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Births and pregnancy outcomes

Births and pregnancy outcomes

In 2015, there were 18,537 births registered in Australia with one or both parents identified as Aboriginal and/or Torres Strait Islander (6.1% of all births registered) [1]. (This probably underestimates the true number slightly as Indigenous status is not always identified, and there may be a lag in birth registrations.) See Appendix 1 for a full discussion of data limitations. For births registered as Indigenous: 30% registered both parents as Aboriginal and/or Torres Strait Islander; 43% recorded only the mother as Aboriginal and/or Torres Strait Islander (including births where paternity was not acknowledged and those where the father's Indigenous status was unknown); and in 28% of registrations only the father was recorded as Aboriginal and/or Torres Strait Islander (including births where the mother's Indigenous status was unknown).

Box 1: About births and fertility

In Australia, all births are required by law to be registered with the Registrar of Births, Deaths and Marriages in the jurisdiction in which the birth occurred. The registration information is limited from a health perspective so health authorities have established parallel maternal/perinatal collections. These collections are based on data recorded by staff attending births and include information about the nature, duration, and complications of the pregnancy, labour, and postnatal periods, and details about the baby (including weight, length, and condition at birth, and complications). Information is collated and reported nationally by the ABS (for registration information) and the AIHW’s National Perinatal Statistics Unit (for maternal/perinatal information).

The actual numbers of births are of limited use for public health purposes. To be useful, the actual numbers of births must be related to the population in which they occur. There are a number of general measures of births and fertility, but detailed analysis involves the use of age-specific rates.7 These rates are the annual number of births per 1,000 women in five-year age-groups from 15 to 44 years. (The relatively small numbers of births to women aged less than 15 years are included in the 15-19 years age-group.) The summary measure of fertility is the total fertility rate, which is the sum of age-specific fertility rates multiplied by five (since five-year age-groups are involved). It estimates the number of children that would be born to 1,000 women if each woman experienced current age-specific fertility rates at each age of her reproductive life.

Age of mothers

In 2015, Aboriginal and Torres Strait Islander women had more babies and had them at younger ages than non-Indigenous women; teenagers had 16% of the babies born to Aboriginal and Torres Strait Islander women, compared with 2.8% of those born to all mothers [1]. The median age of Indigenous mothers was 25.1 years, compared with 31 years for all mothers. The highest fertility rate among Aboriginal and Torres Strait Islander women was among the 20-24 years age-group. In comparison, the fertility rate for all women was highest in the 30-34 years age-group (Table 2). The fertility rate of teenage Indigenous women (58 babies per 1,000 women) was nearly five times that of all teenage women (12 babies per 1,000).

Table 2. Age-specific fertility rates, by Indigenous status of mother, selected jurisdictions, Australia, 2015

Age-group of mother (years)

Jurisdiction

NSW

Vic

Qld

WA

SA

NT

Australia

Aboriginal and Torres Strait Islander mothers

15-19

54

36

60

87

51

65

58

20-24

125

96

131

179

113

117

128

25-29

134

104

122

161

104

92

122

30-34

96

79

91

109

87

72

91

35-39

44

30

47

52

41

41

44

40-44

10

12

12

15

5.0

9.0

11

All mothers

15-19

12

6.9

16

14

11

36

12

20-24

48

35

60

54

47

94

48

25-29

98

83

102

99

98

100

95

30-34

126

121

117

123

122

113

122

35-39

74

74

62

68

63

64

70

40-44

17

15

12

13

12

14

15

Notes:

  1. Rates per 1,000 women in each age-group; the 15-19 years age-group includes births by girls aged 14 years or younger. Figures are not provided for the 45-49 years age-group because of the small numbers involved
  2. Figures are not provided for Tas and the ACT because of the small numbers involved and doubts about the level of identification of Indigenous births, but numbers for these jurisdictions are included in figures for Australia

Source: ABS, 2016 [1]

Total fertility rates

In 2015, total fertility rates were 2,271 births per 1,000 for Aboriginal and Torres Strait Islander women and 1,807 per 1,000 for all women (Table 3) [1]. The highest total fertility rate for Aboriginal and Torres Strait Islander women was for those in WA (3,014 babies per 1,000 women), followed by NSW (2,317 per 1,000) and Qld (2,312 per 1,000).

Table 3. Total fertility rates, by Indigenous status of mother, selected jurisdictions, Australia, 2015

Status of mother

Jurisdiction

NSW

Vic

Qld

WA

SA

NT

Australia

Aboriginal and Torres Strait Islander mothers

2,317

1,780

2,312

3,014

2,010

1,975

2,271

All mothers

1,869

1,678

1,847

1,846

1,763

2,108

1,807

Notes:

  1. Total fertility rate is the number of children born to 1,000 women at the current level and age pattern of fertility (see Box 2)
  2. Figures are not provided for Tas and the ACT because of the small numbers involved and doubts about the level of identification of Indigenous births. Numbers for those jurisdictions are included in figures for Australia

Source: ABS, 2016 [1]

Antenatal care

Antenatal care from health professionals helps pregnant women by monitoring their health, providing information and support, screening and preventative treatment [2]. It can help with the early identiļ¬cation of potentially preventable risk factors that adversely affect maternal and child health outcomes, especially when care is provided during the first trimester of pregnancy [3].

In 2014, pregnant Aboriginal and Torres Strait Islander women attended an average of nine antenatal visits [4].8 (The Department of Health recommends 10 visits for first-time pregnancy without complications and seven visits for subsequent uncomplicated pregnancies [2].) Over half (53%) of these women attended the first antenatal visit during the first trimester of pregnancy. The proportion of expectant Aboriginal and Torres Strait Islander mothers attending antenatal care in the first trimester increased from 41% in 2010 to 52% in 2014 [4].

Birthweight

The average birthweight of babies born to Aboriginal and Torres Strait Islander mothers in 2014 was 3,215 grams, 140 grams less than the average for babies born to non-Indigenous mothers (3,355 grams) [4]. Around 13% of babies born to Aboriginal and Torres Strait Islander mothers were of low birthweight (LBW), compared with 6.6% of babies of non-Indigenous mothers (Table 4). (LBW, defined as a birthweight of less than 2,500 grams, increases the risk of health problems and death in infancy.) There has been a slight decrease in the proportion of LBW babies born to Aboriginal and Torres Strait Islander mothers between 2004 and 2014.

Table 4. Proportion (%) of low birthweight babies, by sub-categories and Indigenous status, Australia, 2014

 

Babies born to Aboriginal and Torres Strait Islander mothers

Babies born to non-Indigenous mothers

Low birthweight (1,500-2,499 grams)

9.7

5.2

Very low birthweight (less than 1,500 grams)

2.1

1.0

Extremely low birthweight (less than 1,000 grams)

1.0

0.4

Source: AIHW, 2016 [4]

In 2014, LBW for babies of Aboriginal and Torres Strait Islander mothers varied slightly by remoteness from 12% of babies in major cities to 13% in very remote areas [4].

Factors impacting on LBW include pre-term birth, socio-economic disadvantage, the age of the mother, and antenatal care [5]. A mother's alcohol consumption and use of tobacco and other drugs during pregnancy also impact on the birthweight of her baby. Tobacco, in particular, has a major impact on birthweight. In 2014, 45% of Aboriginal and Torres Strait Islander mothers and 13% of non-Indigenous mothers reported smoking during pregnancy [4]. The proportion of Aboriginal and Torres Strait Islander mothers who smoked during pregnancy has decreased (from 50% in 2009 to 45% in 2014).

The impact of tobacco smoking during pregnancy can be seen in the proportions of LBW babies [6]. In 2009 - 2011, excluding pre-term and multiple births, 51% of LBW births to Aboriginal and Torres Strait Islander mothers were attributable to smoking during pregnancy, compared with 19% for other mothers [6]. It has been estimated that if the smoking rate for Aboriginal and Torres Strait Islander pregnant women was the same as it was for other mothers, the proportion of LBW babies could be reduced by up to 26%.

References

  1. Australian Bureau of Satistics (2016) Births, Australia, 2015. Retrieved 8 November 2016 from http://www.abs.gov.au/ausstats/abs@.nsf/mf/3301.0?OpenDocument
  2. Australian Department of Health (2012) Clinical Practice Guidelines: Antenatal Care - Module I. Canberra: Australian Department of Health
  3. Brown S, Glover K, Weetra D, Ah Kit J, Stuart-Butler D, Leane C, Turner M, Gartland D, Yelland J (2016) Improving access to antenatal care for Aboriginal women in South Australia: evidence from a population-based study. Birth; 43(2): 134-143
  4. Australian Institute of Health and Welfare (2016) Australia's mothers and babies 2014: in brief. Canberra: Australian Institute of Health and Welfare
  5. Australian Institute of Health and Welfare (2014) Birthweight of babies born to Indigenous mothers. Canberra: Australian Institute of Health and Welfare
  6. Australian Health Ministers' Advisory Council (2015) Aboriginal and Torres Strait Islander health performance framework 2014 report. Canberra: Department of the Prime Minister and Cabinet

Footnotes

7. The study of birth information is known as fertility analysis, where ‘fertility’ refers to the number of babies born alive. This meaning is different to the lay use of the word, which means the capacity to bear children. The technical term for the capacity to bear children is ‘fecundity’.

8. This excludes very pre-term births and data from Vic.

 

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    Last updated: 16 March 2017
     
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