Births Rose for the First Time in Seven Years in 2021

May 24, 2022

The number of births in the United States and the general fertility rate increased for the first time in seven years during 2021. The data released today are featured by CDC’s National Center for Health Statistics (NCHS).

The new report, “Births: Provisional Data for 2021,” analyzes data from more than 99% of birth certificates issued during the year. The report shows a 1% increase in births from 2020, with 3,659,289 births recorded in 2021. The general fertility rate in 2021 was 56.6 births per 1,000 women ages 15–44, also up 1% from 2020. In contrast, the number of births and general fertility rate both declined 4% from 2019 to 2020.

Other findings in the new report:

  • Birth rates declined for women in the age groups between 15 and 24 years, rose for women in the age groups between 25 and 49 years, and were unchanged for adolescents aged 10-14 in 2021.
  • The birth rate for teenagers ages 15–19 declined by 6% in 2021 to 14.4 births per 1,000 females.
  • The teen birth rate has declined every year except for two (2006 and 2007) since 1991. The rates declined in 2021 for both younger (ages 15–17) and older (ages 18–19) teenagers.
  • The cesarean delivery rate increased to 32.1% in 2021. The low-risk cesarean delivery rate
    increased to 26.3%.
  • The preterm birth rate rose 4% in 2021 to 10.48%—the highest rate reported since at least 2007

New NCHS Reports Released This Week

January 21, 2022

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


Births: Final Data for 2018

November 27, 2019

Questions for Joyce Martin, Health Statistician and Lead Author of “Births: Final Data for 2018

Q: What is new in this report from the 2018 provisional birth report?

JM: In addition to providing final numbers and rates for numerous birth characteristics such as fertility rates, teen childbearing, cesarean delivery and preterm and low birthweight, this report presents final information on  teen childbearing by race and Hispanic origin and by state, births to unmarried women, tobacco use during pregnancy, source of payment for the delivery and twin and triplet childbearing.


Q: Was there a specific finding in the 2018 final birth data that surprised you?

JM: The continued decline in birth rates to unmarried women (down 2% for 2017-2018 to 40.1 births per 1,000 unmarried women), the fairly steep decline in tobacco smoking among pregnant women (down 6% to 6.5% of all women) and the continued declines in twin (down 2%) and triplet (down 8%) birth rates.  Also of note is the decline in the percentage of births covered by Medicaid between 2017 and 2018 (down 2% to 42.3%) and the small rise in the percentage covered by private insurance (49.6% in 2018).


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

JM: These data are based on information for all birth certificates registered in the United States for 2018.


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

JM: Birth certificate data provide a wealth of important current and trend information on demographic and maternal and infant health characteristics for the United States.


Q: Why do you think the birth has dropped in the U.S.?

JM: The factors associated with family formation and childbearing are numerous and complex, involving psychological, cultural, demographic, and socio-economic influences. The data on which the report is based come from all birth certificates registered in the U.S. While the data provide a wealth of information on topics such as the number of births occurring in small areas, to small population groups, and for rare health outcomes, the data do not provide information on the attitudes and behavior of the parents regarding family formation and childbearing. Accordingly, the data in and of itself cannot answer the question of why births have dropped in the U.S.


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.


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.


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.


Births: Final Data for 2015

January 5, 2017

Questions for Joyce A. Martin, M.P.H., Demographer, Statistician, and Lead Author on “Births: Final Data for 2015

Q: Was there a result in your study’s analysis of births in the United States that you hadn’t expected and that really surprised you?

JM: Although small, (from 9.57% to 9.63%) the rise in the preterm birth rate (births of less than 37 completed weeks of gestation) was unexpected. This rate had been declining steadily since 2007.

Also of note is the decline in the triplet and higher-order multiple birth rate, down 9% from 2014 to 2015, and a decrease of 46% since 1998. The year 2015 also is the third straight year of declines in the rate of cesarean delivery (rate of 32.0% in 2015).

The continued, large decline in the teen birth rate (down 8% from 2014 to 2015) was also somewhat surprising, although not unprecedented. From 2007 through 2014, the teen birth rates had declined 7% annually.


Q: What is the difference between this new births report and the other reports your office produced on 2015 birth data, like the preliminary data report on 2015 births and the Data Brief on teen births?

JM: The annual report “Births: Final Data for 2015” offers substantially more detail (e.g., age, race and Hispanic origin of mother, state) on key topics, than does the report on preliminary birth statistics (“Births: Preliminary Data for 2015”). The final report also includes information on topics not included in the preliminary reports such as multiple births, attendant and place of birth, birth order and birth rates for fathers.


Q: How has the number of births in the United States changed in 2015 from previous years?

JM: The number of births in the United States declined slightly in 2015 (by 9,579 births to 3,978,497) from 2014. The decline for 2015 followed an increase in births for 2014, which was the first increase since 2007.


Q: What differences, if any, did you see among race and ethnic groups, and among various ages?

JM: Of continued concern are the higher risks of poor birth outcomes as measured by levels of preterm birth and low birthweight among non-Hispanic black mothers compared with total births and other race and Hispanic origin groups. For example, in 2015 the preterm birth rate for births to non-Hispanic black mothers was more than 50% higher at 13.41% than for non-Hispanic white women (8.88%) and nearly 50% higher than the rate for births to Hispanic mothers (9.14%).


Q: Did you observe any regional or state differences in this study on births?

JM: Differences by state were observed for many of the demographic and medical/health items included in the 2015 final birth report. For example, from 2014 to 2015, the general fertility rate–which is the number of births per 1,000 women aged 15–44–declined in eight states and was essentially unchanged in the 42 states and the District of Columbia (DC). In 2015, the general fertility rate ranged among states from 51.1 births per 1,000 women aged 15–44 in Vermont to 78.2 in South Dakota.

Also, increases in preterm birth rates were limited to four states from 2014 to 2015: Arkansas, California, Nebraska, and North Carolina. Rates declined in four states: Montana, New York, Texas and Wyoming. Nonsignificant differences were reported for the remaining states and DC.


Cesarean delivery – more popular than ever before

March 24, 2010

A report released yesterday from the National Center for Health Statistics showed that the cesarean rate rose by 53% from 1996 to 2007, reaching 32%, the highest rate ever reported in the United States. The 1.4 million cesarean births in 2007 represented about one-third of all births in the United States.

Although clear clinical indications often exist for a cesarean delivery, the short- and long-term benefits and risks for both mother and infant have been the subject of intense debate for over 25 years. Despite this, the rate continues to rise for women in all racial and ethnic groups, as well as for women of every age, as shown below.

Rates of cesarean delivery typically rise with increasing maternal age. As in 1996 and 2000, the rate for mothers aged 40–54 years in 2007 was more than twice the rate for mothers under age 20 (48% and 23%, respectively).For more from this recent release, visit http://www.cdc.gov/nchs/data/databriefs/db35.pdf.