Victorian Birth Statistics - What's Happening During Birth
Australia is a place of well women. Compared to many other countries, we are lucky to have a great diet, great health - in fact we are something like 3rd on the list in this department. So the question remains, why are we around 13th on the list for outcomes for mother and baby at birth? Something is going terribly wrong for a country that is so well, affluent, flourishing... here are the sobering figures.
The 2005-2006 data comes out in 2007, but here is a snapshot of what the birth world was like in 2003-2004. You can see the full report HERE:
51% male births, 49% females, 99.0% liveborn and surviving the neonatal period (28 days). Born at <37wks gestation 7.8% and born at >=42 weeks gestation 1.2%
Place of Birth
Birth in hospitals 97%
Birth Centres 2%
Planned homebirths 0.3%
Born before arrival 0.4% - these are the babies born in backseats, laundry floor etc. LOL!
Commencement of Labour
57% spontaneous labour (went into labour naturally - doesn't mean no intervention after this)
19% spontaneous labour with augmentation (artificial stimulation of labour)
26.5% induced labour
16.9% no labour due to more elective caesars (highest since reporting in 1982)
29.5% caesareans (15% elective, 14% emergency caesareans). In 1985, 15% was the rate.
Private vs Public
You would expect the public hospitals to have a higher rate of intervention as many hospitals are teaching hospitals, therefore they need to do their quotas of various interventions as experience, but this is not the case...
Private Inductions - 29.7% Public Inductions - 25.5%
Private caesareans - 21.6% Public caesareans - 13.8%
Assisted delivery
Vacuum: 1985 - 0.5% 2004 - 6.9%
Forceps: 1985 - 15.8% 2004 6.2%
Breech Caesareans: 1985 - 64% 2004 - 95%
Assisted Breech Birth: 1985 - 35% 2005 - 5%
Pain Relief
26% - no pain relief
32% - gas only
25% - intramuscular (e.g. peth, morphine) + or - gas
26% - epidural
92% - epidural for caesar
Private spontaneous cephalic birth epidural rate 20.6% vs Public 10.5%
The Perineum Situation
41% women intact perineum
23% episiotomy
36% requiring suturing
Public spontaneous birth intact perineum rate 48.2% vs Private 26.9%
Twins
3.5% of all births (1,123 sets)
Triplets declined to only 16 sets
28% twin births are to mothers 35 years +
69.6% caesarean rate
Caesareans
The perinatal statistics show a consistent rate of around 15% caesareans are considered elective with emergency cs rates being anywhere between 11% and 14%.
The three main reported indications for elective caesareans in VIC were:
Previous caesareans (57%), malpresentation (18%) and Other reported indications. (12.5%).
The three main reported indications for emergency caesareans in VIC were:
CPD/failure to progress(32%), fetal distress (31%) and malpresentation (12%).
NOW, COMPARE THE ABOVE, TO THIS:
Women who plan homebirths have a caesarean rate of 7% (0.2% elective, 6.8% emergency)
Women who plan birth centre births have a caesarean rate of 11.9% (2.1% elective, 9.8% emergency)
Women who plan hospital births have a caesarean rate of 29.4% (15.6% elective, 14.3% emergency)
Also, if I can read my writing correctly, he's some figures I collected from the homebirth conference 2006. And before you freak out about homebirth, think of it this way - see what our bodies ARE capable of? See how much we are being short-changed by the system? :)
Ina May Gaskin - Stats for 'The Farm'
1970-2005 - 2286 births
births completed 95.1%
transports 4.9%
emergency transports 1.3%
primigravidas 44.7%
multigravidas 55.3%
grand multiparas 8.4%
caesareans 1.5% - transverse etc. First 400 births 0.5%
forceps 0.4%
vacuum 0.1%
inductions 5.4% e.g. with methods like castor oil
maternal mortality 0
neonatal mortality 0.36%
There were no more stats but I found this on her site which I thought I would add, which is only based on stats up to the year 2000:
Cases with no preeclampsia - 99.61%
Cases of preeclampsia - .39%
Cases with no hemorrhage - 98.2%
Cases of postpartum hemorrhage - 1.8%
We were shown other statistics too, one from a doctor in Europe running a homebirth practice who served over 40,000 women and maintained the 1.5% caesarean rate and very low intervention.
NZ birth scene
1996 homebirth changes implimented offering continuity and co-ordinated care across all levels - midwives, doctors, obs etc
Lead maternity carer chosen by woman:
Midwife 78%
GP 8%
Ob 8%
Unregistered / not noted 7%
All of the above are free of charge unless you want a private Ob.
Of the above percent of midwives 80% midwives have their own business and 20% employed by hospitals
there are 59 (!!!) midwifery run units and they estimate around 3-5% are hombirthing - with midwifery run units obviously this would be low anyway.
benefits since adopting new system (which are still being collaborated):
*ante-natal admissions decreased
*fewer sick babies and NICU admissions
*fewer pre-term birth
*immunised at 6 weeks 94%
*lower c/s, induction, instrumental birth, 3rd degree tears, trauma, higher apgars
*declining mortality rates
*increased exclusive breastfeeding
I will have more stats soon, they are handing out report summaries of the talks, but also, in a few weeks, NZ is releasing an official report on the state of things, so it will be interesting to see if it gets out to the media. They have made some amazing inroads and I think Australia has alot to learn from this. No doubt they will be saving their government lots of money too.
The bottom line: Particularly if you are wanting a normal physiological childbirth, you need to make good choices, you need to be aware of what you are up against and you need to be informed and well supported.
