Births and pregnancy outcomes

There have been improvements in birth and pregnancy outcomes for Aboriginal and Torres Strait Islander mothers and babies in recent years [47130]. Evidence shows an increase in the proportion of mothers attending antenatal care in the first trimester, a decrease in the rate of mothers smoking during pregnancy, and a majority of babies being born at a healthy birthweight and normal size for their gestational age. ‘Birthing on Country’ is an area of maternal and infant health that is gathering momentum [41252]. Researchers continue to build the evidence base to show Australian governments that ‘Birthing on Country’ models are effective in providing protective factors for mothers and babies [46506].

In Australia, all births are required by law to be registered with the Registrar of Births, Deaths and Marriages in the jurisdiction in which the birth occurred [49984]. In 2023, there were 24,737 births (12,679 males and 12,058 females) registered in Australia with one or both parents identified as Aboriginal and/or Torres Strait Islander (8.6% of all births registered). This probably underestimates the true number as Indigenous status is not always identified, and there may be a lag in birth registrations (See Appendix 1 for a discussion of data limitations).

In 2023, for births registered as Indigenous: 23% recorded both parents as Aboriginal and/or Torres Strait Islander; 46% recorded only the mother as Aboriginal and/or Torres Strait Islander (including births where paternity was not acknowledged and those where the father’s Indigenous status was unknown) and in 31% of registrations only the father was recorded as Aboriginal and/or Torres Strait Islander (including births where the mother’s Indigenous status was unknown) [49984].

Age of mothers

In 2023, for babies born to Aboriginal and Torres Strait Islander women, 57% were born to mothers aged 20-29 years, and 8.8% were born to teenagers (aged 15-19 years) [49984].

In 2023, the median age of Aboriginal and Torres Strait Islander mothers who gave birth was 26.8 years [49984]. The highest age-specific fertility rates for Aboriginal and Torres Strait Islander women were among those aged 25-29 years (125 per 1,000) and 20-24 years (114 per 1,000). The fertility rate of teenage Aboriginal and Torres Strait Islander women, aged 15-19 years, was 34 births per 1,000 women.

Total fertility rate

In 2023, the total fertility rate was 2.2 babies per 1,000 Aboriginal and Torres Strait Islander women [49984].

Antenatal care

In 2022, 87% (crude proportion) of pregnant Aboriginal and Torres Strait Islander women attended five or more antenatal visits[2] [43321]. The Department of Health and Aged Care recommends 10 visits for first-time pregnancy without complications and 7 visits for subsequent uncomplicated pregnancies [34697]. The proportion of women attending the first antenatal visit during the first trimester of pregnancy (less than 14 weeks) was 71% [43321]. This has increased each year from 51% in 2013. The proportions decreased with remoteness, from major cities/inner regional areas (both 74%), outer regional areas (73%) and remote/very remote areas (both 60%).

Birthweight

In 2022, the average birthweight of babies born to Aboriginal and Torres Strait Islander mothers was 3,209 grams [43321]. Low birthweight (LBW), defined as a birthweight of less than 2,500 grams [38183], increases the risk of health problems and death in infancy [28058]. In 2022, 12% of babies born to Aboriginal and Torres Strait Islander mothers were of LBW [43321], of which 2.0% combined were very LBW (less than 1,500 grams) and extremely LBW (less than 1,000 grams) [38183].

Factors impacting on LBW include preterm birth, mothers smoking during pregnancy, mothers being underweight prior to pregnancy and not attending antenatal care in the first trimester [46072]. Other factors include socioeconomic disadvantage and the age of the mother [28058].

Tobacco smoking while pregnant has a major impact on birthweight. In 2022, 40% (age-standardised proportion) of Aboriginal and Torres Strait Islander mothers reported smoking during pregnancy [43321]. If smoking during pregnancy could be eliminated, the prevention of an estimated 37% of LBW births among Aboriginal and Torres Strait Islander babies could occur [46072].

[1] The study of birth information is known as fertility analysis, where ‘fertility’ refers to the number of babies born alive. This meaning is different to the lay use of the word, which means the capacity to bear children.

[2] This excludes very preterm births.