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News From the Centers for Disease Control and Prevention
September 10, 2019

Declining US Fertility

JAMA. 2019;322(10):919. doi:10.1001/jama.2019.13200

Fertility rates in the United States declined 2% from 60.3 to 59.1 births per 1000 women between 2017 and 2018, according to the latest data from the CDC.

Birth rates declined across all 3 of the largest racial and ethnic groups (non-Hispanic white, non-Hispanic black, and Hispanic) in the United States during this period, according to the report from the CDC’s National Center for Health Statistics. The report, which used data from US birth certificates, found that birth rates among teens also declined 7% from 18.8 to 17.4 births per 1000 females aged 15 to 19 years. Both the overall and teen US birth rates reached record lows in 2018, according to the authors.

A trend toward earlier deliveries also continued with the percentage of preterm births occurring at less than 37 weeks growing from 9.93% in 2017 to 10.02% in 2018, and the percentage of births occurring between 37 to 38 weeks growing from 26% to 26.53%. Non-Hispanic black mothers experienced higher rates of birth before 37 weeks (14.13%) compared with non-Hispanic white (9.09%) and Hispanic mothers (9.73%) in 2018.

The report also found that the percentage of women having a vaginal birth after cesarean delivery increased from 12.8% in 2017 to 13.3% in 2018. These 2018 data marked the third year that nationwide statistics on delivery method were available. The 2003 revision of the US Standard Certificate of Live Birth required states to begin including information on delivery methods, and all states had implemented the change as of 2016, according to the March of Dimes.

The authors note they’ve seen rising national rates of vaginal births after cesarean delivery since the data first became available. A previous 2015 CDC analysis suggested that vaginal deliveries may be associated with less morbidity than repeat cesarean.