Australia is having fewer babies than at any time in recent decades. The nation's fertility rate has fallen well below replacement level, yet maternity workforce shortages continue to affect hospitals and health services across the country. Recruiting and retaining midwives remains a significant challenge in many regions, while specialist obstetric services continue to experience workforce pressures, particularly outside metropolitan centres. With workforce projections pointing to ongoing demand, it is clear that the need for maternity professionals is driven by far more than the number of babies born each year.
Australia's fertility rate continues to fall
Australia's long-term fertility trend has been declining for more than a decade.
According to the Australian Bureau of Statistics (ABS), there were 292,318 registered births in 2024, a slight increase on the previous year. However, the country's total fertility rate remained just 1.48 births per woman, well below the replacement rate needed for a naturally stable population.
This distinction is important. The total number of births may fluctuate from year to year as Australia's population grows, especially via immigration, but the average number of children women are having continues to decline.
The Australian Institute of Health and Welfare (AIHW) also reports that the birth rate in 2023 was the lowest recorded since reporting began in 1998, reflecting a long-term downward trend rather than a temporary fluctuation.
Why do shortages persist despite fewer births?
At first glance, fewer births might suggest less demand for maternity clinicians. However, workforce demand depends on far more than the number of babies born each year.
One of the biggest challenges is workforce supply. Australia's maternity workforce is ageing, experienced clinicians are retiring, and many services continue to report difficulties attracting and retaining midwives. Regional and rural communities face particularly acute recruitment challenges, with some maternity services relying on locums or internationally trained health professionals to maintain service delivery.
The 2024 Midwifery Futures report, commissioned by the Nursing and Midwifery Board of Australia, highlighted widespread workforce pressures across the profession. The report identified localised shortages, concerns about burnout and wellbeing, and warned that the future workforce may be insufficient to meet community needs without sustained investment in education, retention and workforce planning.
In other words, workforce demand is influenced not only by patient numbers, but also by workforce participation, retirement rates, geographic distribution, service models and the ability to retain experienced clinicians.
Pregnancy is becoming more clinically complex
Another important trend is the changing profile of Australian mothers.
The AIHW reports that the average maternal age has increased from 28.9 years in 1998 to 31.3 years in 2023, while the proportion of women giving birth aged 35 years and over has continued to rise. Older maternal age is associated with a higher likelihood of medical conditions requiring additional monitoring and multidisciplinary care during pregnancy. The AIHW also reports that caesarean births have increased substantially over the past two decades, rising from 29% of births in 2004 to 41% in 2023. These changes reflect an increasingly complex maternity environment that often requires greater clinical input than birth numbers alone might suggest.
There is also a broader shift towards more complex reproductive and women's healthcare. As Australians increasingly delay parenthood, demand for fertility assessment and assisted reproductive technologies has continued to grow. This has expanded workforce demand across fertility clinics and women's health services, including fertility specialists, obstetricians and gynaecologists, fertility nurses, sonographers, embryologists and other allied health professionals, reflecting the growing complexity of reproductive healthcare.
What does this mean for employers and healthcare professionals?
For healthcare employers, declining fertility rates should not be interpreted as a sign that recruitment challenges will ease. Workforce shortages are expected to persist, particularly in regional and rural Australia, making retention, succession planning and graduate recruitment increasingly important.
For midwives, obstetricians, doctors considering women's health, and students planning their careers, the outlook remains positive. Australia's ageing maternity workforce, ongoing regional shortages and projected workforce demand suggest there will continue to be strong employment opportunities across both the public and private sectors.
The reality is that Australia may be having fewer babies, but it is investing more healthcare resources into each pregnancy. That shift is reshaping—not reducing—the demand for maternity and women's health professionals.
