National Core Maternity Indicators: PI 13–Third and fourth degree tears for vaginal births, 2019

Identifying and definitional attributes

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

Third and fourth degree tears for vaginal births

Short name:PI 13–Third and fourth degree tears for vaginal births, 2019
METeOR identifier:717548
Registration status:Health, Standard 19/06/2019
Description:

The proportion of all females who have a third or fourth degree perineal laceration after giving birth vaginally for (a) all first births and (b) all births.

Rationale:

Third and fourth degree perineal lacerations cause significant ongoing maternal morbidity. This is an outcome indicator that measures the occurrence of third and fourth degree perineal lacerations.

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

Collection and usage attributes

Computation description:

(a) The number of females who had a third or fourth degree perineal laceration after giving birth for the first time and birth vaginally, divided by the number of females who gave birth for the first time and birth vaginally, and multiplied by 100.

(b) The number of females who had a third or fourth degree perineal laceration after giving birth vaginally, divided by the number of females who gave birth vaginally, 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.

Births included are vaginal births, including non-instrumental and instrumental births. A non-instrumental vaginal birth is one in which the baby is born through the vagina without the assistance of instruments. An instrumental birth is a procedure that uses instruments (forceps or vacuum extraction) to assist the baby come out through the vagina.

Births excluded are caesarean sections.

Third degree laceration is defined as perineal laceration, rupture or tear as in second degree laceration occurring during delivery, also involving: anal sphincter, rectovaginal septum, and sphincter not otherwise specified. Excludes laceration involving the anal or rectal mucosa. Fourth degree laceration is defined as perineal laceration, rupture or tear as in third degree laceration occurring during delivery, also involving: anal mucosa and rectal mucosa.

Computation:

100 × (Numerator ÷ Denominator)

Numerator:

(a) The number of females who had a third or fourth degree perineal laceration after giving birth for the first time and birth vaginally.

(b) The number of females who had a third or fourth degree perineal laceration after giving birth vaginally.

Numerator data elements:
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 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 (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 from 2014 onwards analysis.

Data source type: Administrative by-product data


Data Element / Data SetData Element

 Labour complication: Third/fourth degree tear


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

This data item for 2013 only analysis.

Data source type: Administrative by-product data


Denominator:

(a) The number of females who gave birth for the first time and birth vaginally.

(b) The number of females who gave birth vaginally.

Denominator data elements:
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 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


Disaggregation:
  • Year of birth
  • State or territory of birth
  • Mother's age at birth
  • Hospital annual number of births
  • Hospital sector
  • Remoteness category (from mother's area of usual residence)
  • Indigenous status of mother
  • With and without episiotomy
  • Mother's country of birth
  • 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 SetPerson—Indigenous status, 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 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
Guide for use

Data source type: Administrative by-product data


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 SetData Element

Hospital sector


Data Source
AIHW National Perinatal Data Collection (NPDC)
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

Data source type: Administrative by-product data


Data Element / Data SetPerson—country of birth, code (SACC 2016) NNNN
Data Source
Perinatal National Minimum Data Set (NMDS)
NMDS / DSS
Perinatal NMDS 2014-18
Guide for use

 Data source type: Administrative by-product data


Comments:

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

For the 2013 analysis, third and fourth degree tears was calculated using Labour complication: third/fourth degree data item. A revised collection of perineal status data items in the Perinatal NMDS was introduced in 2014, which meant that the perineal status was split between seven perineal status data items. As a result, for 2014 onwards analysis, third and fourth degree tears was calculated using two data items, Perineal status: third degree laceration (code 4) and Perineal status: fourth degree laceration (code 7).

Modified from Australian Council on Healthcare Standards (ACHS) Indicator 3.1-3.6: Major perineal tears and surgical repair of the perineum. This ACHS indicator is based on the definition by Women's Healthcare Australasia Core Maternity Indicators Project (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:

ACHS (The Australian Council on Healthcare Standards, Health Services Research Group, University of Newcastle) 2014. The Australasian Clinical Indicator Report: 2006-2013. 15th edn. Sydney: ACHS. Viewed 9 April 2018, https://www.achs.org.au/media/88679/clinical_indicator_report_2006_2013.pdf,

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 13–Third and fourth degree tears for vaginal births, 2018 Health, Superseded 19/06/2019