WASHINGTON — In the United States, teenage moms are increasingly rare. In 2016, the teen birth rate dropped 9 percent compared to the previous year, a government report published Friday found.
This record low for teens having babies continues a long-term trend.
The birth rate among teen girls has dropped 67 percent since 1991, according to the National Center for Health Statistics, which presented preliminary data for 2016 based on a majority (99.9 percent) of births.
In 2016, the number of U.S. births totaled 3,941,109, a decline of 1 percent compared to 2015. The fertility rate of 62 births per 1,000 women is a record low for the nation.
The teen rate is a “phenomenal decline,” said Dr. Elise Berlan, a physician in the section of adolescent medicine at Nationwide Children’s Hospital. Berlan, who did not conduct this research.
The reason she’s so excited is “because we know that the vast majority of teen births are unintended.”
What’s fueling the declines?
“Data [from previous years] really suggests it is access to contraceptives and use of contraceptives that has really led to these kind of changes,” said Berlan, who noted “most teens are using some form of birth control” and the top method is “the condom, followed by withdrawal and the pill.”
On the flip side, the increase in births to older moms is also important, Martin said.
For women between the ages of 30 and 34, the birth rate increased by 1 percent over 2015 — the highest rate for this age group since 1964.
The birth rate for women who are between 35 and 39 is up 2 percent over 2015, representing the highest rate since 1962.
Even older women, those between the ages of 40 and 44, showed a swelling increase of 4 percent over 2015 — the highest rate for this group since 1966, according to the statisticians, while the rate of birth for women who are older than 45 is also a record high though the number of births remains essentially unchanged compared to last year.
Joyce A. Martin, a co-author of the report and lead statistician, also noted the declining rate of nonmarital births — births to people who aren’t legally married — in 2016, which fell 3 percent compared to the previous year.
The report, first in a new annual series, provided additional vital statistics.
Three out of four woman got prenatal care in their first trimester, noted Michelle J.K. Osterman, a co-author of the report and statistician.
That said, 6.2 percent of pregnant women in 2016 had late prenatal care (beginning in the third trimester) or no prenatal care.
“In a perfect world, every woman would get early prenatal care,” Osterman said.
She noted “2016 is the first year for which we have national data” measuring prenatal care, so there can be no comparisons to previous years.
The percentage of women receiving prenatal care beginning in the first trimester of pregnancy ranged from 51.9 percent for non-Hispanic native Hawaiian and other Pacific Islanders women to 82.3 percent for non-Hispanic white women.
Nearly 81 percent of Asian women also received prenatal care, while 72 percent of Hispanic and 67 percent of non-Hispanic black women did the same.
“We want to bring everybody up to an overall rate of over 80 percent,” Martin said.
Sarah Verbiest, executive director of the Center for Maternal and Infant Health in the University of North Carolina School of Medicine, noted the “inequities among who is getting early access to care” during pregnancy. Verbiest was not involved in the research.
“We know that the growth of the baby happens really fast, really soon. So in the first nine weeks, all of the key parts of the baby are formed,” Verbiest said.
Prenatal care in the first trimester helps a pregnant woman learn what changes to expect and address any unhealthy factors in her life.
“If someone has diabetes and it’s not really well-controlled that could lead to birth defects,” Verbiest said. “Right away, you want to be helping her manage diabetes or any chronic conditions.”
Pregnant women also need to be taking vitamins while eating and exercising in healthy ways. Prenatal care helps reduce all potential risks as early as possible and leads to healthier babies, Verbiest said.
“For many years in this field we saw that women who are Hispanic had really good birth outcomes — even in the face of some more challenges in terms of accessing care,” Verbiest said. “We always said, ‘Thank heavens for that.'”
However, the new data suggests there may be a shift.
For example, the overall rate of low birthweight rose for the second straight year to 8.2 percent in 2016 from 8.1 percent in 2015. The rate among Hispanic woman was 7.3 percent compared to about 6.9 percent for white women.
Verbiest worries Hispanic women may be adopting some of the “not healthy habits in this country,” including unhealthy eating and lifestyle, while also being affected by “community stress that isn’t good for pregnant women.”
This is the second year in a row for an undesirable rate of low birth weights, Verbiest said.
“It’s not the direction we want it to go,” Verbiest said. “We know that the outcomes for babies who are too thin and too small are not as good — they start life out like a step behind” children who are born at a normal weight at full-term, about nine months.
The preterm birth rate — when a baby is born more than three weeks before a full nine month pregnancy — also rose for American women overall. Preterm births can lead to poor health for babies.
Martin said the increase in the preterm birth rate was not a “small one — a 2 percent rise is fairly substantial. At a minimum, it tells us the improvements that have been going on for the last decade [appear] to have stalled.”
On the positive side, Verbiest celebrated the declining rate of cesarean births noted in the report.
The rate of C-sections decreased for the fourth year in a row to about 32 percent, having peaked in 2009 at about 33 percent.
“That is the result of work across all kinds of partners in this country,” Verbiest said.
Patient advocate groups, payers such as insurance companies and Medicaid, nurses, physicians, and midwives all have worked hard to bring that trend line down, she said.