474 652 total births | 210 779 pimiparous births | 263 873 multiparous births | |||||||
Spontaneous onset of labour | Induction for non-medical reasons | Total population | Spontaneous onset of labour | Induction for non-medial reasons | AOR (99% CI)* | Spontaneous onset of labour | Induction for non-medical reasons | AOR (99% CI)* | |
Proportion n (%) | Proportion n (%) | AOR (99% CI)† | Proportion n (%) | Proportion n (%) | Proportion n (%) | Proportion n (%) | |||
Mode of birth outcomes‡ | |||||||||
Spontaneous vaginal birth | |||||||||
37+0–37+6 | 14 322 (76.2) | 2400 (76.0) | NA‡ | 6081 (70.0) | 676 (54.5) | NA‡ | 8241 (81.6) | 1724 (89.9) | NA‡ |
38+0–38+6 | 42 781 (77.7) | 93 051 (75.1) | NA‡ | 15 779 (67.7) | 1861 (47.8) | NA‡ | 27 002 (85.1) | 7440 (87.7) | NA‡ |
39+0–39+6 | 93 809 (79.0) | 14 615 (72.2) | NA‡ | 33 074 (64.7) | 3422 (45.9) | NA‡ | 60 735 (89.7) | 11 193 (87.6) | NA‡ |
40+0–40+6 | 120 671 (77.2) | 18 319 (63.5) | NA‡ | 42 385 (60.2) | 5602 (39.6) | NA‡ | 78 286 (95.0) | 12 717 (91.7) | NA‡ |
41+0–41+6 | 41 218 (73.2) | 2680 (56.2) | NA‡ | 15 464 (55.8) | 1096 (37.9) | NA‡ | 25 754 (90.0) | 1584 (84.2) | NA‡ |
Instrumental vaginal birth | |||||||||
37+0–37+6 | 2198 (11.7) | 383 (12.1) | 1.16 (0.99 to 1.37) | 1785 (20.5) | 295 (23.8) | 1.50 (1.23 to 1.82) | 413 (4.1) | 88 (4.6) | 1.00 (0.73 to 1.37) |
38+0–38+6 | 6322 (11.5) | 1689 (13.6) | 1.51 (1.39 to 1.64) | 4994 (21.4) | 1031 (26.5) | 1.78 (1.59 to 1.99) | 1328 (4.2) | 658 (7.8) | 1.64 (1.44 to 1.87) |
39+0–39+6 | 15 040 (12.7) | 3019 (14.9) | 1.48 (1.39 to 1.57) | 12 089 (23.7) | 2033 (27.3) | 1.57 (1.45 to 1.70) | 2951 (4.4) | 986 (7.7) | 1.69 (1.53 to 1.87) |
40+0–40+6 | 21 699 (13.9) | 5314 (18.4) | 1.59 (1.52 to 1.67) | 17 555 (25.0) | 4170 (29.5) | 1.71 (1.61 to 1.81) | 4144 (4.8) | 1144 (7.8) | 1.58 (1.45 to 1.73) |
41+0–41+6 | 8253 (14.7) | 906 (19.0) | 1.48 (1.32 to 1.66) | 6880 (24.8) | 767 (26.5) | 1.51 (1.33 to 1.72) | 1373 (4.8) | 139 (7.4) | 1.60 (1.26 to 2.04) |
Caesarean section | |||||||||
37+0–37+6 | 2265 (12.1) | 376 (11.9) | 1.00 (0.86 to 1.17) | 821 (9.5) | 270 (21.8) | 3.13 (2.53 to 3.87) | 1444 (14.3) | 106 (5.5) | 0.34 (0.26 to 0.44) |
38+0–38+6 | 5923 (10.8) | 1392 (11.2) | 1.11 (1.02 to 1.21) | 2530 (10.9) | 1004 (25.8) | 3.38 (3.00 to 3.80) | 3393 (10.7) | 388 (4.6) | 0.38 (0.33 to 0.44) |
39+0–39+6 | 9960 (8.4) | 2600 (12.8) | 1.82 (1.71 to 1.94) | 5952 (11.6) | 1999 (26.8) | 3.13 (2.88 to 3.40) | 4008 (5.9) | 601 (4.7) | 0.80 (0.71 to 0.90) |
40+0–40+6 | 13 955 (8.9) | 5218 (18.1) | 2.45 (2.33 to 2.58) | 10 410 (14.8) | 4381 (31.0) | 3.03 (2.85 to 3.22) | 3545 (4.2) | 837 (5.7) | 1.43 (1.29 to 1.59) |
41+0–41+6 | 6839 (12.1) | 1185 (24.8) | 2.36 (2.13 to 2.62) | 5346 (19.3) | 1027 (35.5) | 2.60 (2.30 to 2.93) | 1493 (5.2) | 158 (8.4) | 1.71 (1.36 to 2.15) |
Pain relief treatment§ | |||||||||
No pain relief treatment | |||||||||
37+0–37+6 | 3117 (16.6) | 272 (8.6) | NA§ | 809 (9.3) | 44 (3.5) | NA§ | 2308 (22.9) | 228 (11.9) | NA§ |
38+0–38+6 | 8956 (16.3) | 926 (7.5) | NA§ | 1627 (7.0) | 76 (2.0) | NA§ | 7329 (23.1) | 850 (10.0) | NA§ |
39+0–39+6 | 19 171 (16.1) | 1435 (7.1) | NA§ | 3230 (6.3) | 136 (1.8) | NA§ | 15 941 (23.5) | 1299 (10.2) | NA§ |
40+0–40+6 | 24 605 (15.7) | 1789 (6.2) | NA§ | 4177 (5.9) | 199 (1.4) | NA§ | 20 428 (23.8) | 1590 (10.8) | NA§ |
41+0–41+6 | 8052 (14.3) | 272 (5.7) | NA§ | 1402 (5.1) | 52 (1.8) | NA§ | 6650 (23.2) | 220 (11.7) | NA§ |
Pharmacological medication | |||||||||
37+0–37+6 | 10 174 (52.4) | 1382 (43.7) | 1.70 (1.41 to 2.03) | 5005 (57.6) | 422 (34.0) | 1.56 (1.02 to 2.38) | 5169 (51.2) | 960 (50.1) | 1.82 (1.51 to 2.27) |
38+0–38+6 | 30 140 (54.8) | 5007 (40.4) | 1.87 (1.70 to 2.07) | 13 029 (55.9) | 1197 (30.7) | 2.01 (1.47 to 2.76) | 17 111 (53.9) | 3810 (44.9) | 1.93 (1.74 to 2.15) |
39+0–39+6 | 66 722 (56.2) | 8084 (40.0) | 1.87 (1.73 to 2.02) | 27 688 (54.2) | 2115 (28.4) | 1.87 (1.48 to 2.36) | 39 034 (57.7) | 5969 (46.7) | 1.89 (1.74 to 2.05) |
40+0–40+6 | 86 655 (55.4) | 11 029 (38.2) | 1.87 (1.75 to 2.01) | 35 552 (50.5) | 3605 (25.5) | 2.18 (1.79 to 2.64) | 51 103 (59.4) | 7424 (50.5) | 1.87 (1.74 to 2.02) |
41+0–41+6 | 30 418 (54.0) | 1754 (36.8) | 1.70 (1.43 to 2.02) | 13 274 (47.9) | 739 (25.6) | 1.52 (1.04 to 2.22) | 17 144 (59.9) | 1015 (54.0) | 1.80 (1.48 to 2.19) |
Epidural anaesthesia | |||||||||
37+0–37+6 | 5411 (28.8) | 1497 (47.4) | 3.65 (3.03 to 4.39) | 2846 (32.8) | 774 (62.4) | 5.32 (3.50 to 8.08) | 2565 (25.4) | 723 (37.7) | 2.81 (2.27 to 3.48) |
38+0–38+6 | 15 702 (28.5) | 6430 (51.9) | 4.79 (4.33 to 5.30) | 8589 (36.9) | 2620 (67.2) | 6.88 (5.03 to 9.41) | 7113 (22.4) | 3810 (44.9) | 4.21 (3.77 to 4.70) |
39+0–39+6 | 32 417 (27.3) | 10 680 (52.8) | 5.42 (5.01 to 5.87) | 20 073 (39.3) | 5196 (69.7) | 6.13 (4.87 to 7.72) | 12 344 (18.2) | 5484 (42.9) | 5.08 (4.65 to 5.54) |
40+0–40+6 | 44 370 (28.4) | 15 991 (55.4) | 5.35 (4.99 to 5.74) | 30 449 (43.3) | 10 342 (73.1) | 6.89 (5.70 to 8.34) | 13 921 (16.2) | 5649 (38.4) | 4.79 (4.42 to 5.19) |
41+0–41+6 | 17 527 (31.1) | 2733 (57.3) | 4.35 (3.65 to 5.19) | 12 939 (46.7) | 2094 (72.5) | 4.23 (2.92 to 6.12) | 4588 (16.0) | 639 (34.0) | 4.11 (3.34 to 5.07) |
Maternal outcomes¶ | |||||||||
Episiotomy | |||||||||
37+0–37+6 | 2843 (17.2) | 452 (16.2) | 1.15 (0.98 to 1.34) | 2158 (27.4) | 309 (31.8) | 1.23 (1.01 to 1.49) | 685 (7.9) | 143 (7.9) | 1.01 (0.79 to 1.31) |
38+0–38+6 | 8374 (17.1) | 1994 (18.1) | 1.52 (1.40 to 1.64) | 6078 (29.3) | 1091 (37.7) | 1.55 (1.39 to 1.73) | 2296 (8.1) | 903 (11.2) | 1.42 (1.27 to 1.59) |
39+0–39+6 | 18 730 (17.2) | 3740 (21.2) | 1.63 (1.54 to 1.73) | 13 731 (30.4) | 2209 (40.5) | 1.58 (1.46 to 1.70) | 4999 (7.8) | 1531 (12.6) | 1.66 (1.53 to 1.81) |
40+0–40+6 | 25 212 (17.7) | 6001 (25.4) | 1.67 (1.60 to 1.75) | 18 824 (31.4) | 4275 (43.7) | 1.68 (1.59 to 1.78) | 6388 (7.7) | 1726 (12.5) | 1.62 (1.50 to 1.75) |
41+0–41+6 | 8590 (17.4) | 948 (26.4) | 1.58 (1.4 2 to 1.77) | 6780 (30.3) | 757 (40.6) | 1.54 (1.36 to 1.76) | 1810 (6.7) | 191 (11.1) | 1.71 (1.38 to 2.11) |
3rd/4th degree tear | |||||||||
37+0–37+6 | 340 (2.1) | 50 (1.8) | 1.10 (0.74 to 1.65) | 284 (3.6) | 44 (4.5) | 1.29 (0.84 to 1.99) | 56 (0.3) | 6 (0.3) | 0.44 (0.13 to 1.48) |
38+0–38+6 | 1136 (2.3) | 151 (1.4) | 0.83 (0.66 to 1.05) | 847 (4.1) | 117 (4.0) | 1.05 (0.81 to 1.38) | 289 (1.0) | 34 (0.4) | 0.47 (0.29 to 0.75) |
39+0–39+6 | 2905 (2.7) | 316 (1.8) | 0.85 (0.72 to 0.99) | 2157 (4.8) | 227 (4.2) | 0.93 (0.77 to 1.02) | 748 (1.2) | 89 (0.7) | 0.66 (0.49 to 0.89) |
40+0–40+6 | 4096 (2.9) | 524 (2.2) | 0.79 (0.70 to 0.90) | 3062 (5.1) | 400 (4.1) | 0.82 (0.71 to 0.94) | 1034 (1.3) | 124 (0.9) | 0.71 (0.55 to 0.91) |
41+0–41+6 | 1696 (3.4) | 115 (3.2) | 0.84 (0.65 to 1.09) | 1279 (5.7) | 91 (4.9) | 0.84 (0.63 to 1.12) | 417 (1.5) | 24 (1.4) | 0.86 (0.49 to 1.50) |
Vaginal repair | |||||||||
37+0–37+6 | 10 467 (63.4) | 1649 (59.3) | 1.04 (0.92 to 1.16) | 6274 (79.8) | 810 (83.4) | 1.25 (0.98 to 1.58) | 4193 (48.5) | 839 (46.3) | 0.96 (0.83 to 1.10) |
38+0–38+6 | 31 954 (65.1) | 7043 (64.1) | 1.25 (1.18 to 1.33) | 17 198 (82.8) | 2538 (87.8) | 1.62 (1.38 to 1.89) | 14 756 (52.1) | 4505 (55.6) | 1.17 (1.09 to 1.25) |
39+0–39+6 | 71 795 (66.0) | 11 952 (67.8) | 1.29 (1.23 to 1.36) | 38 253 (84.7) | 4858 (89.1) | 1.51 (1.34 to 1.70) | 33 542 (52.7) | 7094 (58.2) | 1.24 (1.17 to 1.30) |
40+0–40+6 | 93 383 (65.6) | 17 056 (72.2) | 1.37 (1.31 to 1.43) | 50 740 (84.7) | 8841 (90.5) | 1.68 (1.53 to 1.85) | 42 643 (51.7) | 8215(59.3) | 1.28 (1.22 to 1.35) |
41+0–41+6 | 32 805 (66.3) | 2669 (74.4) | 1.36 (1.22 to 1.52) | 19 049 (85.3) | 1663 (89.3) | 1.40 (1.14 to 1.71) | 13 756 (50.7) | 1006 (58.4) | 1.34 (1.18 to 1.53) |
Postpartum haemorrhage | |||||||||
37+0–37+6 | 210 (1.1) | 56 (1.8) | 1.75 (1.18 to 2.59) | 112 (1.3) | 28 (2.3) | 1.81 (1.04 to 3.14) | 98 (1.0) | 28 (1.5) | 1.72 (0.98 to 3.02) |
38+0–38+6 | 581 (1.1) | 222 (1.8) | 2.10 (1.70 to 2.59) | 275 (1.2) | 95 (2.4) | 2.33 (1.70 to 3.19) | 306 (1.0) | 127 (1.5) | 1.94 (1.46 to 2.58) |
39+0–39+6 | 1299 (1.1) | 352 (1.7) | 1.85 (1.57 to 2.17) | 705 (1.4) | 167 (2.2) | 1.73 (1.38 to 2.17) | 594 (0.9) | 185 (1.4) | 2.01 (1.60 to 2.52) |
40+0–40+6 | 2114 (1.4) | 534 (1.9) | 1.47 (1.29 to 1.67) | 1156 (1.6) | 324 (2.3) | 1.45 (1.23 to 1.72) | 958 (1.1) | 210 (1.4) | 1.50 (1.23 to 1.83) |
41+0–41+6 | 907 (1.6) | 123 (2.6) | 1.58 (1.23 to 2.04) | 526 (1.9) | 86 (3.0) | 1.57 (1.16 to 2.14) | 381 (1.3) | 37 (2.0) | 1.61 (1.02 to 2.52) |
Associations in bold are statistically significant p≤0.01.
*Multinominal and multivariate logistic regression models were adjusted for maternal age, country of birth, socioeconomic status.
†Multinominal and multivariate logistic regression models were adjusted for maternal age, country of birth, socioeconomic status, parity.
‡In the multinominal regression model vaginal birth is the reference group.
§In the multinomial regression model no pain relief treatment is the reference group.
¶The maternal outcomes episiotomy, third/fourth degree tear, vaginal repair are calculated for vaginal births for the total population (n=424 939), first births (n=177 039) and 2nd–8th births (n=247 900).
aOR, adjusted OR; NA, not aaplicable.