The United States recorded 3,945,875 births in 2016, down about 1% from the previous year.
The decline continued a change already visible across the country. Women in their teens and twenties were having fewer children. Birth rates increased among women in their thirties and early forties. The average age at first birth reached a record 26.6 years.
The final figures come from the National Center for Health Statistics report Births Final Data for 2016. The report uses birth certificates registered in all 50 states and Washington, D.C.
The year also brought mixed results for maternal and infant health. Teen births and cesarean deliveries declined. Preterm births and low birthweight increased for a second consecutive year.
Key Findings From The 2016 Birth Data
- The United States recorded 3,945,875 births, about 1% fewer than in 2015.
- The general fertility rate fell to a record low of 62.0 births per 1,000 women ages 15 to 44.
- The teen birth rate dropped 9% to another national record low.
- Women ages 30 to 34 had a higher birth rate than women ages 25 to 29 for the first time since reliable national records began in 1940.
- The average age at first birth rose to a record 26.6 years.
- The cesarean delivery rate declined to 31.9%.
- The preterm birth rate increased to 9.85%.
- The low birthweight rate increased to 8.17%.
How The 2016 Birth Figures Were Collected
NCHS first released provisional 2016 figures in June 2017. The provisional report was based on 99.96% of the birth records received by the agency at that point.
The agency replaced the word preliminary with provisional when it launched a more consistent system of quarterly and annual rapid releases. The change did not represent a major break in how the data were processed.
Final data followed in January 2018. The final report was based on all registered birth certificates and revised several provisional estimates slightly.
| Measure | Provisional Estimate | Final 2016 Figure |
|---|---|---|
| Total births | 3,941,109 | 3,945,875 |
| General fertility rate | 62.0 per 1,000 | 62.0 per 1,000 |
| Preterm birth rate | 9.84% | 9.85% |
| Low birthweight rate | 8.16% | 8.17% |
| Cesarean delivery rate | 31.9% | 31.9% |
The final report was also the first annual birth report in which all 50 states and Washington, D.C. used the 2003 revision of the U.S. Standard Certificate of Live Birth.
That allowed NCHS to publish national information on prenatal care, smoking during pregnancy, payment for delivery, primary cesarean births and vaginal births following a previous cesarean.
Fewer Babies Were Born In The United States
The final total of 3,945,875 births was 32,622 lower than the 2015 total of 3,978,497.
The general fertility rate fell from 62.5 to 62.0 births per 1,000 women ages 15 to 44. It was the lowest rate recorded in the United States at that time and 11% below its 2007 level.
The total fertility rate also declined to 1,820.5 expected births per 1,000 women. Expressed in the more familiar form, that equals about 1.82 children per woman if the age-specific birth rates recorded in 2016 remained unchanged throughout her childbearing years.
Birth certificate records show how many births occurred and the characteristics reported for those births. They do not identify one cause for the national decline. Employment, housing costs, marriage patterns, education, access to contraception and personal decisions can all affect the timing of parenthood.
Birth Rates Fell For Women Under 30
The sharpest division in the 2016 data appeared around age 30.
Birth rates fell for every age group under 30. Rates rose for women ages 30 to 44.
| Age Group | 2016 Birth Rate | Change From 2015 |
|---|---|---|
| 15 to 19 | 20.3 births per 1,000 | Down 9% |
| 20 to 24 | 73.8 births per 1,000 | Down 4% |
| 25 to 29 | 102.1 births per 1,000 | Down 2% |
| 30 to 34 | 102.7 births per 1,000 | Up 1% |
| 35 to 39 | 52.7 births per 1,000 | Up 2% |
| 40 to 44 | 11.4 births per 1,000 | Up 4% |
| 45 to 49 | 0.9 births per 1,000 | Up from 0.8 |
The rate for women ages 30 to 34 reached its highest level since 1964. The rate for women ages 35 to 39 was the highest since 1962. Women ages 40 to 44 recorded their highest rate since 1966.
For the first time since reliable national records became available in 1940, the birth rate for women ages 30 to 34 was higher than the rate for women ages 25 to 29.
The difference was narrow, at 102.7 compared with 102.1 births per 1,000 women, but it marked a clear shift toward later childbearing.
The Average Age At First Birth Reached A Record High
The mean age of mothers at their first birth increased from 26.4 years in 2015 to 26.6 years in 2016.
That was the highest national average recorded at the time.
The national figure concealed large differences among demographic groups. The average age at first birth was 30.1 years for non-Hispanic Asian mothers, 27.4 for non-Hispanic white mothers, 24.8 for non-Hispanic Black mothers and 24.7 for Hispanic mothers.
The data describe when first births occurred. They do not show why an individual woman had a child earlier or later.
Teen Birth Rates Fell To Another Record Low
The teen birth rate fell 9% in one year, from 22.3 births per 1,000 teenagers ages 15 to 19 in 2015 to 20.3 in 2016.
The rate had fallen to a new record low every year since 2009. It was 51% lower than in 2007 and 67% lower than in 1991.
| Teen Age Group | 2016 Birth Rate | Annual Change | Change Since 1991 |
|---|---|---|---|
| Ages 15 to 17 | 8.8 per 1,000 | Down 11% | Down 77% |
| Ages 18 to 19 | 37.5 per 1,000 | Down 8% | Down 60% |
| All teenagers ages 15 to 19 | 20.3 per 1,000 | Down 9% | Down 67% |
The decline was not limited to the youngest teenagers. Birth rates fell for both the 15 to 17 and 18 to 19 age groups.
NCHS reported 209,809 births to mothers ages 15 to 19 in 2016. Of those, 54,741 were to mothers ages 15 to 17 and 155,068 were to mothers ages 18 to 19.
Births To Unmarried Women Also Declined
The birth rate for unmarried women fell to 42.4 births per 1,000 unmarried women ages 15 to 44, down 2% from 2015.
The rate was 18% below the 2007 and 2008 peak of 51.8 births per 1,000.
Unmarried women gave birth to 1,596,796 babies in 2016. Those births represented 39.8% of all U.S. births, down from 40.3% in 2015 and below the 2009 peak of 41.0%.
The birth rate among married women moved in the opposite direction. It reached 89.6 births per 1,000 married women ages 15 to 44, up 6% from its recent low in 2010.
Nonmarital birth percentages also varied widely across demographic groups. The share ranged from 12.0% among non-Hispanic Asian mothers to 69.8% among non-Hispanic Black mothers.
Most Mothers Started Prenatal Care In The First Trimester
In 2016, 77.1% of mothers began prenatal care during the first trimester. Another 16.7% started during the second trimester.
About 6.2% began care during the third trimester or received no prenatal care.
| Timing Of Prenatal Care | Share Of Births |
|---|---|
| First trimester | 77.1% |
| Second trimester | 16.7% |
| Third trimester or no care | 6.2% |
First-trimester care ranged from 61.2% among mothers under age 20 to 82.1% among mothers ages 30 to 34.
Differences were also recorded by race and Hispanic origin. First-trimester care was reported for 82.3% of non-Hispanic white mothers and 80.6% of non-Hispanic Asian mothers. The figure was 66.5% for non-Hispanic Black mothers and 72.0% for Hispanic mothers.
Medicaid Paid For More Than Four In Ten Deliveries
The revised birth certificate allowed NCHS to publish national payment data for the first time in the annual report.
| Main Payment Source | Share Of 2016 Deliveries |
|---|---|
| Private insurance | 49.4% |
| Medicaid | 42.6% |
| Self-pay | 4.1% |
| Other sources | Remaining births |
Private insurance paid for nearly half of all deliveries. Medicaid covered more than four in ten.
The payment source changed sharply with maternal age. Medicaid paid for 76.7% of deliveries to mothers under age 20 and 63.5% of deliveries to mothers ages 20 to 24.
Cesarean Deliveries Declined For A Fourth Year
The cesarean delivery rate fell from 32.0% in 2015 to 31.9% in 2016.
The decline was small, but it marked the fourth consecutive annual reduction. The rate was 3% below its 2009 peak of 32.9% and fell below 32% for the first time in nearly a decade.
The low-risk cesarean rate also declined, from 25.8% to 25.7%.
Low-risk cesarean births refer to first births involving one baby at term in a head-first position. That measure is useful because the pregnancies generally have fewer of the conditions that make a surgical delivery more likely.
| Maternal Age | Cesarean Delivery Rate In 2016 |
|---|---|
| Under age 20 | 20.2% |
| Ages 20 to 29 | 28.5% |
| Ages 30 to 39 | 36.3% |
| Age 40 and older | 47.9% |
Cesarean delivery became more common as maternal age increased. Mothers age 40 and older were more than twice as likely to have a cesarean delivery as mothers under age 20.
Preterm Births Increased For A Second Year
The preterm birth rate increased from 9.63% in 2015 to 9.85% in 2016.
A preterm birth occurs before 37 completed weeks of pregnancy. The 2016 increase followed an earlier rise from the recent low of 9.57% in 2014.
Most of the increase came from late preterm births at 34 to 36 completed weeks. The late preterm rate increased from 6.82% in 2014 to 7.09% in 2016. The early preterm rate remained close to 2.76%.
| Gestational Age | 2014 Rate | 2015 Rate | 2016 Rate |
|---|---|---|---|
| All preterm births before 37 weeks | 9.57% | 9.63% | 9.85% |
| Early preterm births before 34 weeks | About 2.75% | 2.76% | 2.76% |
| Late preterm births at 34 to 36 weeks | 6.82% | 6.87% | 7.09% |
The increase reversed part of the progress made from 2007 through 2014. The national preterm rate had fallen from 10.44% in 2007 to 9.57% in 2014.
Earlier coverage of that decline is available in the NCHStats report on final U.S. birth data for 2014.
Low Birthweight Also Increased
The percentage of babies born weighing less than 2,500 grams, or about 5 pounds and 8 ounces, increased from 8.07% in 2015 to 8.17% in 2016.
The figure represented 321,839 low birthweight babies.
Very low birthweight, defined as less than 1,500 grams, remained at 1.40%.
Multiple births were much more likely to involve low birthweight. The rate was 6.44% among single births, 55.47% among twins and 95.60% among triplets.
| Type Of Birth | Preterm Rate | Low Birthweight Rate |
|---|---|---|
| Singleton births | 8.02% | 6.44% |
| Twin births | 59.91% | 55.47% |
| Triplet births | 98.08% | 95.60% |
Higher-Order Multiple Births Continued To Decline
The rate of triplet and higher-order multiple births fell to 101.4 per 100,000 births in 2016.
The annual decline from 2015 was not statistically significant, but the longer trend was clear. The 2016 rate was 48% below the 1998 peak of 193.5 per 100,000 births.
The United States recorded 131,723 twin births and 4,003 triplet or higher-order births in 2016.
Smoking During Pregnancy Was Reported In More Than Seven Percent Of Births
National data based on the revised birth certificate showed that 7.2% of mothers reported smoking at some point during pregnancy.
Smoking was more common early in pregnancy. About 7.0% reported smoking during the first trimester, 6.0% during the second and 5.7% during the third.
Among women who smoked during the three months before pregnancy, one-quarter stopped before pregnancy began.
Reported smoking during pregnancy was highest among mothers ages 20 to 24 at 10.7%. Rates also differed considerably by race and Hispanic origin.
Methodology
The final figures were published in Births Final Data for 2016 by Joyce A. Martin, Brady E. Hamilton, Michelle J.K. Osterman, Anne K. Driscoll and Patrick Drake.
The report used data from birth certificates registered in all 50 states and Washington, D.C. More than 99% of births occurring in the United States are registered.
The provisional report released in June 2017 covered 99.96% of 2016 birth records available at the time. Final data later replaced those estimates.
Rates and percentages describe registered live births. They do not include pregnancies that ended in miscarriage, abortion or fetal death.
Conclusion
The 2016 figures show that American women were having fewer babies and starting families later.
Teen births and births among women in their twenties reached new lows. Women in their thirties and early forties recorded higher birth rates, and the average age at first birth reached 26.6 years.
Maternal and infant health results moved in different directions. Cesarean deliveries declined for a fourth year, but preterm births and low birthweight increased for a second year.
Those changes make 2016 a notable year in U.S. birth data. It was the year women ages 30 to 34 became the age group with the highest birth rate, replacing women ages 25 to 29 for the first time in the national record.
References
- Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Drake P. Births Final Data for 2016. National Vital Statistics Reports. 2018 January 31;67(1):1–55.
- Hamilton BE, Martin JA, Osterman MJK, Driscoll AK, Rossen LM. Births Provisional Data for 2016. Vital Statistics Rapid Release Report No. 2. June 2017.
- Martin JA, Hamilton BE, Osterman MJK. Births in the United States, 2016. NCHS Data Brief No. 287. September 2017.
