Maternal and perinatal outcomes during the 2020 and 2021 COVID-19 pandemic

Labour can occur spontaneously or may be induced by medical or surgical intervention. If there is no labour, a caesarean section is performed. For more information on onset of labour, see Onset of labour in Australia's mothers and babies.

In Australia, clinical advice early in the pandemic was to consider delaying induction of labour for women with suspected or confirmed COVID-19 infection (RANZCOG 2020).

A study in New South Wales found that there was no significant change in induction rates during the first year of the pandemic (Melov et al. 2023).

Between 2015 and 2021, the 3 most common reasons for induction of labour were diabetes, prelabour rupture of membranes and prolonged pregnancy. Prolonged pregnancy was the most common reason for induction in 2015 (17%) and 2016 (16%) and diabetes was the most common reason for induction from 2017 onwards (between 14% and 15%).

Figure 16 presents data on onset of labour.

Figure 16: Proportion of women who gave birth, by onset of labour and state and territory of birth, 2015 to 2021

Between 2015 and 2019, the proportion of women who had an induction increased across Australia (from 29.4% in 2015 to 34.7% in 2019). Modelling showed that this was an annual increase of 1.5 percentage points. The observed proportion of women who had an induction was 35.5% in 2020 and 34.2% in 2021, which was lower than the predicted proportions based on the modelling (36.6% in 2020 and 38.1% in 2021). This equated to around 15,380 more women without induction of labour than predicted in 2020 and 2021 combined.

Data for modelling exclude 'Not stated' data and therefore may not match the proportions presented in the data visualisation above. For more information on modelling the trend over time, see Methods.

In 2020 and 2021, despite the decrease in the proportion of mothers who had an induction, there was no increase in the proportion of babies with adverse outcomes among mothers who had an induction, such as an Apgar score of less than 7. There was a decrease in the proportion of babies who were born pre-term, of low birthweight or required admission to SCN or NICU, compared with previous years.

Women who lived in some geographical locations were more likely to have an induction. Explore the map below (Figure 17) to view data on the number and proportion of women who had an induction by PHN, remoteness and SA3.

Figure 17: Proportion of women who gave birth and had an induction, by selected geography, 2017 to 2021