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Australian Atlas of Healthcare Variation 2018: Caesarean section at less than (i) 39 completed weeks, (ii) 37 completed weeks without medical/obstetric indication, 2015

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termEarly planned caesarean section without obstetric or medical indication, 2015
METeOR identifier:Help on this term709063
Registration status:Help on this termAustralian Commission on Safety and Quality in Health Care, Standard 13/12/2018
Description:Help on this term

The proportion of women who gave birth by caesarean section at less than (i) 39 completed weeks (273 days) gestation, (ii) 37 completed weeks (259 days) gestation, without adequate obstetric/medical indication.

Rationale:Help on this term

Neonatal respiratory morbidity can be reduced by minimising early delivery. This indicator is used to benchmark practice.

Indicator set:Help on this termAustralian Atlas of Healthcare Variation 2018 Australian Commission on Safety and Quality in Health Care, Standard 13/12/2018
Quality statement:Help on this termNational Perinatal Data Collection, 2015: Quality Statement AIHW Data Quality Statements, Archived 02/08/2018

Collection and usage attributes

Computation description:Help on this term

The number of women who gave birth by caesarean section at less than (i) 39 completed weeks (273 days) gestation, (ii) 37 completed weeks (259 days) gestation, without adequate obstetric/medical indication and where there was no established labour, divided by the number of women who gave birth by caesarean section at less than (i) 39 completed weeks (273 days) gestation, (ii) 37 completed weeks (259 days) gestation, and where there was no established labour, and multiplied by 100.

A birth is defined as the event in which a baby comes out of the uterus after a pregnancy of at least 20 weeks gestation or weighing 400 grams or more.

Births included are caesarean deliveries (where there was no established labour) at less than (i) 39 completed weeks (273 days), (ii) 37 completed weeks (259 days).

'Without adequate obstetric/medical indication' includes the following reasons for caesarean section:

  • previous caesarean section
  • previous severe perineal trauma
  • previous shoulder dystocia
  •  maternal choice in the absence of any obstetric, medical, surgical, psychological indications

Births excluded are:

  • caesarean deliveries at or after (i) 39 completed weeks (273 days) gestation, (ii) 37 completed weeks (259 days) gestation 
  • where there was established labour
  • all vaginal deliveries
  • those delivered pre-term by caesarean section (where there was no established labour) with obstetric/medical indication (all reasons for caesarean section other than those listed previously)

Cells of less than 5 have been suppressed. This is the lowest level of suppression that all states and territories have agreed to for the release of data from the National Perinatal Data Collection.            

Proportions have been suppressed where the denominator is less than 100, for reliability purposes.   

Computation:Help on this term

100 x (Numerator ÷ Denominator)

Numerator:Help on this term

The number of women who gave birth by caesarean section at less than (i) 39 completed weeks (273 days) gestation, (ii) 37 completed weeks (259 days) gestation, without adequate obstetric/medical indication and where there was no established labour.

Numerator data elements:Help on this term
Data Element / Data SetBirth event—main indication for caesarean section, code N[N]
Data Source
AIHW National Perinatal Data Collection (NPDC)
NMDS / DSS
Perinatal NMDS 2014-18
Data Element / Data SetBirth event—birth method, code N
Data Source
AIHW National Perinatal Data Collection (NPDC)
NMDS / DSS
Perinatal NMDS 2014-18
Data Element / Data SetBirth event—labour onset type, code N
Data Source
AIHW National Perinatal Data Collection (NPDC)
NMDS / DSS
Perinatal NMDS 2014-18
Data Element / Data SetProduct of conception—gestational age, completed weeks N[N]
Data Source
AIHW National Perinatal Data Collection (NPDC)
NMDS / DSS
Perinatal NMDS 2014-18
Guide for use

Data source type: Administrative by-product data


Denominator:Help on this term

The number of women who gave birth by caesarean section at less than (i) 39 completed weeks (273 days) gestation, (ii) 37 completed weeks (259 days) gestation, and where there was no established labour.

Denominator data elements:Help on this term
Data Element / Data SetBirth event—birth method, code N
Data Source
AIHW National Perinatal Data Collection (NPDC)
NMDS / DSS
Perinatal NMDS 2014-18
Data Element / Data SetBirth event—labour onset type, code N
Data Source
AIHW National Perinatal Data Collection (NPDC)
NMDS / DSS
Perinatal NMDS 2014-18
Data Element / Data SetProduct of conception—gestational age, completed weeks N[N]
Data Source
AIHW National Perinatal Data Collection (NPDC)
NMDS / DSS
Perinatal NMDS 2014-18
Guide for use

Data source type: Administrative by-product data


Disaggregation:Help on this term

State or territory of mother's usual residence.

State or territory of mother's usual residence by:

  • Indigenous status of mother
  • Patient elected accommodation status

 

Disaggregation data elements:Help on this term
Data Element / Data SetPerson—Indigenous status, code N
Data Source
AIHW National Perinatal Data Collection (NPDC)
NMDS / DSS
Perinatal NMDS 2014-18
Data Element / Data SetPerson—area of usual residence, statistical area level 2 (SA2) code (ASGS 2016) N(9)
Data Source
AIHW National Perinatal Data Collection (NPDC)
NMDS / DSS
Perinatal NMDS 2014-18
Guide for use

Data source type: Administrative by-product data


Comments:Help on this term

Data elements are from the Perinatal National Minimum Data Set (NMDS). Records with data that are missing, not stated or not interpretable have been excluded from the denominator.

The national data collection for this indicator is relatively new in Australia and many states and territories do not yet collect all elements consistent with the national specification. For this reason, the available data used for the Atlas for individual states are not available for publication.

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termPerson
Format:Help on this term

N[NN.N]

Data source attributes

Data sources:Help on this term
Data SourceAIHW National Perinatal Data Collection (NPDC)
Frequency
Calendar years ending 31 December each year
Data custodian

Australian Institute of Health and Welfare


Accountability attributes

Reporting requirements:Help on this term

Australian Commission on Safety and Quality in Health Care

The Third Australian Atlas of Healthcare Variation (2018)

Organisation responsible for providing data:Help on this term

Australian Institute of Health and Welfare

Accountability:Help on this term

Australian Commission on Safety and Quality in Health Care

Release date:Help on this term11/12/2018

Source and reference attributes

Reference documents:Help on this term

Women's Healthcare Australasia 2007. Supporting excellence in maternity care: the core maternity indicators project: findings from the core maternity indicators project. Canberra: WHA.

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