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

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 or induction of labour without medical or obstetric indication, 2017
METeOR identifier:Help on this term724678
Registration status:Help on this termAustralian Commission on Safety and Quality in Health Care, Standard 27/04/2021
Description:Help on this term

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 or who had labour induced, without medical or obstetric 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 2021 Australian Commission on Safety and Quality in Health Care, Standard 27/04/2021
Quality statement:Help on this termNational Perinatal Data Collection, 2017: Quality Statement AIHW Data Quality Statements, Archived 29/05/2020

Collection and usage attributes

Computation description:Help on this term

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 or who had labour induced, 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 or who had labour induced, multiplied by 100.

Includes females who, at less than 37 (259 days), 38 (266 days) and 39 (273 days) completed weeks gestation, had:

  • no established labour and gave birth by caesarean section,
  • induced labour and gave birth vaginally (including non-instrumental, forceps and vacuum extraction), or
  • induced labour and gave birth by caesarean section.

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.

'Without medical or obstetric indication' includes the following reasons for induction:

  • administrative or geographical indication
  • maternal choice in the absence of any obstetric, medical, fetal, administrative or geographical indication.

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:Help on this term

100 x (Numerator ÷ Denominator)

Numerator:Help on this term

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 or who had labour induced, without medical or obstetric indication.

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 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


Data Element / Data SetBirth event—main indication for induction of labour, 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


Denominator:Help on this term

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 or who had labour induced.

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
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:Help on this term

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: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
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:Help on this term

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: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

Australian Atlas of Healthcare Variation 2021

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

Further data development / collection required:Help on this term

The collection of the data elements Birth event—main indication for caesarean section, code N[N] and Birth event—main indication for induction of labour, 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 specifications. For this reason, the available data used for the Atlas for individual states and territories are not available for publication.

Release date:Help on this term28/04/2021

Source and reference attributes

Submitting organisation:Help on this term

Australian Commission on Safety and Quality in Health Care

Relational attributes

Related metadata references:Help on this term

See also Caesarean section 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

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