Births: Provisional Data for 2018

May 15, 2019

Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author of “Births: Provisional Data for 2018.”

Q: How does the provisional 2018 birth data compare to previous years?

BH: The  number of births, the general fertility rate, the total fertility rate, birth rates for women aged 15-34, the cesarean delivery rate and the low-risk cesarean delivery rate declined from 2017 to 2018, whereas the birth rates for women aged 35-44 and the preterm birth rate rose.


Q: When do you expect the final 2018 birth report to come out?

BH: The 2018 final birth report is scheduled for release in the fall of 2019.


Q: How did the data vary by age and race?

BH:  Birth measures shown in the report varied widely by age and race and Hispanic origin groups. Birth rates ranged from 0.2 births per 1,000 females aged 10-14 to 99.6 births per 1,000 women aged 30-34. By race and Hispanic origin, the cesarean delivery rate ranged from 28.7% of births for non-Hispanic American Indian or Alaska Native women to 36.1% for non-Hispanic black women and the preterm birth rate ranged from 8.56% for non-Hispanic Asian women to 14.12% for non-Hispanic black women.


Q: Was there a specific finding in the provisional data that surprised you?

BH: The report includes a number of interesting findings. The record lows reached for the general fertility rate, the total fertility rate and birth rates for females aged 15-19, 15-17, 18-19, and 20-24 are noteworthy. In addition, the magnitude of the continued decline in the birth rate for teens aged 15-19, down 7% from 2017 to 2018, is also historic.


Q: What is the take home message for this report?

BH:  The number of births for the United States was down 2% from 2017 to 2018, as were the general fertility rate and the total fertility rate, with both at record lows in 2018. Birth rates declined for nearly all age groups of women under 35, but rose for women in their late 30s and early 40s. The birth rate for teenagers aged 15–19 was down 7% from 2017 to 2018. The cesarean delivery rate and low-risk cesarean delivery rate were down in 2018. The preterm birth rate rose for the fourth year in a row in 2018.


Q: Do you anticipate this drop will continue?

BH: The factors associated with family formation and childbearing are numerous and complex. The data on which the report are based come from all birth certificates registered in the U.S. While the scope of these data is wide, with detailed demographic and health   information on rare events, small areas, or small population groups, the data do not provide information on the attitudes and behavior of the parents regarding family formation and childbearing. Accordingly, these data do not answer the question of why the number of births dropped in 2018 or if the decline will continue.

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Educational Attainment of Mothers Aged 25 Years and Over: United States, 2017

February 21, 2019

Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author of “Educational Attainment of Mothers Aged 25 Years and Over: United States, 2017.”

Q: Why study education attainment of mothers in the United States?

BH: Educational attainment of the mother is considered an important measure of socioeconomic status. Maternal education has been shown to be associated with the number of births per woman, timing of childbearing, contraceptive use, and risk of adverse birth outcomes. Women with higher educational attainment have been shown to be more likely to desire and give birth to fewer children and are less likely to engage in behaviors detrimental to their health and pregnancy.


Q: How did you obtain data on educational attainment of mothers?

BH: Information on the educational attainment of mother shown in the report is based on data from 100% of the birth certificates filed in the states and District of Columbia in 2017. The birth certificate includes a question on the highest degree or level of school completed by the mother at the time of delivery. Data collected from the birth certificates on this and other items are provided to the National Center for Health Statistics.


Q: How did educational attainment of mother vary by race and state in 2017?

BH: Large differences in maternal educational attainment are observed by race and Hispanic origin and by state. For example, for mothers aged 25 and over with a Bachelor’s or advanced degree in 2017,  levels ranged from a low of 12.7% and 13.2% for non-Hispanic American Indian or Alaska Native and Native Hawaiian or Other Pacific Islander mothers to a high of 67.9% for non-Hispanic Asian mothers. By state, the percentage of births to mothers aged 25 and over with a Bachelor’s or advanced degree ranged from a low of 26.6% for Nevada to a high of 58.5% for the District of Columbia.


Q: Do you have trend data on educational attainment of mothers that goes back 10 or 20 years?

BH: No, this report is the first to present information on the educational attainment of mothers in the United States in more than 20 years. During this time, comparable data on the education level of mothers were not available for all of the states and District of Columbia and so national data could not be produced. Comparable national data on the education level became available only recently, in 2016. The last report to present national data on the educational attainment was published in 1997 (https://www.cdc.gov/nchs/data/mvsr/supp/mv45_10s.pdf .


Q: Was there a specific finding in your report that surprised you?

BH: The range in the mean number of live births by level of educational attainment is certainly noteworthy. The difference in the mean between women with less than a 12th grade education with no diploma and women with an advanced degree is nearly 1 whole birth. In addition, the wide range in the percentage of births by educational attainment for the race and Hispanic origin groups and state, mentioned above, were also notable.


Total Fertility Rates by State and Race and Hispanic Origin: United States, 2017

January 10, 2019

Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author of “Total Fertility Rates by State and Race and Hispanic Origin: United States, 2017

Q: Why did you decide to do a report on the total fertility rate in the United States?

BH: We produced this report because we were interested in what differences there were in the total fertility rate (TFR) by state and population group (race and Hispanic origin). This report presents the TFR for each state in 2017, both overall and for the three largest population groups — non-Hispanic white, non-Hispanic black, and Hispanic. As noted in the report, fertility levels affect the size and composition of the population, and family size is associated with female labor force participation and economic growth, as well as other social and economic changes.


Q: Can you explain what the total fertility rate is and how is it different from the general fertility rate and crude birth rate?

BH: The total fertility rate is the number of births expected for a (hypothetical) group of 1,000 women over their lifetime, assuming the current age-specific birth rate hold. The crude birth rate and general fertility rate measure the number of births occurring for either the whole population or the population of women in their childbearing years (ages 15-44 year) in a given year. The TFR, on the other hand, estimates the number of births for women over a generation. For that reason, the TFR can be used to ascertain whether the number of births is at “replacement,” that is, the level at which a given group of women can exactly replace themselves (generally considered to be 2,100 births per 1,000 women for the TFR).


Q: How did total fertility rates vary by state and race in 2017?

BH: Differences in the total fertility rates among the states by race and Hispanic origin were considerable. For non-Hispanic white women, the TFR for Utah (2,099.5, the highest) was more than double the TFR for the District of Columbia (1,012.0, the lowest). For non-Hispanic black women, the TFR for Maine (4,003.5) was 3.5 times higher than that for Wyoming (1,146.0). For Hispanic women, the TFR for Alabama (3,085.0) was 2.6 times higher than the TFR for Vermont (1,200.5). In addition, there were no states with TFRs above replacement for non-Hispanic white women in 2017. However, for non-Hispanic black women, the TFRs for 12 states was above replacement. The TFRs for Hispanic women were above replacement in 29 states.


Q: Do you have trend data on total fertility rates that goes back 10 or 20 years?

BH: The report includes only data for 2017. However, trend data for the total fertility rate at the national level, by race and Hispanic origin group, are available from Births: Final Data for 2017 (https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_08-508.pdf), Births: Final Data for 2015 (https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf), and Trends and Variations in Reproduction and Intrinsic Rates: United States, 1990-2014 (https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_02.pdf). In general, the TFR has declined over the last six decades, with the TFR being below replacement for all but two years (2006 and 2007) since 1971. In 2017, the rates for all groups were below replacement.


Q: Is there a finding in this report that surprised you?

BH: The range between the highest and lowest total fertility rate among the states by race and Hispanic origin groups is noteworthy. As we mentioned, for non-Hispanic white women, the TFR for Utah was more than double the TFR for the District of Columbia. For non-Hispanic black women, the TFR for Maine was 3.5 times higher than that for Wyoming. For Hispanic women, the TFR for Alabama was 2.6 times higher than the TFR for Vermont.


“Births: Final Data for 2017” Released

November 7, 2018

The comprehensive report on final births data for the United States was released on November 7, 2018, documenting a total of 3,855,500 births registered in the United States, down 2% from 2016. Compared with rates in 2016, the general fertility rate declined to 60.3 births per 1,000 women aged 15–44. The birth rate for females aged 15–19 fell 7% in 2017. Birth rates declined for women in their 20s and 30s but increased for women in their early 40s. The total fertility rate declined to 1,765.5 births per 1,000 women in 2017. Birth rates for both married and unmarried women declined from 2016 to 2017, and the percentage of babies born to unmarried women (39.8) did not change between 2016 and 2017.  Many of these findings were documented in a May 2018 provisional release of 2017 data.

The final data are contained in the new publication “Births: Final Data for 2017.”

Some new data for 2017 are included for the first time in the new report:

  • The percentage of women who began prenatal care in the first trimester of pregnancy rose to 77.3% in 2017.
  • The percentage of all women who smoked during pregnancy declined to 6.9%. Percentages dropped for all race/ethnic groups from 2016 to 2017 except for Hispanic mothers (no change) and Native Hawaiian or Other Pacific Islander mothers (a 0.1 percentage point increase).
  • Medicaid was the source of payment for 43.0% of all births in 2017, up 1% from 2016.
  • Twin and triplet and higher-order multiple birth rates were essentially stable in 2017.
  • The average age of U.S. mothers at first birth in 2017 was 26.8 years, an increase from 26.6 years in 2016 – and a new all-time high.

Fact or Fiction: Do women who live in rural counties in the U.S. give birth at an earlier age than women in large metropolitan counties?

October 17, 2018

Source: National Vital Statistics System, 2017

https://www.cdc.gov/nchs/data/databriefs/db323-h.pdf


Trends in Fertility and Mother’s Age at First Birth Among Rural and Metropolitan Counties: United States, 2007–2017

October 17, 2018

Questions for Danielle Ely, Health Statistician and Lead Author of “Trends in Fertility and Mother’s Age at First Birth Among Rural and Metropolitan Counties: United States, 2007–2017

Q: Why did you decide to look at fertility rates and mother’s age at first birth among rural and metropolitan U.S. counties?

DE: Rural and metropolitan counties have a variety of differences related to general health, birth outcomes, and mortality rates. However, we noticed that recent research did not focus on the overall fertility differences in these areas or maternal age, which can affect birth outcomes. Looking at these items can help us understand why we might see differences between rural and metro counties in births and birth outcomes.


Q: How did the findings vary by race?

DE: Patterns for total fertility rates were similar by race and Hispanic origin. There were higher total fertility rates in rural counties than in metropolitan counties among the three race and Hispanic origin groups in 2007. In 2017, this pattern was the same for non-Hispanic white and Hispanic women, but non-Hispanic black women had higher total fertility rates in small or medium metro counties compared with rural and large metro counties. Hispanic women had the highest total fertility rates for each urbanization level in both 2007 and 2017

Non-Hispanic white, non-Hispanic black and Hispanic women had lower ages at first birth in rural counties compared with both metro county types. This was true in both 2007 and 2017, and differences between county types widened over this time.


Q: How did the findings vary by mean age of mothers at first birth?

DE: Mean age at first birth was lower in rural counties than small or medium metro counties and large metro counties from 2007-2017. Each of the three race and Hispanic origin groups had lower mean age at first birth in rural counties compared with metropolitan counties.


Q: Is there any comparable trend data prior to 2007?

DE: We have not computed trend data on total fertility rates or mean age at first birth by urbanization level prior to 2007.


Q: What is the take home message in this report?

DE: The important message in this report is that there are differences in the fertility rates and mean age at first birth between rural and metro areas, and these differences have gotten larger over time. These trends are generally the same by race and Hispanic origin. Information on differences in birth rates and maternal age by urbanization level can inform decisions on resource allocation and ultimately lead to improvement in infant and maternal health.


Describing the Increase in Preterm Births in the United States, 2014–2016

June 13, 2018

Questions for Joyce Martin, Statistician, and Lead Author of “Describing the Increase in Preterm Births in the United States, 2014–2016

Q: What did you think was the most interesting finding in your report?

JM: Two things – that the rate has increased for three straight years following several years of decline, and that the increase generally occurred among babies born late preterm.


Q: Why are total preterm birth rates increasing?

JM: The reasons for the rise are not well understood, but appear to be largely among births occurring at the highest end of the preterm/late range, that is, at 36 weeks.  That said, it is important to note that early preterm births, those at the greatest risk of poor outcome increased among non-Hispanic black births.


Q: Why did you decide to examine preterm birth rates?

JM: The preterm birth rate is a basic indicator of the maternal and infant health of a nation and, accordingly, changes in the preterm rate have important implications for the public health. Babies born prior to 37 weeks of gestation are more likely to die within the first year of life and more likely to suffer life-long morbidities than those born later in pregnancy.


Q: How did preterm birth rates vary among U.S. states from 2014-2016?

JM: Preterm rates rose significantly in 23 states and the District of Columbia and non-significant increased were seen in an additional 22 states.  In short, rates are trending upward for the vast majority of states.


Q: What is the take home message in this report?

JM: The incidence of infants born too soon is on the rise in the US, appears to be largely among late preterm births and the rise does not appear to be limited to any specific maternal race, age or geographic group.