In 2024, the national birth rate fell to 53,054 births, continuing the decline since 2009. Although the annual birth rate is an important measure and contributes to the strategic planning and allocation of resources, it is necessary to consider the level of complexity within the birthing population. Rising levels of caesarean section, induction and other interventions, as well as advancing maternal age and associated co-morbidities, present additional challenges for the maternity service beyond the birth rate.