Department of Family and Community Services

Focus Topic: Antenatal and maternity health, women in NSW

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Mothers are getting older1

As we saw in Chapter One, NSW non-Aboriginal women are living longer on average and giving birth at an older age than in the past.

In 1996, 15 percent of births were to women aged 35 years and over. By 2010, this figure had grown with over 24 percent of births being to women 35 years and over.

Births by women 19 years and younger had dwindled to just over 3 percent of the total, down from 5 percent in 1961, although the rate is higher in regional areas (see Chapter One).

What are some of the other characteristics of women’s antenatal (before the birth) and maternity experiences in NSW and how have these changed over time?

When do mothers first receive antenatal care?

NSW Health recommends women seek their first antenatal check-up as soon as the pregnancy is confirmed. Most NSW women’s behaviour today is in accordance with this guideline.

The percentage of women having their first antenatal visit in the first 14 weeks of gestation has been rising, and in 2010 reached nearly 79 percent of pregnant mothers, up from 62 percent in 1994.

Women living in remote and very remote parts of the state tend to have lower rates of early antenatal care. However, their rates of first trimester health visits have also been increasing in the last two decades. In 2010, 73 percent had the first antenatal check-up within 14 weeks, up from 61 percent of confinements in 1994.

Smoking during pregnancy

NSW Health promotes smoking cessation strategies to pregnant women and their families.2 NSW 2021, the State Plan contains the following targets:

  • Reduce the rate of smoking by pregnant non-Aboriginal women by 0.5 percent per year by 2015.
  • Reduce the rate of smoking by pregnant Aboriginal women by 2 percent per year by 2015.

In the 14-year period 1996 to 2010, smoking in pregnancy halved among non-Aboriginal mothers (falling from 20 percent to 10 percent) and fell by a fifth (from 61 percent to 48 percent) among Aboriginal mothers.

Just over 9 percent of pregnant women reported smoking in the second half of the gestation period, when the risk to both mother and baby is greatest.

Drinking during pregnancy

The Australian Guidelines state that the safest option for pregnant mothers and babies is not to drink during pregnancy.3

In the latest survey (2009-10), 72 percent of mothers of children 11 months and younger reported not drinking during pregnancy. A further 20 percent reduced the amount they drank. Only 2 percent of mothers reported ‘they did not try to give up drinking alcohol’.4

The percentage of women not drinking alcohol during pregnancy was slightly lower (65 percent) in rural NSW.

Type of birth

The rate of normal vaginal births decreased over the last two decades in NSW, and the rate of caesarean and in particular, elective caesarean births grew. Fourteen percent fewer mothers had vaginal births in 2010 than in 1990 (see Figure 2.10). Nine percent more mothers had elective caesareans, up to 18 percent of total births in 2010.

Infant feeding at time of discharge from hospital

The Australian National Breastfeeding Strategy aims to increase the percentage of babies fully breastfed to six months of age, with continued breastfeeding and complementary food to 12 months and beyond.5 Women in NSW 2012 reported that only 27 percent of children were fully breastfed to six months in NSW, although most two-year-olds had been breastfed at some time.

While no new data is available to update this figure, NSW Health data on how many babies are breastfed at the time of discharge from hospital is available.

Overall, 80 percent of babies were fully breastfed at the time of leaving hospital in 2010 (up from 75 percent in 2006).

The percentage varies significantly by country of birth and whether babies have Aboriginal mothers, as shown in Figure 2.11 below.

Babies of Aboriginal, English speaking country, Southern European and Pacific country mothers are more likely to leave hospital having infant formula only. Babies whose mothers are from Western, Northern and Eastern Europe and Central Asia are most likely to be fully breastfed.

Aboriginal and Torres Strait Islander births

The reported number of confinements among Aboriginal (including Torres Strait Islander) mothers in NSW has been rising steadily since 1990.

Babies born to Aboriginal mothers rose from 1,213 in 1990, which was 1.4 percent of all births to 3,090 in 2010 or 3.3 percent of all births.

This reflects the lower median age of Aboriginal women and could also be due to greater willingness on the part of Aboriginal women to identify as Aboriginal.

Nineteen percent of Aboriginal mothers were teenagers, down from 26 percent in 1990.

While the antenatal and maternity health of Aboriginal women remains poorer than that of other NSW women, positive change is evident in many areas. Selected antenatal and maternity health indicators of Aboriginal and non-Aboriginal women are listed in Table 2.9 below.

1 All data in this section is from the NSW Ministry of Health, Centre for Epidemiology and Evidence. Health Statistics New South Wales, or the NSW Mothers and Babies Reports on the NSW Health website.

2 NSW Health (2012) NSW Tobacco Strategy 2012-2017, available at www.health.nsw.gov.au

3 NHMRC (2009) Australian Guidelines to Reduce Health Risks from Drinking Alcohol, available at www.alcohol.gov.au

4 NSW Ministry of Health (2012) New South Wales Child Health Survey 2009- 10, available at www.health.nsw.gov.au

5 Australian Health Ministers (2010) Australian National Breastfeeding Strategy 2010-15, available at www.health.gov.au

Figure 2.10 Type of delivery, NSW mothers, 1990 and 2010

Fig 2.10

Figure 2.11 Infant feeding by birth region of mother and Aboriginal status, 2010Fig 2.11

Note: Est Eur Ctr Asia includes Russia, Central Asia and the Baltic States. English speaking countries includes Australia. Pacific is Polynesia, Melanesia and Micronesia. Country groupings are provided in the source. Regions are ordered from highest to lowest rate of fully breastfed.
Population: Live-born babies in NSW.
Source: NSW Perinatal Data Collection (HOIST). Centre for Epidemiology and Evidence, NSW Ministry of Health.

Table 2.9 Aboriginal women’s antenatal maternity health compared, 2010

Birth type

Aboriginal women %

All women %

Change since 2006 Percentage points*

Births to teenage mothers

19

3

- 2

Births to mothers 35 years and older

9

24

+1

Commenced antenatal care at less than 14 weeks

71

80

+12

Smoking in pregnancy

48

10

-6

Low birth weight babies

11.2

5.9

-1.2

Infant feeding when leaving hospital

63

80

NA

Note*: The percentage point change is for Aboriginal women.

Population: Women giving birth in NSW.
Source: NSW Health Mothers and Babies reports, 2006 and 2010.