National Core Maternity Indicators: PI 03–Episiotomy for females giving birth for the first time and giving birth vaginally, 2019

Identifying and definitional attributes

Metadata item type:Indicator
Indicator type:Indicator
Common name:

Episiotomy for females giving birth for the first time and giving birth vaginally

Short name:PI 03–Episiotomy for females giving birth for the first time and giving birth vaginally, 2019
METeOR identifier:717532
Registration status:Health, Standard 19/06/2019
Description:

Among all females who had their first baby (a) the proportion who received an episiotomy during a non-instrumental vaginal birth, and (b) the proportion who received an episiotomy during an instrumental vaginal birth.

Rationale:

This indicator is used to benchmark practice.

Indicator set:National Core Maternity Indicators, 2019 Health, Standard 19/06/2019

Collection and usage attributes

Computation description:

(a) The number of females having their first baby who had an episiotomy during a non-instrumental vaginal birth, divided by the number of females having their first baby who gave birth vaginally and had a non-instrumental vaginal birth, and multiplied by 100.

(b) The number of females having their first baby who had an episiotomy during an instrumental vaginal birth, divided by the number of females having their first baby who gave birth vaginally and had an instrumental vaginal birth, and multiplied by 100.

A birth is defined as an 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.

Included are those females who gave birth for the first time and had a vaginal birth, with or without instruments. Females who had a multiple birth are included if this was the first time they had given birth.

Excluded are those females who did not give birth for the first time or gave birth by caesarean section.

Instrumental vaginal birth means that the baby was delivered with the use of forceps or vacuum extraction.

Computation:

100 × (Numerator ÷ Denominator)

Numerator:

(a) The number of females having their first baby who had an episiotomy during a non-instrumental vaginal birth.

(b) The number of females having their first baby who had an episiotomy during an instrumental vaginal birth.

Numerator data elements:
Data Element / Data SetBirth event—birth method, code N
Data Source
Perinatal National Minimum Data Set (NMDS)
NMDS / DSS
Perinatal NMDS 2014-18
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetFemale—parity, total pregnancies N[N]
Data Source
Perinatal National Minimum Data Set (NMDS)
NMDS / DSS
Perinatal NMDS 2014-18
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetFemale (mother)—postpartum perineal status, code N[N]
Data Source
Perinatal National Minimum Data Set (NMDS)
NMDS / DSS
Perinatal NMDS 2014-18
Guide for use

This data item (code 5) was used for 2014 onwards analysis.

Data source type: Administrative by-product data


Data Element / Data SetFemale (mother)—postpartum perineal status, code N
Data Source
Perinatal National Minimum Data Set (NMDS)
NMDS / DSS
Perinatal NMDS 2013-14
Guide for use

This data item (code 5 & 6) was used for 2004 to 2013 analysis.

Data source type: Administrative by-product data


Denominator:

(a) The number of females having their first baby who gave birth vaginally and had a non-instrumental vaginal birth

(b) The number of females having their first baby who gave birth vaginally and had an instrumental vaginal birth.

Denominator data elements:
Data Element / Data SetBirth event—birth method, code N
Data Source
Perinatal National Minimum Data Set (NMDS)
NMDS / DSS
Perinatal NMDS 2014-18
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetFemale—parity, total pregnancies N[N]
Data Source
Perinatal National Minimum Data Set (NMDS)
NMDS / DSS
Perinatal NMDS 2014-18
Guide for use

Data source type: Administrative by-product data


Disaggregation:
  • Year of birth
  • State or territory of birth
  • Mother's age at birth
  • Hospital annual number of births
  • Hospital sector
  • Primary Health Network (from mother's area of usual residence)
  • Statistical local area 3 (from mother's area of usual residence)
Disaggregation data elements:
Data Element / Data SetBirth event—state/territory of birth, code N
Data Source
Perinatal National Minimum Data Set (NMDS)
NMDS / DSS
Perinatal NMDS 2014-18
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetPerson—date of birth, DDMMYYYY
Data Source
Perinatal National Minimum Data Set (NMDS)
NMDS / DSS
Perinatal NMDS 2014-18
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetData Element

Hospital annual number of births


Data Source
AIHW National Perinatal Data Collection (NPDC)
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetData Element

Hospital sector


Data Source
AIHW National Perinatal Data Collection (NPDC)
Data Element / Data SetPerson—area of usual residence, statistical area level 2 (SA2) code (ASGS 2016) N(9)
Data Source
Perinatal National Minimum Data Set (NMDS)
NMDS / DSS
Perinatal NMDS 2014-18
Comments:

Data elements are from the Perinatal National Minimum Data Set (NMDS) or have been provided as voluntary non-standardised items by the states and territories. Records with data that are missing, not stated or not interpretable have been excluded from the denominator.

In 2004-2013 analysis, total number of episiotomy was been calculated using the perineal status item in the Perinatal NMDS 2013-14, by combining code 5 (episiotomy) and 6 (combined laceration and episiotomy). However, there is no information on the degree of laceration on code 6. Therefore, there is an undercount in the degree of laceration.

In 2014, there was a revision of the perineal status data items in the Perineal NMDS 2014-2018 from 2014. This meant that the perineal status was split between seven perineal status data items, which captures the perineal status relevant to each delivery. As a result, the episiotomy can be calculated using one data item, Perineal status: Episiotomy (code 5). Note that a female can have both an episiotomy and recorded laceration, the new data item has been operationalised to allow this.

Source of definition: Core Maternity Indicator Project, Indicator 4 (WHA 2007).

Representational attributes

Representation class:Percentage
Data type:Real
Unit of measure:Person
Format:

N[NN.N]

Data source attributes

Data sources:
Data SourcePerinatal National Minimum Data Set (NMDS)
Frequency
Annual
Data custodian

Australian Institute of Health and Welfare



Data SourceAIHW National Perinatal Data Collection (NPDC)
Frequency
Calendar years ending 31 December each year
Data custodian

Australian Institute of Health and Welfare


Source and reference attributes

Submitting organisation:

Australian Institute of Health and Welfare.

Reference documents:

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

Relational attributes

Related metadata references:

Supersedes National Core Maternity Indicators: PI 03–Episiotomy for females giving birth for the first time and giving birth vaginally, 2018 Health, Superseded 19/06/2019