Caesarean section at less than 37, 38 and 39 completed weeks gestation without medical or obstetric indication, 2017

Identifying and definitional attributes

Metadata item type:Indicator
Indicator type:Indicator
Short name:Early planned caesarean section without medical or obstetric indication, 2017
METeOR identifier:723681
Registration status:Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021
Description:

The proportion of females who gave birth at less than 37 (259 days), 38 (266 days) and 39 (273 days) completed weeks gestation by caesarean section, without medical or obstetric indication.

Rationale:

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

Indicator set:Australian Atlas of Healthcare Variation 2021 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021
Quality statement:National Perinatal Data Collection, 2017: Quality Statement AIHW Data Quality Statements, Archived 29/05/2020

Collection and usage attributes

Computation description:

The number of females who gave birth at less than 37 (259 days), 38 (266 days) and 39 (273 days) completed weeks gestation by caesarean section with no established labour, without medical or obstetric indication, divided by the number of females who gave birth at less than 37 (259 days), 38 (266 days) and 39 (273 days) completed weeks gestation by caesarean section with no established labour, multiplied by 100.

Includes females who gave birth by caesarean section with no established labour at less than 37 (259 days), 38 (266 days) and 39 (273 days) completed weeks gestation.

A birth is defined as the complete expulsion or extraction from a female, of a product of conception of 20 or more completed weeks of gestation or of 400 grams or more birthweight.

'Without medical or obstetric 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.

​While these may be indications for planned caesarean section, they are not considered reasons for early planned caesarean section - that is, before 39 weeks.

Analysis by state/territory, remoteness and Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-Economic Disadvantage (IRSD) is based on the usual residence of the mother.

Records with data that are missing, not stated or not interpretable have been excluded from the denominator.

Cells of less than 5 are 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 reasons.   

Presented as a:

  • number, and
  • percentage.
Computation:

100 x (Numerator ÷ Denominator)

Numerator:

The number of females who gave birth at less than 37 (259 days), 38 (266 days) and 39 (273 days) completed weeks gestation by caesarean section with no established labour, without medical or obstetric indication.

Numerator data elements:
Data Element / Data SetBirth event—main indication for caesarean section, code N[N]
Data Source
AIHW National Perinatal Data Collection (NPDC)
NMDS / DSS
Perinatal NBEDS 2017-18
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetBirth event—birth method, code 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


Data Element / Data SetBirth event—labour onset type, code 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


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:

The number of females who gave birth at less than 37 (259 days), 38 (266 days) and 39 (273 days) completed weeks gestation by caesarean section with no established labour.

Denominator data elements:
Data Element / Data SetBirth event—birth method, code 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


Data Element / Data SetBirth event—labour onset type, code 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


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:

National and state/territory, by:

  • Admitted patient elected accommodation status
  • Indigenous status of the mother
  • remoteness (Australian Statistical Geography Standard (ASGS) 2016 Remoteness Structure)
  • 2016 Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-economic Disadvantage (IRSD) quintiles.

Note that data collection methods for Indigenous status of the mother may vary between states and territories.

Some disaggregations may result in numbers too small for publication.

 

Disaggregation data elements:
Data Element / Data SetPerson—Indigenous status, code 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


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.

Used for disaggregation by state/territory, remoteness and SEIFA IRSD.

Geographic unit used is Statistical Area Level 2 (SA2) in the Australian Statistical Geography Standard (ASGS).

Remoteness is based on the ASGS 2016 Remoteness Structure.

SEIFA IRSD is based on the 2016 SEIFA IRSD.


Data Element / Data SetEpisode of admitted patient care—patient election status, code N
Data Source
AIHW National Perinatal Data Collection (NPDC)
Guide for use

Data source type: Administrative by-product data


Comments:

Information is included in the National Perinatal Data Collection (NPDC) for both live births and stillbirths, where gestational age is at least 20 weeks or birthweight is at least 400 grams, except in Victoria and Western Australia, where births are included if gestational age is at least 20 weeks or, if gestation is unknown, birthweight is at least 400 grams. For information about NPDC data limitations, see the Technical supplement of the Fourth Atlas

The term ‘Aboriginal and Torres Strait Islander people’ is preferred when referring to the separate Indigenous peoples of Australia. However, the term ‘Indigenous’ is used interchangeably with ‘Aboriginal and Torres Strait Islander’ in this indicator to assist readability.

Representational attributes

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

N[NN].N

Data source attributes

Data sources:
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:

Australian Commission on Safety and Quality in Health Care

Australian Atlas of Healthcare Variation 2021

Organisation responsible for providing data:

Australian Institute of Health and Welfare

Accountability:

Australian Commission on Safety and Quality in Health Care

Further data development / collection required:

The collection of the data element Birth event—main indication for caesarean section, code N[N] is relatively new in Australia and many states and territories are not yet able to collect this data element according to the national specification. For this reason, the available data used for the Atlas for individual states and territories are not available for publication.

Release date:15/03/2021

Source and reference attributes

Submitting organisation:

Australian Commission on Safety and Quality in Health Care

Relational attributes

Related metadata references:

See also Caesarean section or induction of labour at less than 37, 38 and 39 completed weeks gestation without medical or obstetric indication, 2017 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021

See also Early planned caesarean section without medical or obstetric indication, 2015 Australian Commission on Safety and Quality in Health Care, Standard 13/12/2018