US Birth Rate Falls to Lowest Level in More Than 3 Decades

Megan Brooks

May 15, 2019

The number of babies born in the United States has reached another record low, as birth rates declined in 2018 for women in nearly all age groups, including teenagers, with the exception of women in their late 30s and early 40s, a group that has seen rising birth rates for several years, according to new federal data released today.

The preliminary figure for the number of births in the US in 2018 was 3,788,235 — down 2% from 2017. This is the fourth year that the number of births has declined after the increase in 2014 and the lowest number of births in 32 years, according to the report from the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

The preliminary general fertility rate was 59.0 births per 1000 women aged 15 to 44 years, down 2% from 2017, another record low for the United States. From 2014 to 2018, the general fertility rate has declined by an average of 2% per year, Brady Hamilton, PhD, and colleagues with the NCHS Division of Vital Statistics note in their report.

The provisional total fertility rate in 2018 was 1728.0 births per 1000 women, down 2% from the rate in 2017 (1765.5/1000), another record low. The total fertility rate is an estimate of the number of births that a hypothetical group of 1000 women would have over their lifetimes based on the age-specific birth rate in a given year.

The total fertility rate in 2018 was again below the replacement rate for the US, "the level at which a given generation can exactly replace itself (2100 births per 1000 women). The rate has generally been below replacement since 1971 and consistently below replacement for the last decade," the authors write.

Slightly Fewer Cesarean Deliveries

From 2017 to 2018, while birth rates declined for women aged 15 to 34 they rose for women aged 35 to 44.

The birth rate for teenagers aged 15 to 19 hit another record low in 2018 — 17.4 births per 1000, down 7% from 2017 (18.8/1000). The birth rate among this age group has declined by 58% (nearly 8% per year) since 2007, the most recent period of continued decline, and 72% (or nearly 5% per year) since 1991, the most recent peak, the authors note.

The birth rate for women aged 35 to 39 and those aged 40 to 44 was 52.6 and 11.8 births per 1000, respectively, up 1% and 2%, respectively, from 2017. The birth rate for these two age groups has generally risen since 1982 by 2% and 3% per year, respectively.

The rate of cesarean deliveries decreased slightly to 31.9% in 2018 (from 32.0% in 2017), returning to the lowest rate since 2009 (the rate peaked in 2009 at 32.9%) after an uptick in 2017.

The preterm birth rate rose for a fourth year in a row, increasing to 10.02% in 2018, from 9.93% in 2017 and 9.85% in 2016. The percentage of infants born preterm (< 37 weeks' gestation) fell 8% from 2007 to 2014 but rose 5% from 2014 to 2018.

The rate of low birthweight (LBW) births was unchanged in 2018 from the prior year at 8.28%. The 2017 to 2018 LBW rate (the percentage of infants born at < 2500 g or 5 lb, 8 oz per 100 births) is similar to the highest level ever reported (8.26% in 2006). Following a downward trend from 2007 to 2014, the LBW rate has risen 3%, the authors note.

LBW declined among births to non-Hispanic white women (7.00% to 6.91%) but rose among births to non-Hispanic black women (13.89% to 14.06%). The rate of births to Hispanic women was 7.48% in 2018, a nonstatistically significant increase from 2017 (7.43%), but a record high for this group since national data became available in 1993.

In 2018, the percentage of women receiving prenatal care in the first trimester was 77.5%, up from 77.3% a year earlier, while the percentage of women receiving late prenatal care (beginning in the third trimester) or no prenatal care decreased to 6.2% from 6.3% in 2017.

These preliminary 2018 data on US births were compiled from all birth certificates recorded in all 50 states and the District of Columbia and US territories as part of the National Vital Statistics System.

National Vital Statistics System. Report No. 007. Published online May 15, 2019.

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