“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.
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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.


Timing and Adequacy of Prenatal Care in the United States, 2016

May 30, 2018

Questions for Michelle Osterman, Statistician, and Lead Author of “Timing and Adequacy of Prenatal Care in the United States, 2016

Q: What do you feel was the most significant finding in your analysis?

MO: Overall more than 3 out of 4 women are receiving prenatal care in the first trimester of pregnancy, but this varies by race and Hispanic origin.


Q: Did you find anything surprising about the findings?

MO: The wide variation in first trimester prenatal care between race and Hispanic origin groups among different sources of payment for the delivery (Supplemental Tables 1 and 2).


Q: How has the percentage of mothers who received adequate prenatal care changed over the years?

MO: Trends were not analyzed in this report because 2016 is the first year for which national data on prenatal care is available. Provisional 2017 data show that the percentage of women receiving prenatal care in the first trimester increased to 77.3%


Q: Do you have any insight as to why some groups of women seem to be less likely to have at least adequate prenatal care and/or start their care in the first trimester?

MO: Differences in utilization and initiation may be due to differences in access and resources.


Q: What is the take-home message from your report?

MO: Healthy People 2020, a set of national health objectives for the country, includes a goal for prenatal care.  The goal for 2020 is for 77.9% of pregnant women to receive prenatal care in the first trimester of pregnancy, a target only about 1% higher than the national level of 77.1% we are reporting in this analysis. This target may be achievable for the United States as a whole, but may be less achievable for certain subgroups.


Births: Provisional Data for 2017

May 17, 2018

Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author of “Births: Provisional Data for 2017

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

BH: The report includes a number of very interesting findings. The general fertility rate, 60.2 births per 1,000 women aged 15–44, declining 3% in 2017 and reaching a record low is certainly noteworthy. In addition, the continued decline in the birth rate for teens, down 7% from 2016 to in 2017, and reaching another record low, is very significant. The increase in the cesarean delivery rate following several years of decline is noteworthy as are the recent increase in rates of preterm and low birthweight births.


Q: Why does fertility keep going down in the U.S.?

BH: In general, there are a number of factors associated with fertility. The data on which the report is based comes from the birth certificates registered for births in the U.S. While the scope of this data is essentially all births in the country, and provides detailed information about rare events, small areas, or small population groups, the data does not provide information about the parent’s decision to have (or not have) a child. And so, accordingly, we cannot examine the “why” of the changes and trends in births.


Q: Does the decline in the Total Fertility Rate essentially mean fertility is down below “replacement” levels?  Could you explain this in general terms?

BH: “Replacement” refers to a minimum rate of reproduction necessary for generation to exactly replace itself, that is, enough children born to replace a group of 1,000 women and their partners. For the total fertility rate, this rate is generally considered to be 2,100 births per 1,000 women. In 2017, the total fertility rate, 1,764.5 births per 1,000 women, was below replacement.


Q: Do the increases among women over 40 suggest a “new norm” in people waiting till much later to have children?

BH: Birth rates for women aged 40-44 and 45-49 years have increased generally over the last 3 decades. Given this, it reasonable to expect this trend to continue.


Q: Are the annual declines in teen pregnancy something that we are in danger of taking for granted?

BH: The birth rate for females aged 15-19 has decreased 8% per year from 2007 through 2017. For comparison, the decline in the birth rates for women aged 20-24 and 25-29 was 4% and 2% from 2007 through 2017. The decline in teen births is very noteworthy.


Q: Can you explain how the increases in preterm births and low birthweight are connected?

BH: Infants born preterm are also often, but not exclusively, born low birthweight and vice-versa.  The causes of the recent upward shift in these rates are not well understood.


Declines in Births to Females Aged 10–14 in the United States, 2000–2016

April 25, 2018

TJ Mathews, NCHS Demographer

Questions for T.J. Mathews, M.S., Demographer, Statistician, and Lead Author of “Declines in Births to Females Aged 10–14 in the United States, 2000–2016

Q: Why did you decide to examine trends in births to females aged 10-14 in the U.S.?

TM: We have published data on births to females aged 10-14 for decades but only once before have we published data specific to this group. We decided this significant decline was noteworthy and needed publishing.


Q: How have U.S. birth rates to females ages 10-14 changed since 2000?

TM: The birth rate to females aged 10-14 in the U.S. has declined 78% from 0.9 per 1,000 in 2000 to 0.2 in 2016.


Q: What differences or similarities did you see among race and Hispanic origins in this analysis?

TM: From 2000 to 2016, all groups observed declines in the birth rate for this age group. The largest decline was seen for non-Hispanic black females, a decline of 79%. This group had the highest rate in both time periods.


Q: Is there any comparable trend data on U.S. births to females aged 10-14 older than 2000?

TM: While we didn’t study trends in birth rates to 15-19 year olds in this publication we have been reporting significant declines for this age group over this time period.


Q: Were there any surprises in the findings from this report?

TM: First is the wide range of birth rates for this age by state. Using 2014 to 2016 combined the highest rate was seen in Mississippi, 0.7 per 1,000 while a handful of states had rates as low as 0.1. A second interesting observation is that the majority,  81%, of births to 10-14 years old occurred to those 14 years old.


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

TM: Birth and birth rates to females aged 10-14 in the U.S. have declined significantly since 2000.  Disparities by race and Hispanic origin and by state persist.