I had a chance to spend some time with the National Vital Statistics Reports, “Births: Final Data for 2013.” Even though it is full of dreaded statistics, the report is fascinating. Here are some highlights.
Births are down as is the total fertility rate
There has been a slight decline in the number of births (<1%) comparing the study year (2013) to the year before. The number of births in the U.S. has actually been declining since 2007, but the rate of decline has slowed since 2010. Since the Great Recession was officially December 2007 to June 2009, some suggest that we may just now be starting to recover from the impact of the economic downturn (you know, no money so no babies.) The total number of births over a woman’s lifetime, something known as the “total fertility rate,” has declined 1% to 1,857.5 births per 1,000 women. That is below replacement levels, generally considered to be 2,100 births per 1,000 women. We have actually been below replacement since 1971! What this means, particularly as us boomers continue to roll into our retirement years, is that there are fewer youngsters to pay into the social programs that the oldsters rely on. It also means when boomers gets sick and need someone to take care of them, the burden will fall on fewer and fewer family members. If you want to know what this is going to be like, check out this review of the impact of aging on Japan.
Younger women are waiting, while older women are having more babies
Births in the U.S. have declined to historic lows for women in their 20s, but birth rates have increased for women 30+. The report noted that there were 677 births to women age 50 and older up from 600 the year before. The increase in birth rates for the oldest women (35 and higher) is linked, in part, to fertility enhancing therapies. The age at first birth increased to 26 years old from 25.8 the year before. A remarkable finding in the report is a stunning 10% drop in teen births to 26.5 births per 1,000 women—a historic low. This is because teens are having less sex in the first place, or because more teens are using effective contraception, or a combination of the two. A 2014 report from the Guttmacher Institute suggests that improvements in teen contraceptive use is key. Comprehensive sex education programs (not abstinence only programs that have not been proven to work), changing social norms, the AIDS epidemic, and the media have also been important contributors to the decline.
40.6% of births are to unmarried women
Although births to unmarried women have declined (maybe related to the decline in the teens and 20 somethings birth rate?), unmarried births still account for 40.6% of births overall in this country—the rate is 71% for non-Hispanic black mothers. These stats shouldn’t be much of a surprise given declining marriage rates in this country.
C-section rates still alarmingly high
Despite years of focus on reducing unnecessary C-section rates in the U.S., they are still way too high. In 2013, the rate fell very slightly from 32.8 in 2012 to 32.7. The peak rate was 32.9 in 2009. Lest you try to justify this by thinking it is all due to more complex situations of older women giving birth, it turns out that C-section rates in low-risk pregnancies (1st birth, one baby, head down) were 26.9, down a bit from 27.3 in 2012. That means overall a third of pregnancies have operative births, including a quarter of them that were low risk and could have benefited from a vaginal delivery.
Twins, triplets, and more
The final thing I will cover here is that the incidence of triplets and greater fell by 4% while twin births increased by 2%. That is credited to improvements in the approaches of assisted reproductive technology.