Health 1987; 77: 200-202.

6. Chan A, Keane RJ. Prevalence of induced abortion in a reproductive lifetime. Am J Epidemiol 
2004;159:475-480.

7. Chan A, Sage LC. Estimating Australia s abortion rates 1985-2003. MJA  2005;182:447-452.

3. Perinatal epidemiology

1. Connon AF, Macharper T. Teenage pregnancies in South Australia. Adelaide: South Australian Health 
Commission, September 1986.

2. South Australian Health Commission, Epidemiology Branch:  Characteristics of pregnancies and births 
among migrant women in South Australia. Adelaide : South Australian Health Commission, October 1986.

3. South Australian Health Commission, Epidemiology Branch. Risk factors for adverse perinatal outcome: 
determination from a perinatal statistics collection. Adelaide: South Australian Health Commission, 
December 1986.

4. South Australian Health Commission, Epidemiology Branch. Variation in perinatal risk by place of residence 
of mother in South Australia. Adelaide: South Australian Health Commission, December 1986.

5. South Australian Health Commission, Epidemiology Branch. Variations in Perinatal Risk by Hospital of Birth 
in South Australia. Adelaide: South Australian Health Commission, January 1987.

6. South Australian Health Commission, Epidemiology Branch. Aboriginal Births in South Australia, 1981-
1986: An Analysis of Perinatal Outcomes, Adelaide: South Australian Health Commission, May 1988.

7. South Australian Health Commission, Epidemiology Branch: Pregnancy Outcome Attributes by Postcode: 
South Australia 1981-1986. South Australian Health Commission, Adelaide: August 1988.

8. Jonas O, Scott J, Chan A, Macharper T, Lister J. A validation study of the 1986 perinatal data collection 
form. Adelaide: Pregnancy Outcome Unit, South Australian Health Commission, 1991.

9. South Australian Cancer Registry. Associations between perinatal characteristics and risk of childhood 
cancer: South Australian cancer cases born in 1981-1993. In: Epidemiology of Cancer in South Australia. 
Incidence, Mortality and Survival 1977 to 1994. Adelaide South Australian Health Commission, 1995.

10. Taylor A, Twisk A-M, Chan A. Perinatal risk factors by postcode in South Australia 1989-1992. Epidemiology 
Branch, South Australian Health Commission, Adelaide: June 1995.

11. Pregnancy Outcome Unit. Perinatal Statistics Collection. Guidelines for the Supplementary Birth Record. 
Adelaide: South Australian Health Commission, December 1997.

Pregnancy Outcome in South Australia 2014page 88

Publications



12. McLean A, Scott J, Keane RJ, Sage L, Chan A. Validation of the 1994 South Australian perinatal data 
collection form. Adelaide: Pregnancy Outcome Unit, Department of Human Services, 2001.

13. Hart G, MacHarper T, Moore D, Roder D. Aboriginal pregnancies and births in South Australia. MJA 1985; 
143: S54-56.

14. Chan A, Roder D, Macharper, T. Obstetric Profiles of Immigrant Women from Non-English Speaking 
Countries in South Australia, 1981-83. Aust NZ J Obstet Gynaecol 1988; 28: 90-95.

15. Jonas O, Roder D, Esterman A, Macharper T, Chan A. Pregnancy and Birth Risk Factors for Intellectual 
Disability in South Australia. Eur J Epidemiol 1989; 5: 322-327.

16. Jonas O, Chan A, Macharper T, Roder D. Pregnancy and Perinatal Factors associated with persistently low 
Apgar scores: an analysis of the birth records of infants born in South Australia. Eur J Epidemiol 1990; 6: 
136-141.

17. Crotty M, Ramsay AT, Smart R, Chan A. Planned Homebirths in South Australia 1976-1987 MJA 1990; 153: 
664-671.

18. Jonas O, Chan A, Roder D, Macharper T. Pregnancy Outcomes in primigravid women aged 35 years and 
over in South Australia, 1986-1988.  MJA 1991; 154: 246-249.

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

20. Jonas O, Roder D, Chan A. The Association of Maternal and Socioeconomic Characteristics in Metropolitan 
Adelaide with Medical, Obstetric and Labour Complications and Pregnancy Outcomes. Aust NZ J Obstet 
Gynaecol 1992; 32: 1-5.

21. Chan A, Roder D, Priest K, Esterman A. A perinatal perspective on South Australia in the 1980s. MJA 1992; 
157: 515-518.

22. Jonas O, Roder D, Chan A. The association of low socio-economic status in Metropolitan Adelaide with 
maternal demographic and obstetric characteristics and pregnancy outcome. Eur J Epidemiol 1992; 8:708.

23. Jonas O, Roder D. Breech Presentation in South Australia, 1987-1989. Aust NZ J Obstet Gynaecol 1993; 33: 
17-21.

24. Scott J, Chan A. Planned birthing unit deliveries in South Australia. Proceedings, 14th Annual Congress 
Australian Perinatal Society, Adelaide, March 1996, P21.

25. Dal Grande E, Chan A, Keane R. Asian, but different: Obstetric characteristics of women born in Vietnam 
and Philippines who delivered in South Australia in 1991-1994. Proceedings, 14th Annual Congress 
Australian Perinatal Society, Adelaide, March 1996, P22.

26. Keane R, Dal Grande E, Chan A, McCaul K. Episiotomy   a decline in the cutting edge. Proceedings, 14th 
Annual Congress Australian Perinatal Society, Adelaide, March 1996, P75.

27. Chan A, McPhee AJ. A safer leap into this dangerous world. Lancet 1996; 348 (suppl II) :12.

28. Carter JR, Hiller JE, Ryan P, Chan A. The Association between maternal age and preterm births to 
primiparous women in South Australia, 1991-1993, Proceedings, First Annual Congress, Perinatal Society of 
Australia and New Zealand, Fremantle, Western Australia, 16-24 March 1997.

29. Zhang B, Hiller JE, Chan A. Asthma in pregnancy in South Australia. Proceedings, First Annual Congress, 
Perinatal Society of Australia and New Zealand, Fremantle, Western Australia, 16-24 March 1997.

30. Roder D, Nguyen A-M, Chan A. Trends in perinatal characteristics in South Australia, 1981 to 1994, by 
place of residence of mother. Aust NZ J Public Health 1997; 21: 483-8.

31. Zhang B, Hiller JE, Chan A. Asthma in pregnancy: Association with Spontaneous Preterm Birth. Proceedings 
of the 3rd Annual Congress of the Perinatal Society of Australia and New Zealand, Melbourne, 1999, A113.

32. McLean AP, Hiller JE, Chan A. Maternal epilepsy and fetal outcomes in South Australia. Perinatal Society 
of Australia and New Zealand 4th Annual Congress. Brisbane Convention and Exhibition Centre, Brisbane, 
Australia, 12-15 March 2000, P192.

33. Chan A, Keane RJ, Robinson JS. The contribution of maternal smoking to preterm birth, small for 
gestational age and low birthweight among Aboriginal and non-Aboriginal births in South Australia. MJA 
2001;174: 389-93.

Pregnancy Outcome in South Australia 2014 page  89

Publications



34. van der Klis KAM, Westenberg L, Chan A, Dekker G, Keane RJ. Teenage pregnancy: trends,characteristics 
and outcomes in South Australia and Australia. Aust N Z J Public Health 2002; 26: 125-31.

35. Westenberg L, van der Klis KAM, Chan A, Dekker G, Keane RJ. Aboriginal teenage pregnancies compared 
with non-Aboriginal in South Australia 1995-1999. Aust N Z J Obstet Gynaecol 2002;42: 187-191.

36. Wang JX, Knottnerus A-M, Schuit G, Norman RJ, Chan A, Dekker GA. Surgically obtained sperm and risk of 
gestational hypertension and pre-eclampsia. Lancet 2002;359: 673-4.

37. Jacobs DJ, Vreeburg SA, Dekker GA, Heard AR, Priest KR, Chan A. Risk factors for hypertension during 
pregnancy in South Australia. Aust NZ J Obstet Gynaecol 2003; 3: 421-428.

38. Heard AR, Dekker GA, Chan A, Jacobs DJ, Vreeburg SA, Priest KR. Hypertension during pregnancy in South 
Australia, Part 1: Pregnancy outcomes. Aust NZ J Obstet Gynaecol 2004; 44: 404-409.

39. Vreeburg SA, Jacobs DJ, Dekker GA, Heard AR, Priest KR, Chan A. Hypertension during pregnancy in South 
Australia, Part 2: Risk factors for adverse maternal and/or perinatal outcome   results of multivariable 
analysis. Aust NZ J Obstet Gynaecol 2004;44: 410-418.

40. Leahy K, Elliot E, Kennare R, Chan A. Characteristics and pregnancy outcomes of first time mothers aged 
35 years and over compared to younger first time mothers in South Australia 1991-2002. Before and 
Beyond Birth. Abstract Book. Perinatal Society of Australia and New Zealand 9th Annual Congress. Adelaide 
Convention Centre, Adelaide, South Australia, 13-16 March 2005, A144.

41. Kennare R, Heard A, Chan A. Substance use during pregnancy: risk factors and obstetric and perinatal 
outcomes in South Australia. Aust NZ J Obstet Gynaecol  2005;45:220-225.

42. Freak-Poli R, Chan A, Tucker G, Street J. Previous abortion and risk of spontaneous preterm birth. Perinatal 
Society of Australia and New Zealand 10th Annual Congress. Perth Convention Exhibition Centre, Perth, 
Western Australia, 3-6 April 2006, FC17.1, p 165.

43. Scott J, Chan A. South Australian Perinatal Statistics Collection. Guidelines for the Supplementary Birth 
Record. Adelaide: Pregnancy Outcome Statistics Unit, South Australian Department of Health, 2006.

44. Budde MP, De Lange TE, Dekker GA, Chan  A, Nguyen AM. Risk factors for placental abruption in a socio-
economically disadvantaged region. J Matern Fetal Neonat Med 2007 Sep; 20(9):687-93. 

45. Freak-Poli R, Chan A, Tucker G, Street J. Previous abortion and risk of pre-term birth: a population study. J 
Matern-Fetal Neonat Med 2009;22(1):1-7.

46. Kennare R, Keirse M, Tucker G, Chan A. Planned home and hospital births in South Australia, 1991 2006: 
differences in outcomes. MJA 2010; 192: 76 80.

47. Dodd J, Grivell R, Nguyen AM, Chan A, Robinson J. Maternal and perinatal health outcomes by body mass 
index category. ANZJOG 2011: 51,2: 136 140.

48. Grivell RM, Reilly AJ, Oakey H, Chan AC, Dodd JM. Maternal and neonatal outcomes following induction of 
labor: a cohort study. Acta Obstet Gynecol Scand 2012; 91:198 203.

49. Ludford I, Scheil W, Tucker G, Grivell R. Pregnancy outcomes for nulliparous women of advanced maternal 
age in South Australia, 1998-2008. The Australian &amp; New Zealand Journal of Obstetrics &amp; Gynaecology. 
2012 Jun;52(3):235-41. PubMed PMID: 22553967.

50. Dodd JM, Catcheside B, Scheil W. Can shoulder dystocia be reliably predicted? The Australian &amp; New 
Zealand Journal of Obstetrics &amp; Gynaecology. 2012 Jun;52(3):248-52. PubMed PMID: 22428758.

51. Hodyl NA, Stark MJ, Scheil W, Clifton VL. Maternal asthma is a significant contributor to neonatal morbidity. 
Journal of Developmental Origins of Health and Disease 01/2011; 2:S120-S121. 

52. Hodyl NA, Stark MJ, Scheil W, Grzeskowiak LE, Clifton VL. Perinatal outcomes following maternal asthma 
and cigarette smoking during pregnancy. European Respiratory Journal: 2013 erj00549-02013.

53. Baghurst, P, Robson, S, Antoniou, G, Scheil, W and Bryce, R.  The association between increasing maternal 
age at first birth and decreased rates of spontaneous vaginal birth in South Australia from 1991 to 2009. 
Australian and New Zealand Journal of Obstetrics and Gynaecology, 2014; 54:237 243. doi:10.1111/
ajo.12182.

54. Baghurst P. The case for retaining severe perineal tears as an indicator of the quality for obstetric care. 
ANZJOG 2013; 53(1): 3-8.

Pregnancy Outcome in South Australia 2014page 90

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55. Hodyl NA, Grzeskowiak LE,Stark MJ, Scheil W, Clifton VL. The impact of Aboriginal status, cigarette 
smoking and smoking cessation on perinatal outcomes in South Australia. MJA 2015; 201(5): 274-278.

56. Smithers LG, Searle AK, Chittleborough CR, Scheil W, Brinkman SA, Lynch JW. A whole-of-population 
study of term and post-term gestational age at birth and children s development. BJOG 2015; DOI: 
10.1111/1471-0528.13324.

57. Mittiga C, Ettridge K, Martin K, Tucker G, Dubyna R, Catcheside B, Scheil W, Maksimovic L. 
Sociodemographic correlates of smoking in pregnancy and antenatal care attendance in Indigenous and 
non-Indigenous women in South Australia. Australian Journal of Primary Health Research 2015: http://
dx.doi.org/10.1071/PY15081.

58. Verburg, P, Tucker G, Scheil W, Dekker G &amp; Roberts C. Opposite trends in seasonality of gestational diabetes 
mellitus and pregnancy induced hypertensive disorders   A South Australian population study. Placenta 
2015, 36 (9) A42. 

59. Verburg PE, Tucker G, Scheil W, Erwich JJHM, Dekker GA, Roberts CT. Sexual Dimorphism in Adverse 
Pregnancy Outcomes   A Retrospective Australian Population Study 1981-2011. PLoS ONE 2016,11(7): 
e0158807. doi:10.1371/journal.pone.0158807.

4. Perinatal mortality

1. Roder D, Chan A, Esterman A. Birthweight   specific trends in perinatal mortality by hospital category in 
South Australia, 1985   1990. MJA 1993; 158: 664-667.

2. Connon AF, Chan A on behalf of the Postneonatal Subcommittee, maternal, perinatal and Inmfant 
Mortality Committee. Accidental deaths of babies in the postneonatal period in South Australia (letter). 
MJA 1994;161:397. 

3. Roder D, Chan A, Priest K. Perinatal mortality trends among South Australian Aboriginal births 1981-92. J 
Paediatr Child Health 1995; 31: 446-450.

4. Haslam R, McPhee A, Chan A, Keane R. Neonatal mortality   a system of classification and trends in South 
Australia. Proceedings of the 3rd Annual Congress of the Perinatal Society of Australia and New Zealand, 
Melbourne, 1999. P86.

5. Robson S, Chan A, Keane RJ, Luke CG. Subsequent birth outcomes after an unexplained stillbirth: 
preliminary population-based retrospective cohort study. Aust NZ J Obstet Gynaecol 2001;41: 29-35.

6. Flenady V, Chan A, Haslam R, King J, Tudehope D, McCowan L. Cause specific perinatal mortality in 
Australia and New Zealand using a new clinical classification system (ANZACPM and ANZNDC). Perinatal 
Society of Australia and New Zealand 7th Annual Congress, Hotel Grand Chancellor, Hobart, Tasmania, 
March 9th-12th 2003, A87.

7. Dodd JM, Robinson JS, Crowther CA, Chan A. Stillbirth and neonatal outcomes in South Australia, 1991-
2000. Am J Obstet Gynecol 2003;189: 1731-1736.

8. Chan A, King JF, Flenady V, Haslam RH, Tudehope DI. Classification of perinatal deaths: Development of the 
Australian and New Zealand classifications. J Paediatr Child Health 2004;40: 340-347.

9. Flenady V, King J, Chan A, McCowan L, Tudehope D, Haslam R, Charles A, Roberts C for the Perinatal 
Mortality Audit Guidelines Working Party of the PSANZ Perinatal Mortality Special Interest Group. 
Development of Clinical Practice Guideline for Perinatal Mortality Audit incorporating psychological and 
social aspects of perinatal bereavement. Before and Beyond Birth. Abstract Book. Perinatal Society of 
Australia and New Zealand 9th Annual Congress, Adelaide Convention Centre, Adelaide, South Australia, 
13-16 March 2005, P58.

10. De Lange TE, Budde MP, Heard AR, Tucker G, Kennare R, Dekker GA. Avoidable risk factors in perinatal 
deaths: a perinatal audit in South Australia. Aust NZ J Obs Gynaecol 2008;48:50-57.

11. Kennare R, Scheil W, Tucker G. A public health approach to review of sudden unexpected infant deaths   
challenges and interventions. Australian Journal of Child and Family Health Nursing 2015; 12: 1.

Pregnancy Outcome in South Australia 2014 page  91

Publications



5. Caesarean section

1. Jonas O, Chan A, Macharper T. Caesarean Section in South Australia, 1986. Aust NZ J Obstet Gynaecol 
1989; 29: 99-106.

2. Chan A. Epidemiology of the rising Caesarean section rate. Proceedings, 14th Annual Congress Australian 
Perinatal Society, Adelaide, March 1996, A70.

3. Chan A, Keane RJ, Scott J. Elective Caesarean section and child deprivation (letter). Lancet 1996; 347: 
1196.

4. Kennare, R. Why is the caesarean section rate rising? MIDIRS Midwifery Digest 2003; 13 (4): 503-508.

5. Kennare R, Heard A, Chan A. Is caesarean section in the first birth a problem for women in the next 
birth? Before and Beyond Birth. Abstract Book. Perinatal Society of Australia and New Zealand 9th Annual 
Congress. Ade;laide Convention Centre, Adelaide, South Australia, March 13-16 2005, A 127. 

6. Kennare R, Tucker G, Heard A, Chan A. Risks of adverse outcomes in the next birth after caesarean delivery. 
Obstet Gynecol 2007;109:270-276.

7. Dekker G, Chan A, Luke C, Priest K, Riley M, Halliday J, King J, Gee V, O Neill M, Snell M, Cull V, Cornes S. 
Risk of uterine rupture in Australian women attempting vaginal birth after one prior caesarean section: a 
retrospective population-based cohort study. BJOG 2010;117:1358 1365.

8. Smithers LG, Mol BW, Wilkinson C, Lynch JW. Implications of caesarean section for children s school 
achievement: a population-based study. Australian and New Zealand Journal of Obstetrics and Gynaecology 
2016 DOI: 10.1111/ajo.12475

Appendix 1: Definitions

Abortion rate:

 =                                                                                                             x 1,000
Estimated resident population of same group in the same year

Number of induced abortions in a group of women in a year  

The abortion rate per 1,000 women in the reproductive age group 15-44 years has been calculated in this report 
using as the numerator all abortions; the denominator used has been the estimated resident population for women 
aged 15-44 years in that year.

Abortion proportion:

Abortions + live births

Abortions
 =   

This is often called the abortion ratio, which is strictly: 
Live births

Abortion

Apgar score: A numerical scoring system applied after birth (usually at 1 minute and again at 5 minutes) to evaluate 
the condition of the baby, as specified below:

Sign
Score

0 1 2

Heart rate Absent Slow (below 100) Over 100

Respiratory effort Absent Slow, irregular Good, crying

Muscle tone Flaccid Some flexion of extremities Active motion

Reflex irritability No response Grimace Vigorous cry

Colour Blue, pale Body pink, extremities blue Completely pink

Pregnancy Outcome in South Australia 2014page 92

Appendix



Birthweight: The first weight of a fetus or newborn obtained after birth.  This is preferably measured within the first 
hour of life before significant post-natal weight loss has occurred.

Low birthweight:  Birthweight of less than 2,500g.
Very low birthweight:  Birthweight of less than 1,500g.

Body Mass Index (BMI):  weight (in kg)   height2 (in metres).
This is used as a standard for recording obesity statistics and also as a measure of underweight. However the 
categories do not take into account factors such as frame size, muscularity, varying proportions of components such 
as fat, bone, cartilage and water, and may be misleading in athletes, children and some ethnic groups. The categories 
for describing weight using BMI are:

BMI category Name
&lt;18.5 Underweight
18.5  to &lt; 25 Normal
25 to &lt; 30 Overweight
30 to &lt; 35 Obese
35 to &lt; 40 Severely obese
40 or greater Morbidly obese

Caesarean section: Birth of a child by an abdominal operation.
Elective caesarean section:  One which takes place as a planned procedure before the spontaneous onset 
of labour.
Emergency caesarean section:  One which is undertaken for a complication:

(a) before the onset of labour or
(b) during labour, whether that labour is of spontaneous onset or following induction of labour.

Fertility rates:

Age-specific fertility rate:

Estimated resident population of women of that age group in the same year

Number of live births to women in an age group in a year
x 1,000

General fertility rate:

Estimated resident population of womens aged 15 - 44  years in the same year

Total number of live births in a year
x 1,000

Total fertility rate (TFR): The sum of age-specific fertility rates (live births at each age of women per female 
population of that age). It represents the number of children a woman would bear during her lifetime if she 
experienced current age-specific fertility rates at each age of her reproductive life. 

Gestational age:  The duration of pregnancy in completed weeks determined by the best obstetric estimate, using 
ultrasonography and the first day of the last normal menstrual period.

Induction of labour:  An intervention undertaken to stimulate the onset of labour by pharmacological or other 
means.

Live birth: The complete expulsion or extraction from its mother of a product of conception, irrespective of the 
duration of pregnancy, which after such separation breathes or shows any other evidence of life, such as beating of 
the heart, pulsation of the umbilical cord or definite movement of voluntary muscles, whether or not the umbilical 
cord has been cut or the placenta is attached.

Maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, 
irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy 
or its management  but not from accidental or incidental causes.1

1 World Health Organisation. International Statistical Classification of Diseases and Related Health Problems. Tenth Revision. Volume 2. Geneva: WHO, 
1993, p 134.

Pregnancy Outcome in South Australia 2014 page  93

Appendix



Maternal deaths are divided into two groups:

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

2. Indirect obstetric deaths: those resulting from previous existing disease or disease that developed during pregnancy 
and which was not due to direct obstetric causes, but which was aggravated by physiologic effects of pregnancy.

As an extension of the WHO definition, accidental and incidental deaths occurring in pregnant women are also 
reviewed by the Maternal, Perinatal and Infant Mortality Committee so as to avoid missing indirect deaths which may 
be difficult to distinguish from incidental deaths. Examples of incidental deaths are deaths from drowning and road 
accidents, where the pregnancy is unlikely to have contributed significantly to the death, although it may be possible 
to postulate a remote association.

Multigravida: A woman who has been pregnant more than once.

Parity:  The total number of previous pregnancies resulting in live births or stillbirths.

Perinatal deaths:
Early fetal death: Death in a fetus of less than 400g birthweight, and of less than 20 weeks gestation.  
A miscarriage is a spontaneous early fetal death.

Fetal death: Death prior to the complete expulsion or extraction from a woman of a product of conception, 
irrespective of the duration of pregnancy; the death is indicated by the fact that after such separation the 
fetus does not breathe or show any other evidence of life, such as beating of the heart, pulsation of the 
umbilical cord, or definite movement of voluntary muscles.

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:

=                                                                                           x 1,000
Number of live births and still births in that year

Number of late fetal deaths or stillbirths in any year

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

Neonatal death rate:

 =                                                                     x 1,000
Number of live births in that year

Number of neonatal deaths in any year

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

Perinatal mortality rate (PMR):

=                                                                           x 1,000
Number of stillbirths and live births

Number of stillbirths and neonatal deaths

For South Australian statistics, the rate refers to live births and stillbirths of at least 400g birthweight or 20 
weeks gestation.

For national statistics, the rate refers to all births of at least 20 weeks gestation or 400g birthweight, and 
neonatal deaths occurring within 28 days of birth.

For international comparison, the rate refers to all births of at least 1,000g 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).

Preterm: less than 37+0 completed weeks gestation.

Primigravida: A woman pregnant for the first time.

Primipara: A pregnant woman who has had no previous pregnancy resulting in a live birth or stillbirth.

Pregnancy Outcome in South Australia 2014page 94

Appendix



Race
1.  Caucasian: individuals of European descent.
2.  Aboriginal: this includes part-Aboriginals as well as full blood Aboriginals.  An Aboriginal is a person of 

Aboriginal descent who identifies as an Aboriginal and is accepted as such by the community in which he 
or she lives.

3.  Asian: (exclude Asia Minor) - In this category, include women originating from all Asian countries, 
including the Indian subcontinent (India, Bangladesh, Pakistan, Nepal, Sri Lanka), who were formerly 
listed as  Other  race.

4.  Torres Strait Islander (TSI): A Torres Strait Islander is a person of Torres Strait Islander descent who 
identifies as a Torres Strait Islander and is accepted as such by the community in which he or she lives.

5.  Aboriginal &amp; TSI: persons of both Aboriginal and Torres Strait Islander descent. 
6.  Other:  Races other than (1) - (5).  Include women from the Middle East and Africa.

Guidelines for use regarding Indigenous Status - categories (2), (4) and (5).

There are three components to the definition:
 &gt; descent

 &gt; self identification

 &gt; community acceptance

It is not possible to collect the three components of the definition in a single question. The Australian Bureau 
of Statistics (ABS) proposes that the focus of a single question should be the descent, the first component 
of the definition. The ABS therefore proposes the use of the following alternative questions, depending on 
whether the person is present or not.

Where the person is present :  Are you of Aboriginal or Torres Strait Islander origin? ;

OR

where the person is not present and someone who knows the person well responds for him/her:  Is the 
person of Aboriginal or Torres Strait Islander origin? 

If the response is  Yes , then clarify whether the person is of Aboriginal origin (2), Torres Strait Islander 
origin (4) or both Aboriginal and Torres Strait Islander origin (5).

Self reporting of descent is not equivalent to self reporting of identity but because of the absence of a 
second  identity  question some respondents will interpret the  origin  question to mean both descent and 
identification. What identification in the context of the variable Indigenous Status should measure is an 
individual s self assessed historical and cultural affiliation.

Termination of pregnancy:  (synonym   induced abortion) The removal or expulsion of a pregnancy from the uterus 
via surgical or medical intervention,  performed by a medical practitioner in a prescribed hospital in South Australia, 
on specified grounds under the Criminal Law Consolidation Act and notified under the Criminal Law Consolidation 
(Medical Termination of Pregnancy) Regulations 1996. Terminations of pregnancy at gestations of 20 weeks or later or 
where the fetus weighs at least 400g, performed by induction of labour resulting in a birth  are included in the South 
Australian perinatal data collection. These are usually for congenital abnormalities or medical reasons.

Total abortion rate = the sum of the five-year age-specific induced abortion rates multiplied by 5.  

This represents the number of induced abortions 1,000 women would have during their lifetime if they experienced 
the rates of the year shown.

Pregnancy Outcome in South Australia 2014 page  95

Appendix



Appendix 2: 2014 Supplementary Birth Record Form

Pregnancy Outcome in South Australia 2014page 96

Appendix

page 96



Appendix 3: Congenital Abnormality Form

Pregnancy Outcome in South Australia 2014 page  97

Appendix

page  97



For more information 

Pregnancy Outcome (Statistics) Unit 
Epidemiology Branch 
SA Health, Government of South Australia 
Citi Centre Building 
11 Hindmarsh Square  
Adelaide 5000 South Australia

Postal Address 
Pregnancy Outcome (Statistics) Unit 
SA Health, Government of South Australia  
PO Box 6 Rundle Mall 
Adelaide  5000 South Australia 
Telephone: (08) 8226 6382 
Fax: (08) 8226 6672 
Web: www.sahealth.sa.gov.au/pregnancyoutcomes  
E-mail: Pregnancy.Stats@health.sa.gov.au

Public-I2-A1

  Department for Health and Ageing, Government of South Australia.  
All rights reserved.  FIS: 16148.1   ISSN: 0819-3835   Printed November 2016.

www.ausgoal.gov.au/creative-commons



	Table 1: Births and crude birth rate by ABS Statistical Geographical Boundaries (ASGS 2014) regions, 
South Australia, 2014
	Table 2: Total births notified in 2014, by place of birth and plurality, South Australia 
	Table 3a: Hospital births by Perinatal Service Delineation, South Australia, 2014
	Table 3b: Hospital births in South Australia in 2014 by race and hospital*
	Table 4a: Race of women who gave birth, South Australia, 2014
	Table 4b: Table 4b: Race and birthplace category of women who gave birth, South Australia, 2014
	Table 4c: Age and race of women who gave birth, South Australia, 2014
	Table 4d: Age  specific fertility rates (ASFR), South Australia, 2014
	Table 5a: Country of birth, major groups,* women who gave birth, South Australia, 2014
	Table 5b: Specified country of birth,* women who gave birth, South Australia, 2014
	Table 6a: Marital status and age, women who gave birth, South Australia, 2014
	Table 6b: Type of patient and marital status, women who gave birth, South Australia, 2014
	Table 7: Occupation* of father and mother, women who gave birth, South Australia, 2014
	Table 8a: Parity by race, women who gave birth, South Australia, 2014
	Table 8b: Previous pregnancy outcomes, women who gave birth, South Australia, 2014 
(multigravidae only, n= 14,193)
	Table 9a: Gestation at first antenatal visit, women who gave birth, by race, South Australia, 2014 (n=20,448)
	Table 9b:	BMI of women who gave birth, South Australia, 2014
	Table 9c: Antenatal visits by race, women who gave birth, South Australia, 2014
	Table 9d: Type of antenatal care, women who gave birth, South Australia, 2014 (n = 20,448)
	Table 10a: Tobacco smoking status at first antenatal visit, non-Aboriginal and Aboriginal women who gave birth, South Australia, 2014
	Table 10b: Average number of tobacco cigarettes smoked per day in the second half of pregnancy, non-Aboriginal and Aboriginal women who gave birth, South Australia, 2014
	Table 11: Medical conditions in current pregnancy, women who gave birth, South Australia, 2014
	Table 12: Frequency of some obstetric complications, women who gave birth, South Australia, 2014
	Table 13: Procedures performed in current pregnancy, women who gave birth, South Australia, 2014
	Table 14a:	 Onset of labour, women who gave birth, South Australia, 2014
	Table 14b: Method of induction of labour, women who gave birth, South Australia, 2014
	Table 14c: 	Augmentation of labour after spontaneous onset, women who gave birth, South Australia, 2014
	Table 15a: Method of birth, women who gave birth, South Australia, 2014
	Table 15b: Method of birth by presentation, all births, South Australian 2014 (n=20,749)
	Table 15c: Method of birth in breech presentation, by plurality, all births, South Australia, 2014 (n= 956)
	Table 16: Frequency of some complications of labour and birth, women who gave birth, South Australia, 2014
	Table 17a: CTG performed during labour, women who gave birth, South Australia, 2014
	Table 17b: Fetal scalp pH taken during labour, women who gave birth, South Australia, 2014
	Table 18a:  Analgesia for labour,* women who gave birth, South Australia, 2014
	Table 18b: Anaesthesia for birth,* women who gave birth, South Australia, 2014
	Table 19a: Postnatal length of stay by type of patient, women who gave birth in South Australian hospitals, 2014
	Table 19b: Average postnatal length of stay by type of patient &amp; type of birth, women who gave birth in South Australian hospitals, 2014
	Table 20: Sex of baby, all births, South Australia, 2014
	Table 21: 	Birthweight distribution of all births, South Australia, 2014
	Table 22: Birth injuries* in 20,604 live births, South Australia, 2014
	Table 23: Neonatal treatment given, all live births, South Australia, 2014
	Table 24: Level of nursery care* utilised by birthweight, all live births, South Australia, 2014
	Table 25: 	Length of stay of liveborn babies in hospital, South Australia, 2014
	Table 26: Selected congenital anomalies notified to the perinatal statistics collection 2004-2014, South Australia.
	Table 27a: Birthweight by plurality, all births, South Australia, 2014
	Table 27b: Gestation at birth by plurality all births, South Australia, 2014
	Table 27c: Perinatal outcome by plurality, all births, South Australia, 2014
	Table 28a: Perinatal mortality by birthweight, all births, South Australia, 2014
	Table 28b: Perinatal mortality by gestational age at birth, South Australia, 2014
	Table 28c: Perinatal mortality, South Australia, 2014 (all births of specified birthweight/gestation)
	Table 28d: Perinatal mortality by race, all births, South Australia, 2014
	Table 29: Planned home births by age of women, South Australia, 2014
	Table 30: Method of birth in planned home births, South Australia, 2014
	Table 31: Birthweight distribution of planned home births, South Australia, 2014
	Table 32: Perinatal outcome in planned home births, South Australia, 2014
	Table 33:	Planned birthing unit births by age of women, South Australia, 2014
	Table 34 Method of birth in planned birthing unit births, South Australia, 2014
	Table 35: Birthweight distribution of planned birthing unit births, South Australia, 2014
	Table 36: Perinatal outcome in planned birthing unit births, South Australia, 2014
	Table 37: Number* of pregnancy terminations, and rate per 1,000 women aged 15-44 years, 
South Australia, 1970-2014
	Table 38: Terminations of pregnancy by age, South Australia, 2014
	Table 39: Termination of pregnancy and live birth rates and termination of pregnancy proportions by age, South Australia, 2014
	Table 40: Terminations by place of residence, South Australia, 2014
	Table 41: Terminations by hospital category, South Australia, 2014
	Table 42: 	Terminations by category of doctor, South Australia, 2014
	Table 43: 	Reason for termination for fetal reasons, South Australia, 2014
	Table 44a: Complications of termination procedures, South Australia, 2014
	Table 44b: Complications by method of termination procedure, South Australia, 2014
	Table 45a: Women with previous terminations by age, South Australia, 2014
	Table 45b: Calculation of total induced abortion rate (TAR), South Australia, 2014*
	Table 45c: Calculation of total first induced abortion rate (TFAR), South Australia, 2014
	Table 46: 	Obstetric profiles by hospital category, South Australia, 2014: live births and stillbirths of &gt;=400g or &gt;=20 weeks gestation#
	Table 47: Socio-demographic aspects of perinatal statistics, South Australia, 1981 and 2005-2014
	Table 48: Obstetric aspects of perinatal statistics, South Australia, 1981 and 2004   2014
	Figure 1a: South Australian hospitals with obstetric beds in 2014
	Figure 1b: Hospitals with obstetric beds in 2014, Central Region of SA 2014 
	Figure 2: Distribution of hospital births by hospital category, South Australia, 2014 (n=20,647)
	Figure 3: Age and race of women who gave birth, 2014 (n=20,448)
	Figure 4: Reasons for induction of labour, SA, 2014 (n=6,590)
	Figure 5a: Method of birth, women who gave birth, South Australia, 2014 (n = 20,448)
	Figure 5b: Reason for caesarean section, 2014 (n=6,930) 
	Figure 5c: Reason for elective caesarean section, 2014 (n=3,399)
	Figure 5d: Reason for emergency caesarean section, 2013 (n=3,531)	
	Figure 6: Perinatal mortality rate by birthweight, all births, South Australia, 2014
	Figure 7: Pregnancy termination rate per 1,000 women aged 15-44 years, South Australia, 1970-2014
	Figure 8a: Termination of pregnancy and live births by age, South Australia, 2014
	Figure 8b: Teenage pregnancy, termination of pregnancy and birth rates, South Australia, 1970-2014
	Figure 9: Percentage of Aboriginal women by hospital category
	Figure 10: Percentage of women with &lt;7 antenatal visits by hospital category
	Figure 11: Percentage of teenage women by hospital category
	Figure 12: Percentage of women 35 years or more by hospital category
	Figure 13: Percentage of single women by hospital category
	Figure 14: Percentage of women with 4 or more prior livebirths by hospital category
	Figure 15: Percentage of women with 1 or more prior perinatal deaths by hospital category
	Figure 16: Percentage of women with obstetric complications by hospital category
	Figure 17: Percentage of women with complications during labour or birth by hospital category
	Figure 18: Percentage of women with induction of labour by hospital category
	Figure 19: Percentage of women having epidural analgesia by hospital category
	Figure 20: Percentage of breech births by hospital category
	Figure 21: Percentage of emergency caesarean sections by hospital category
	Figure 22: Percentage of elective caesarean sections by hospital category
	Figure 23: Percentage of total caesarean sections by hospital category
	Figure 24: Percentage of births with birthweight below 2,500g by hospital category
	Figure 25: Percentage of births with gestation less than 37 weeks by hospital category
	Figure 26: Percentage of births with prolonged hospitalisation by hospital category
	Figure 27: Percentage of live births requiring neonatal intensive care by hospital category
	Figure 28: Percentage of births with birth defects by hospital category
	Figure 29a: Induction of labour proportion for selected primiparae, SA hospitals 
with &gt;=550 births per year, 2014
	Figure 29b: Caesarean section rate for selected primiparae, SA hospitals with &gt;=550 births per year, 2014
	Figure 29c: VBAC: Proportion of women who had a vaginal birth following a previous primary (first) caesarean section &amp; no intervening births, SA hospitals with &gt;=550 births per year, 2014
	Figure 29d: Proportion of selected primiparae with an intact perineum after a vaginal birth, SA hospitals with &gt;=550 births per year, 2014
	Figure 29e: TERM NICU: proportion of term babies admitted to NICU for reasons other than congenital abnormality, SA hospitals with &gt;=550 births per year, 2014
	Figure 29f: SPMR (Standardized Perinatal Mortality Ratio) for all births, SA hospitals with &gt;=550 births per year, 2014
	Figure 29g: SPMR (Standardized Perinatal Mortality Ratio) for all births, SA hospitals with &gt;=550 births per year, 2010-2014
	Figure 30.1: Percentage of teenage women among women giving birth in SA
	Figure 30.2: Percentage of women aged 35 years and over among women giving birth in SA
	Figure 30.3: Percentage of primiparous women aged 35 years and over in SA
	Figure 30.4: Percentage of Aboriginal women and Asian women among women giving birth in SA
	Figure 30.5: Percentage of women never married and with no de facto partner among women giving birth in SA
	Figure 30.6: Percentage of multiple births among births in SA
	Figure 30.7 Percentage of low birthweight babies among births in SA
	Figure 30.8: SA standardised perinatal mortality ratio (SPMR)
	Acknowledgements
	Executive Summary
	1. Numbers and fertility rates
	2. Place of birth
	3. Teenage women
	4. Older women and first time mothers
	5. Country of birth and race
	6. Smoking during pregnancy and Body Mass Index
	7. Antenatal care and length of stay
	8. Aboriginal women and babies
	9. Procedures
	10. Method of birth
	11. Multiple births
	12. Abortions
	13. Perinatal mortality

	I. Introduction
	1. The Perinatal Statistics Collection
	2. The Abortion Statistics Collection

	II. Mothers and Babies: Characteristics &amp; Outcomes
	1. Place of residence of mother
	2. Place of birth of baby
	3. Maternal and baby race
	4. Maternal age
	5. Country of birth
	6. Marital status and type of patient
	7. Occupation of father and mother
	8. Previous pregnancy outcomes
	9a. Gestation at first antenatal visit
	
9b. Body Mass Index (BMI)
	9c. Antenatal visits
	9d. Type of antenatal care
	10. Smoking
	11. Medical conditions
	12. Obstetric complications
	13. Procedures performed in current pregnancy
	14a. Onset of labour
	14b. Reasons for induction of labour
	15a. Presentation and method of birth
	15b. Reason for caesarean section
	16. Complications of labour and birth and perineal status after birth
	17. Fetal monitoring during labour
	18. Analgesia for labour and anaesthesia for birth
	19. Postnatal length of stay of women
	20. Sex of baby
	21. Birthweight and gestation
	22. Birth injuries
	23. Treatment given in neonatal period
	24. Level of care* utilised
	25. Length of stay of babies
	26. Congenital anomalies
	27. Multiple births
	28. Perinatal mortality
	29. Home births
	30. Birthing unit births

	III. Terminations of Pregnancy
	1. Numbers and rates
	2. Age of women
	3. Place of residence and place where termination performed
	4. The reason for termination
	5. Gestation, method and complications
	6. Previous terminations. Total termination of pregnancy rate and total first termination of pregnancy rate

	IV. Obstetric Profiles by Hospital Category
	V. Clinical and Maternity Performance Indicators
	1. Clinical indicators
	INDICATOR 1: Smoking in pregnancy 
	INDICATOR 2: Antenatal care in the first trimester for all women giving birth
	INDICATOR 3: Episiotomy for women having their first baby and giving birth vaginally
	INDICATOR 4: Apgar score of less than 7 at 5 minutes for births at or after term
	INDICATOR 5: Induction of labour for selected primiparae
	INDICATOR 6: Caesarean section for selected primiparae
	INDICATOR 7: Normal (non-instrumental) vaginal birth for selected primiparae
	INDICATOR 8: Instrumental vaginal birth for selected primiparae
	INDICATOR 9: General anaesthetic for women giving birth by caesarean section
	INDICATOR 10: Small babies among births at or after 40 weeks gestation

	2. Maternity performance indicators, hospitals with at least 550 births per year

	VI. Trends in Perinatal Statistics in South Australia, 1981-2014
	Trends in Perinatal Statistics in South Australia (SA), 1985   2014

	VII.	Summary Statistics for 2014
	1. Number of births
	2. Place of birth
	3. Sex
	4. Plurality and condition at birth
	5. Race of women
	6. Obstetric interventions in 20,448 women who gave birth
	7. Low birthweight (&lt;2,500g)
	8. Congenital anomalies
	9. Perinatal mortality rates (numbers of deaths in parentheses)
	10. Terminations of pregnancy


	References
	Publications
	Annual Reports
	Other reports/papers
	1. Birth defects
	2. Termination of pregnancy
	3. Perinatal epidemiology
	4. Perinatal mortality
	5. Caesarean section


	Appendix 1: Definitions
	Appendix 2: 2014 Supplementary Birth Record Form?
	Appendix 3: Congenital Abnormality Form



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