Declines in Births by Month: United States, 2020

June 23, 2021

NCHS released a report that presents provisional 2020 and final 2019 and 2018 data on changes in the number of U.S. births by race and Hispanic origin of mother and by month of birth and state.

Findings:

  • From 2019 to 2020, the number of births for the United States declined for each month, with the largest declines occurring in December (8%), August (7%), and October and November (6%).
  • Larger declines in births were seen in the second half of 2020 (down 6%) compared with the first half (down 2%) of 2020.
  • The number of births declined in both the first and second 6 months of 2020 compared with 2019 for nearly all race and Hispanic-origin groups, with larger declines in the second half of 2020 compared with the first half of the year.
  • Births declined in 20 states in the first half of 2020, and in all states in the second half of 2020 (declines in 7 states were not significant).
  • Changes in births by race and Hispanic origin and by state were less pronounced from 2018 to 2019; the number of births declined for 9 months by 1%–3%.

 


Total Fertility Rates, by Maternal Educational Attainment and Race and Hispanic Origin: United States, 2019

May 12, 2021

NVSR70_5_cover1Questions for Brady Hamilton, Health Statistician and Lead Author of “Total Fertility Rates, by Maternal Educational Attainment and Race and Hispanic Origin: United States, 2019.”

Q: What is the difference between general fertility rates and total fertility rates?

BH: The general fertility rate is the number of births per 1,000 females aged 15–44 in a given year, whereas, the total fertility rate is the estimated number of births that a group of 1,000 women would have over their lifetimes, based on age-specific birth rates in a given year.


Q: Why did you decide to compare educational attainment with total fertility rates?

BH: Educational attainment is considered an important measure of socioeconomic status and can be useful in interpreting patterns and differences in fertility behavior both overall and among population groups. Maternal education has been shown to be associated with contraceptive use, the timing of childbearing, and the total number of children women have in their lifetimes. I wanted to examine the association between educational attainment and the expected number of births for women using the latest available vital statistics birth data (2019) from NCHS.


Q: How did the total fertility rates differ by educational attainment?

BH: Total fertility rates decreased as level of education increased from women with a 12th grade education or less through an associate’s and bachelor’s degree, and then increased from bachelor’s degree through a doctorate or professional degree, although the increase from master’s to doctorate or professional degree was not statistically significant.


Q: How did the total fertility rates by educational attainment differ by race?

BH: The patterns in and levels of the total fertility rates by educational attainment differed across the three race and Hispanic-origin groups shown in the report.

Total fertility rates generally declined from the lowest educational level through a bachelor’s degree for non-Hispanic white women, and through an associate’s degree for Hispanic women, and then generally rose for both groups for women with advanced degrees. Rates for non-Hispanic black women declined by educational level through a master’s degree.

Total fertility rates for non-Hispanic black and Hispanic women with some college credit or less were generally higher than the rates for non-Hispanic white women, but TFRs for non-Hispanic black and Hispanic women with a master’s degree or more were generally lower than the rates for non-Hispanic white women


Q: Was there a specific finding in the data that surprised you from this report?

BH: Yes, the span of the range in the total fertility rates was surprising, from the low of 1,284 for women with a bachelor’s degree to the high of 2,791 for women with a 12th grade education or less. To put this difference in perspective, a woman with a 12th grade education or less would be expected to have more than one additional birth compared with a woman with a bachelor’s degree.


PODCAST: Effects of the Pandemic on Births in New York City

May 7, 2021

STATCAST, MAY 2021: DISCUSSION WITH ELIZABETH GREGORY, STATISTICIAN, ABOUT HEALTHY PEOPLE INITIATIVE.

https://www.cdc.gov/nchs/pressroom/podcasts/2021/20210507/20210507.htm

podcast-iconHOST:  Elizabeth Gregory is a health scientist with the CDC’s National Center for Health Statistics.  Elizabeth has authored a new study examining the effects of the pandemic on births in New York City, one of the hardest-hit areas by COVID-19.  The study looked at changes in the percentage of births to women who are residents of New York City but who gave birth outside the city.  The data covered the period between 2018-2019 and 2019-2020.

HOST:  So this is a different study than what we usually get from NCHS.  Can you explain why you chose this topic?

ELIZABETH GREGORY:  Sure.  Early on during the height of the pandemic in New York City in 2020 there were a lot of news stories about residents leaving the city and busy hospitals with a brief ban on support persons during labor and delivery at some hospitals.  So we decided to take a look at what are these things resulted in women going out of the city to give birth.

HOST: Now a lot of people are anxiously awaiting new data from 2021 to see if there were any major changes in fertility due to the pandemic, but your report is showing really that the pandemic did impact births in New York, at least from a health care utilization, from a delivery perspective, is that correct?

ELIZABETH GREGORY:  So we found that from 2019 to 2020 the percentage of New York City residents giving birth outside the city increased overall for all months from March through November, peaking in April and May.  And the timing of these increases in these out-of-city births correspond with the height of the early pandemic in New York City.

HOST:  is there any indication that these patterns were also true for other cities that were hard hit that in the early stages of the pandemic?

ELIZABETH GREGORY:   We didn’t look at any other cities – but this would be something that would be really interesting to look at.

HOST:  Is there any indication whether these New York City residents were just going across the state line and into New Jersey or Connecticut to have their babies or were they actually traveling further than that? Do you have any information on that?

ELIZABETH GREGORY:   So this is also another thing that be really interesting to look at but for this report we didn’t specifically look at where the out-of-city births were occurring.

HOST:  NCHS of course is also releasing their annual births report on Wednesday and there will be state data and also data for New York City available soon.  Now what happens data-wise in the situation your study focuses on – so for example if a New York City woman goes to New Jersey to give birth does that count as a New Jersey birth or is it still a New York birth?

ELIZABETH GREGORY:  So birth certificates are filed in the state where the birth occurred but are usually looked at by the mother’s state of residence for NCHS reports.  So in this report, a birth to a mother that lived in New York City occurring outside of the city will be considered a birth to a New York City resident.  And in this report it would just be classified as an out-of-city birth.

HOST:   Did we see a surge in births in these neighboring states like New Jersey or Connecticut for 2020?

ELIZABETH GREGORY:  So we didn’t specifically look at where the out-of-city births were occurring but maybe that’s something that could be looked at in the future.

HOST:  So what are some of the conclusions that you’ve drawn from this research?

ELIZABETH GREGORY:  Well from 2019 to 2020 the percent of New York City residents giving birth outside the city increased overall from March through November, peaking in April and May, with the timing of the increases in these out-of-city births corresponding with the height of the early pandemic in New York City.  And additionally, the overall rise in out-of-city births is largely the result of increases among non-Hispanic white women while increases were less pronounced for births to non-Hispanic black and Hispanic residents.

HOST:   Are you planning any other similar geographic studies based on the 2020 data?

ELIZABETH GREGORY:  We currently have a report in the works that will be looking at whether there were any changes between 2019 and 2020 in the percentage of births by whether the mother was born inside or outside the U.S.  I just wanted to mention that we are also working on another report about home births, just to see whether there was a change in the percentage of home births that were occurring in the U.S. from 2019 to 2020.

HOST:  Elizabeth Gregory’s new study was released on the same day that the full-year 2020 birth statistics for the U.S. were released.  These new data were based on over 99% of birth certificates issued in the U.S. during the year, and were featured in a new report that had a number of noteworthy findings:

The nation’s general fertility rate, which is the number of births per 1,000 women age 15-44, reached another record low in 2020, dropping 4% from 2019.  The total number of births in 2020 also fell 4%, to 3,605,201 – the sixth straight year the number of births declined.

The new report also revealed that births in the U.S. continue to be at below replacement levels, based on another decline in the total fertility rate.  Birth rates declined for females of all age groups except two:  adolescents age 10-14 and women age 45-49.

The birth rate for teenagers age 15–19 declined by 8% in 2020 to 15.3 births per 1,000 women in that age group.  The teen birth rate has declined every year going all the way back to 1991 except for two – 2006 and 2007.  The rates in 2020 declined for both younger teens age 15–17 and older teens age 18–19.

Nearly one-third of all births in 2020 were by cesarean delivery, and over one-fourth of births were low-risk cesarean deliveries.  Also, the preterm birth rate in the U.S. declined in 2020 for the first time since 2014, to just over 10% of all births in 2020.


Fact or Fiction: The pandemic had a significant impact on fertility in the United States during 2020

May 5, 2021

Source: National Vital Statistics System

https://www.cdc.gov/nchs/data/vsrr/vsrr012-508.pdf


Births: Provisional Data for 2020

May 5, 2021

lady-holding-baby-mask-01The general fertility rate in the U.S. reached another record low in 2020 and the number of births in 2020 fell for the sixth straight year, according to provisional statistics released today by NCHS.

The provisional data are featured in a new report, “Births: Provisional Data for 2020,” which is based on over 99% of birth certificates issued during the year. The report reveals that the number of births in 2020 was 3,605,201, down 4% from 2019. The general fertility rate in 2020 was 55.8 births per 1,000 women ages 15–44, also down 4% from 2019.

Other findings in the report:

  • The total fertility rate (TFR) was 1,637.5 births per 1,000 women in 2020, down 4% from 2019 and another record low for the nation. The TFR in 2020 means the U.S. continues to be at “below replacement levels.”
  • Birth rates were unchanged for adolescents ages 10-14 and women ages 45-49, but declined for all other age groups.
  • The birth rate for teenagers ages 15–19 declined by 8% in 2020 to 15.3 births per 1,000 females. The teen birth rate has declined every year except for two (2006 and 2007) going back to 1991. The rates declined in 2020 for both younger (ages 15–17) and older (ages 18–19) teenagers.
  • The cesarean delivery rate increased to 31.8% in 2020, and the low-risk cesarean delivery rate increased to 25.9%.
  • The preterm birth rate declined for the first time since 2014, to 10.09% in 2020.

NYC-medium_croppedNCHS also released a second report today that examined changes in the proportion of births to New York City residents outside the city for 2018-2019 and 2019-2020.

Other findings in the report:

  • From 2019 to 2020, the percentage of births to New York City residents that occurred outside of the City increased for all months from March through November, ranging from +15% for September to +70% for April.
  • Out-of-city births peaked in April (10.2%) and May (10.3%) at more than one and onehalf times the 2019 levels (6.0% and 6.2%, respectively).
  • Among non-Hispanic white women, the percentage of out-of-city births was nearly 2.5 times higher in 2020 than in 2019 in April (15.6% versus 6.6%) and May (15.8% versus 6.5%).
  • The percentage of out-of-city births among non-Hispanic black and Hispanic residents increased in only two months in 2020.

NCHS UPDATES”STATS OF THE STATES” PAGE WITH LATEST FINAL DATA

March 26, 2021

SOS_Nav_Page

The CDC National Center for Health Statistics web page “Stats of the States” has been updated to include the latest state-based final data on selected vital statistics topics, including:

  • General fertility rates
  • Teen birth rates
  • Selected other maternal and infant health measures
  • Marriage & divorce rates
  • Leading causes of death
  • Other high profile causes of death.

The site’s map pages allow users to rank states from highest to lowest or vice versa.  This latest version of “Stats of the States” also includes two new topics:  Life expectancy by state and COVID-19 death rates by state (provisional data on a quarterly basis, through Q3 of 2020).  All death rates are adjusted for age.  Rates are featured in the maps because they best illustrate the impact of a specific measure on a particular state.

The main “Stats of the States” page can be accessed at:  https://www.cdc.gov/nchs/pressroom/stats_of_the_states.htm


Increases in Prepregnancy Obesity: United States, 2016–2019

November 25, 2020

A new NCHS report presents trends in prepregnancy obesity for 2016 through 2019 by maternal race and Hispanic origin, age, and educational attainment. Trends by state for 2016–2019 and 2019 rates also are shown.

Key Findings:

  • Prepregnancy obesity in the United States rose from 26.1% in 2016 to 29.0% in 2019 and increased steadily for non-Hispanic white, non-Hispanic black, and Hispanic women.
  • From 2016 through 2019, prepregnancy obesity increased among women of all ages and was lowest for women under age 20 (20.5% in 2019).
  • From 2016 through 2019, women with less than a bachelor’s degree were more likely to have prepregnancy obesity than those with a bachelor’s degree or higher, but obesity increased over time among all education levels.
  • Compared with 2016, prepregnancy obesity rose in every state but Vermont in 2019.

Births in the United States, 2019

October 9, 2020

A new NCHS report presents selected highlights from 2019 final birth data on key demographic, health care utilization, and infant health indicators.

General fertility rates (the number of births per 1,000 women aged 15–44), prenatal care timing (the percentage of mothers with first trimester care), source of payment for the delivery (the percentage of births covered by Medicaid), and preterm birth rates are presented.

All indicators are compared between 2018 and 2019 and are presented for all births and for the three largest race and Hispanic-origin groups: non-Hispanic white, non-Hispanic black, and Hispanic.

Findings from the Report:

  • The U.S. general fertility rate declined 1% in 2019 to 58.3 births per 1,000 women aged 15–44 from 59.1 in 2018; rates declined for non-Hispanic white, non-Hispanic black, and Hispanic women.
  • The percentage of mothers beginning prenatal care in the first trimester of pregnancy increased from 2018 to 2019 among non-Hispanic white and non-Hispanic black women, but decreased among Hispanic women.
  • Medicaid as the source of payment for the delivery declined from 42.3% to 42.1% from 2018 to 2019.
  • The preterm birth rate rose 2% from 2018 to 2019 from 10.02% to 10.23%; rates rose for each race and Hispanic origin group.

State Teen Birth Rates by Race and Hispanic Origin: United States, 2017–2018

July 10, 2020

New NCHS report presents changes in state-specific birth rates for teenagers between 2017 and 2018 by race and Hispanic origin of mother.

Click to access NVSR69-6-508.pdf


Effects of Changes in Maternal Age Distribution and Maternal Age-specific Infant Mortality Rates on Infant Mortality Trends: United States, 2000–2017

June 25, 2020

Questions for Anne Driscoll, Health Statistician and Lead Author of “Effects of Changes in Maternal Age Distribution and Maternal Age-specific Infant Mortality Rates on Infant Mortality Trends: United States, 2000–2017.”

Q: What is difference between maternal age distribution and maternal age-specific infant mortality rates?

AD: “Maternal age distribution” refers to the percentage of women with a birth in each maternal age category; for example, the percentage who are 15-19 years old, the percentage who are 20-24 years old. The “maternal age-specific infant mortality rate” is the mortality rate of infants born to women in a given maternal age category; for example, the mortality rate of infants born to women who were 20-24 years old.


Q: Was there a specific finding in the data that surprised you from this report?

AD: It was somewhat surprising that changes in maternal age distribution mattered little or not at all for the mortality trends for infants born to non-Hispanic black and Hispanic women given the significant changes in the maternal age distribution for both groups during the study period.


Q: How did you obtain this data for this report?

AD: The data are from the National Vital Statistics System (NVSS); we used natality data sets and infant mortality data sets from 2000-2017. Natality data sets are comprised of information from all birth certificates in a given year; infant mortality data sets are comprised of information from all death certificates to persons under one year of age in a given year.


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

AD: Changes in the age distribution of women giving birth accounted for about one-third of the decline in infant mortality rates from 2000 through 2017 while declines in maternal age-specific mortality rates accounted for about two-thirds of this decline. However, these patterns varied markedly by race and Hispanic origin.