vsrr012-508
Vital Statistics Rapid Release Report No. 012 May 2021 Births: Provisional Data for 2020. Brady E. Hamilton, Ph.D., Joyce A. Martin, M.P.H., and Michelle J.K ...
Vital Statistics Rapid Release Report No. 012 May 2021 Births: Provisional Data for 2020 Brady E. Hamilton, Ph.D., Joyce A. Martin, M.P.H., and Michelle J.K. Osterman, M.H.S., Division of Vital Statistics, National Center for Health Statistics Abstract Objectives--This report presents provisional 2020 data on U.S. births. Births are shown by age and race and Hispanic origin of mother. Data on cesarean delivery and preterm births also are presented. Methods--Data are based on 99.87% of all 2020 birth records received and processed by the National Center for Health Statistics as of February 11, 2021. Comparisons are made with final 2019 data and earlier years. Results--The provisional number of births for the United States in 2020 was 3,605,201, down 4% from 2019. The general fertility rate was 55.8 births per 1,000 women aged 1544, down 4% from 2019 to reach another record low for the United States. The total fertility rate was 1,637.5 births per 1,000 women in 2020, down 4% from 2019 to also reach another record low for the nation. In 2020, birth rates declined for women in all age groups 1544 and were unchanged for adolescents aged 1014 and women aged 4549. The birth rate for teenagers aged 1519 declined by 8% in 2020 to 15.3 births per 1,000 females; rates declined for both younger (aged 1517) and older (aged 1819) teenagers. The cesarean delivery rate rose to 31.8% in 2020; the low-risk cesarean delivery rate increased to 25.9%. The preterm birth rate declined to 10.09% in 2020, the first decline in the rate since 2014. Keywords: birth rates · maternal and infant health · vital statistics · National Vital Statistics System Introduction This report from the National Center for Health Statistics (NCHS) is part of the National Vital Statistics System Rapid Release Quarterly Provisional Estimates. This series provides timely vital statistics for public health surveillance based on provisional data received and processed by NCHS as of a specified date. Estimates (quarterly and 12-month period ending with each quarter) for selected key vital statistics indicators are presented and released online through Quarterly Provisional Estimates (https://www.cdc.gov/nchs/ nvss/vsrr/natality-dashboard.htm). The series also includes reports that provide additional information on specific topics to help readers understand and interpret provisional natality and mortality data. Also, now available are provisional birth estimates developed to monitor health services utilization and maternal and infant outcomes that may be directly or indirectly impacted by COVID-19. Information is updated quarterly and is available from: https://www.cdc.gov/ nchs/covid19/covid-birth.htm. Using provisional birth data for the 12 months of 2020 (1), this report supplements the Quarterly Provisional Estimates for 2020 by presenting longer temporal trends in context and more detail (by race and Hispanic origin of the mother and by state of residence). Statistics from previous provisional reports have been shown to be consistent with the final statistics for the year (2,3). This report presents provisional data on births and birth rates and cesarean delivery and preterm birth rates for the United States in 2020. Information on prenatal care, low birthweight, and other health utilization and maternal and infant risk factors is presented with final birth data for 2020. Methods The provisional estimates shown in this report are collected via the National Vital Statistics System (4). Findings are based on all birth records received and processed by NCHS for calendar year 2020 as of February 11, 2021; these records represent nearly 100% (99.87%) of registered births occurring in 2020. Comparisons in this report are based on the final data for 2019 and earlier years (3). Data for American Samoa, Guam, and the U.S. Virgin Islands were not available as of the release of the 2020 provisional birth file. Detailed information on reporting completeness and criteria may be found elsewhere (4,5). Hispanic origin and race are reported separately on the birth certificate. Data shown by Hispanic origin include all persons of Hispanic origin of any race. Data for non-Hispanic persons are shown separately for each single-race group. Data by race are based on the revised standards issued by the Office of Management and Budget (OMB) in 1997 (6). The race and Hispanicorigin groups shown are: non-Hispanic, single-race white; non-Hispanic, singlerace black; non-Hispanic, single-race American Indian or Alaska Native (AIAN); non-Hispanic, single-race Asian; non-Hispanic, single-race Native Hawaiian or Other Pacific Islander (NHOPI); and Hispanic. For brevity, text references to race omit the term "singlerace" (3). U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics · National Vital Statistics System NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm. Vital Statistics Surveillance Report Rate per 1,000 women aged 1544 Birth and fertility rates for the United States and by maternal race and Hispanic origin for 2020 were based on population estimates derived from the 2010 census as of July 1, 2020 (7). Changes and differences presented in this report are statistically significant at the 0.05 level, unless noted otherwise. For information and discussion on computing rates and percentages and for detailed information on items presented in this report, see "User Guide to the 2019 Natality Public Use File" (4). Beginning with Quarterly Provisional Estimates for Quarter 3, 2020, the use of record weights for provisional birth data was discontinued (1,5). This change was implemented because of the recent high levels of completeness of provisional birth data; the change in weighting had limited, if any, impact on the provisional birth estimates. Data shown in this report are based directly on the counts of all (unweighted) birth records received and processed by NCHS as of February 11, 2021. Figure 1. Number of live births and general fertility rates: United States, final 19902019 and provisional 2020 5 80 Number of births (millions) Number 70 4 Rate 60 3 50 1990 1995 2000 2005 2010 2015 0 2020 SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality. Figure 2. Birth rates for teenagers, by age of mother: United States, final 19912019 and provisional 2020 100 Results Births and birth rates Key findings, illustrated in Tables 13 and Figures 1 and 2, show: The provisional number of births for the United States in 2020 was 3,605,201, down 4% from the number in 2019 (3,747,540) (Tables 13 and Figure 1). This is the sixth consecutive year that the number of births has declined after an increase in 2014, down an average of 2% per year, and the lowest number of births since 1979 (3,8,9). From 2019 to 2020, the provisional number of births declined 3% for Hispanic women, 4% for non-Hispanic white and non-Hispanic black women, 6% for non-Hispanic AIAN women, and 8% for non-Hispanic Asian women (Tables 2 and 3). The 2% decline in the number of births for non-Hispanic NHOPI women was not significant. Rate per 1,000 females 80 1819 years 60 40 1519 years 20 1517 years 0 1991 1995 2000 2005 2010 2015 2020 SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality. The provisional general fertility rate (GFR) for the United States in 2020 was 55.8 births per 1,000 women aged 1544, down 4% from the rate in 2019 (58.3), another record low for the nation (Tables 1 and 2 and Figure 1) (3,8,9). From 2014 to 2020, the GFR declined by an average of 2% per year. GFRs declined for each of the race and Hispanic-origin groups from 2019 to 2020, down 3% for non-Hispanic NHOPI women; 4% for non-Hispanic white, non-Hispanic black, and Hispanic women; 7% for non-Hispanic AIAN women; and 9% for non-Hispanic Asian women. U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics · National Vital Statistics System 2 Vital Statistics Surveillance Report The provisional total fertility rate (TFR) for the United States in 2020 was 1,637.5 births per 1,000 women, down 4% from the rate in 2019 (1,706.0), another record low for the nation (3,9,10). The TFR estimates the number of births that a hypothetical group of 1,000 women would have over their lifetimes, based on the agespecific birth rate in a given year. The TFR in 2020 was again below replacement--the level at which a given generation can exactly replace itself (2,100 births per 1,000 women). The rate has generally been below replacement since 1971 and has consistently been below replacement since 2007 (3,8,9). Maternal age Provisional birth rates declined for women in all age groups 1544 from 2019 to 2020 and were unchanged for adolescents aged 1014 and women aged 4549 (Table 1). The provisional birth rate for teenagers in 2020 was 15.3 births per 1,000 females aged 1519, down 8% from 2019 (16.7), reaching another record low for this age group (Table 1 and Figure 2) (3,810). The rate has declined by 63% since 2007 (41.5), the most recent period of continued decline, and 75% since 1991, the most recent peak. The rate declined an average of 7% annually from 2007 to 2020 (3,8). The number of births to females aged 1519 was 157,548 in 2020 (Table 1), down 8% from 2019 (3,810). The provisional birth rates for teenagers aged 1517 and 1819 in 2020 were 6.3 and 28.8 births, respectively, down by 6% and 7% from 2019, again reaching record lows for both groups (3,810). From 2007 to 2020, the rates for teenagers aged 1517 and 1819 declined by 9% and 7% per year, respectively (3,8). The provisional birth rate for females aged 1014 was 0.2 births per 1,000 in 2020, unchanged since 2015. The provisional birth rate for women aged 2024 in 2020 was 62.8 births per 1,000 women, down 6% from 2019 (66.6), reaching yet another record low for this age group (Table 1) (3,8,9). This rate has declined by 40% since 2007. The number of births to women in their early 20s also declined by 6% from 2019 to 2020 (Table 1). The provisional birth rate for women aged 2529 was 90.0 births per 1,000 women, down 4% from 2019 (93.7), reaching another record low for this age group (3,8,9). The number of births to women in their late 20s declined 5% from 2019 to 2020. The provisional birth rate for women aged 3034 in 2020 was 94.8 births per 1,000 women, down 4% from 2019 (98.3) (Table 1) (3,8,9). The number of births to women in this age group declined by 2% from 2019 to 2020. The provisional birth rate for women aged 3539 was 51.7 births per 1,000 women, down 2% from 2019 (52.8). The number of births to women in this age group declined by 2% from 2019 to 2020. The provisional birth rate for women aged 4044 in 2020 was 11.8 births per 1,000 women, down 2% from 2019 (12.0). The rate for this age group had risen almost continuously from 1985 to 2019, by an average of 3% per year (3,8). The number of births to these women was essentially unchanged from 2019 to 2020. The provisional birth rate for women aged 4549 (which includes births to women aged 50 and over) was 0.9 births per 1,000 women, unchanged since 2015. However, the number of births to women in this age group declined 4% from 2019 to 2020 (Table 1). Maternal and infant health characteristics Key findings, illustrated in Tables 3 and 4 and Figure 3, show: Cesarean delivery In 2020, the overall cesarean delivery rate increased to 31.8% from 31.7% in 2019 (Tables 3 and 4); despite this increase, the rate had generally declined from 2009 (32.9%) to 2019 (3). See Table 4 for statespecific rates. From 2019 to 2020, cesarean delivery rates increased for non-Hispanic white (30.7% to 30.8%), non-Hispanic black (35.9% to 36.3%), non-Hispanic NHOPI (30.2% to 32.3%), and Hispanic (31.3% to 31.4%) women; declines in rates for non-Hispanic AIAN (28.9% to 28.8% ) and non-Hispanic Asian (32.7% to 32.6%) women were not statistically significant. The low-risk cesarean delivery rate, or cesarean delivery among nulliparous (first birth), term (37 or more completed weeks based on the obstetric estimate), singleton (one fetus), vertex (head first) births, also increased in 2020, to 25.9% from 25.6% in 2019 (Table 3). Low-risk cesarean rates increased from 2019 to 2020 for non-Hispanic white (24.7% to 24.9%), non-Hispanic black (30.0% to 30.6%), non-Hispanic NHOPI (26.1% to 29.1%), and Hispanic (24.8% to 25.2%) women; increases for non-Hispanic AIAN (22.8% to 23.6%) and non-Hispanic Asian (27.4% to 27.7%) women were not significant. Preterm birth The preterm birth rate declined to 10.09% in 2020 from 10.23% in 2019 (Table 3 and Figure 3), the first decline in this rate since 2014. The percentage of infants born preterm (births at less than 37 completed weeks of gestation) fell 8% from 2007 (the most recent year for which national data are available based on the obstetric estimate of gestation [11]) to 2014, then rose 7% from 2014 (9.57%) to 2019 (3). See Table 4 for state-specific rates. U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics · National Vital Statistics System 3 Vital Statistics Surveillance Report Figure 3. Preterm birth rates: United States, final 20072019 and provisional 2020 12 10 10.44 10.36 10.07 9.98 9.81 9.76 9.62 9.57 9.63 9.85 9.93 10.02 10.23 10.09 8 6 7.51 7.47 7.24 7.15 6.99 6.96 6.83 6.82 6.87 7.09 7.17 7.28 7.46 7.39 Late preterm Percent 4 2 2.93 2.89 2.83 2.84 2.81 2.80 2.79 2.75 2.76 2.76 2.76 2.75 2.77 2.69 Early preterm 0 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 NOTE: Percentages may not add to totals due to rounding. SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality. Declines were observed in both early preterm (less than 34 completed weeks of gestation) and late preterm births (3436 weeks) from 2019 to 2020 (Table 3). The early preterm rate declined from 2.77% to 2.69%, the lowest level reported since at least 2007 (11). The late preterm rate declined from 7.46% to 7.39% (Figure 3). The preterm birth rate declined 3% among births to non-Hispanic Asian women (8.72% to 8.50%), 2% among non-Hispanic white women (9.26% to 9.10%), and 1% among Hispanic women (9.97% to 9.83%) from 2019 to 2020; changes for births to non-Hispanic AIAN (11.59% to 11.57%), non-Hispanic black (14.39% to 14.35%), and non-Hispanic NHOPI (11.15% to 11.98%) women were not significant. Late preterm births declined among non-Hispanic Asian (6.59% to 6.42%) and non-Hispanic white mothers (6.99% to 6.90%), but changes for non-Hispanic black (9.45% to 9.54%), non-Hispanic AIAN (8.69% to 8.55%), non-Hispanic NHOPI (8.25% to 8.93%), and Hispanic (7.36% to 7.32%) mothers were not significant. Early preterm births were down for the three largest race and Hispanicorigin groups (non-Hispanic white, non-Hispanic black, and Hispanic), but were not significantly changed for the others (Table 3). References 1. Driscoll AK, Osterman MJK, Hamilton BE, Martin JA. Quarterly provisional estimates for selected birth indicators, 2018Quarter 4, 2020. National Center for Health Statistics. National Vital Statistics System, Vital Statistics Rapid Release Program. 2021. Available from: https://www.cdc.gov/nchs/ nvss/vsrr/natality.htm. 2. Hamilton BE, Martin JA, Osterman MJK. Births: Provisional data for 2019. Vital Statistics Rapid Release; no 8. Hyattsville, MD: National Center for Health Statistics. May 2020. Available from: https://www. cdc.gov/nchs/data/vsrr/vsrr-8-508. pdf. U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics · National Vital Statistics System 4 Vital Statistics Surveillance Report 3. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK. Births: Final data for 2019. National Vital Statistics Reports; vol 70 no 2. Hyattsville, MD: National Center for Health Statistics. 2021. DOI: https://dx.doi. org/10.15620/cdc:100472. 4. National Center for Health Statistics. User guide to the 2019 natality public use file. Available from: ftp://ftp.cdc.gov/pub/Health_ Statistics/NCHS/Dataset_ Documentation/DVS/natality/ UserGuide2019-508.pdf. 5. National Center for Health Statistics. Quarterly Provisional Estimates-- Technical Notes--Natality, Quarter 4, 2020. Available from: https://www.cdc.gov/nchs/nvss/vsrr/ natality-technical-notes.htm. 6. Office of Management and Budget. Revisions to the standards for the classification of federal data on race and ethnicity. Fed Regist 62(210):5878290. 1997. Available from: https://www.govinfo.gov/ content/pkg/FR-1997-10-30/pdf/9728653.pdf. 7. United States Census Bureau. 2019 monthly national population estimates by age, sex, race, Hispanic origin, and population universe for the United States: April 1, 2010 to December 1, 2020 (NC-EST2019ALLDATA). Monthly postcensal resident population. Available from: https://www.census.gov/data/tables/ time-series/demo/popest/2010snational-detail.html. 8. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Mathews TJ. Births: Final data for 2015. National Vital Statistics Reports; vol 66 no 1. Hyattsville, MD: National Center for Health Statistics. 2017. Available from: https://www.cdc.gov/nchs/ data/nvsr/nvsr66/nvsr66_01.pdf. 9. National Center for Health Statistics. Vital statistics of the United States, 2003, Volume I, Natality. 2003. Available from: https://www.cdc.gov/nchs/products/ vsus/vsus_1980_2003.htm. 10. Ventura SJ, Hamilton BE, Mathews TJ. National and state patterns of teen births in the United States, 19402013. National Vital Statistics Reports; vol 63 no 4. Hyattsville, MD: National Center for Health Statistics. 2014. Available from: https://www.cdc.gov/nchs/data/nvsr/ nvsr63/nvsr63_04.pdf. 11. Martin JA, Osterman MJK, Kirmeyer SE, Gregory ECW. Measuring gestational age in vital statistics data: Transitioning to the obstetric estimate. National Vital Statistics Reports; vol 64 no 5. Hyattsville, MD: National Center for Health Statistics. 2015. Available from: https://www.cdc.gov/nchs/ data/nvsr/nvsr64/nvsr64_05.pdf. List of Detailed Tables Report tables 1. Births and birth rates, by age of mother: United States, final 2019 and provisional 2020 . . . . . . . . . . . . . . . . . . . 6 2. Total number of births and general fertility rates, by race and Hispanic origin of mother: United States, final 2019 and provisional 2020 . . . . . . . . . . . 7 3. Totalnumberofbirthsandpercentages of cesarean delivery and preterm births, by race and Hispanic origin of mother: United States, final 2019 and provisional 2020 . . . . . . . . . . . . . . . . . . . 8 4. Total number of births, by state of residence, provisional 2020, and percentages of cesarean delivery and preterm births, by state of residence: United States, each state and territory, final 2019 and provisional 2020 . . . . . . . 9 U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics · National Vital Statistics System 5 Vital Statistics Surveillance Report Table 1. Births and birth rates, by age of mother: United States, final 2019 and provisional 2020 [Data for 2020 were based on a continuous file of records received from the states. Rates were per 1,000 women in specified age group. Rates for all ages were the total number of births (regardless of the age of the mother) per 1,000 women aged 1544. Populations estimated as of July 1] Age of mother Number 2020 Rate Number 2019 Rate All ages 1014 1519 1517 1819 2024 2529 3034 3539 4044 45541 3,605,201 55.8 3,747,540 58.3 1,765 0.2 1,787 0.2 157,548 15.3 171,674 16.7 38,459 6.3 41,081 6.7 119,089 28.8 130,593 31.1 663,732 62.8 704,342 66.6 1,022,033 90.0 1,078,097 93.7 1,067,798 94.8 1,089,281 98.3 562,833 51.7 572,598 52.8 120,278 11.8 120,152 12.0 9,214 0.9 9,609 0.9 1The birth rate for women in this age group was computed by relating the number of births to women aged 45 and over to women aged 4549 because most of the births in this group were to women aged 4549. SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality. U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics · National Vital Statistics System 6 Vital Statistics Surveillance Report Table 2. Total number of births and general fertility rates, by race and Hispanic origin of mother: United States, final 2019 and provisional 2020 [Data for 2020 were based on a continuous file of records received from the states. Rates were the total number of births (regardless of the age of the mother) per 1,000 women aged 1544 in specified race and Hispanic-origin group. Populations estimated as of July 1] Year All races and origins1 White2 Non-Hispanic, single race Black2 American Indian or Alaska Native2 Asian2 Native Hawaiian or Other Pacific Islander2 Hispanic3 2020 2019 2020 2019 3,605,201 3,747,540 55.8 58.3 1,839,565 1,915,912 53.2 55.3 528,448 548,075 59.0 61.4 Number 26,638 28,450 Rate 52.4 56.2 218,860 238,769 50.1 55.3 9,612 9,770 72.6 74.9 863,949 886,467 62.8 65.3 1Includes births to race and origin groups not shown separately, such as Hispanic white, Hispanic black, and non-Hispanic multiple-race women, and births with origin not stated. 2Race and Hispanic origin are reported separately on birth certificates. Persons of Hispanic origin may be of any race. In this table, non-Hispanic women are classified by race. Race categories are consistent with the 1997 Office of Management and Budget standards. Race categories in this table include only single race; that is, the race reported alone with only one race reported. 3Includes all persons of Hispanic origin of any race. SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality. U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics · National Vital Statistics System 7 Vital Statistics Surveillance Report Table 3. Total number of births and percentages of cesarean delivery and preterm births, by race and Hispanic origin of mother: United States, final 2019 and provisional 2020 [Data for 2020 were based on a continuous file of records received from the states] Characteristic All races and origins1 White2 Non-Hispanic, single race Black2 American Indian or Alaska Native2 Asian2 Native Hawaiian or Other Pacific Islander2 Hispanic3 Number of births 2020 2019 Cesarean delivery Total4: 2020 2019 Low risk5: 2020 2019 Gestational age6 Preterm (under 37 weeks): 2020 2019 Late preterm (3436 weeks): 2020 2019 Early preterm (under 34 weeks): 2020 2019 3,605,201 3,747,540 31.8 31.7 25.9 25.6 10.09 10.23 7.39 7.46 2.69 2.77 1,839,565 1,915,912 30.8 30.7 24.9 24.7 9.10 9.26 6.90 6.99 2.20 2.27 528,448 548,075 36.3 35.9 30.6 30.0 26,638 28,450 Percent 28.8 28.9 23.6 22.8 14.35 14.39 9.54 9.45 4.81 4.94 11.57 11.59 8.55 8.69 3.03 2.90 218,860 238,769 32.6 32.7 27.7 27.4 8.5 8.72 6.42 6.59 2.08 2.13 9,612 9,770 32.3 30.2 29.1 26.1 11.98 11.15 8.93 8.25 3.05 2.90 863,949 886,467 31.4 31.3 25.2 24.8 9.83 9.97 7.32 7.36 2.51 2.61 1Includes births to race and origin groups not shown separately, such as Hispanic white, Hispanic black, and non-Hispanic multiple-race women, and births with origin not stated. 2Race and Hispanic origin are reported separately on birth certificates. Persons of Hispanic origin may be of any race. In this table, non-Hispanic women are classified by race. Race categories are consistent with the 1997 Office of Management and Budget standards. Race categories in this table include only single race; that is, the race reported alone with only one race reported. 3Includes all persons of Hispanic origin of any race. 4All births by cesarean delivery per 100 live births. 5Low-risk cesarean was defined as singleton, term (37 or more weeks of gestation based on obstetric estimate), vertex (not breech), cesarean deliveries to women having a first birth per 100 women delivering singleton, term, vertex first births. 6Completed weeks of gestation based on the obstetric estimate. SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality. U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics · National Vital Statistics System 8 Vital Statistics Surveillance Report Table 4. Total number of births, by state of residence, provisional 2020, and percentages of cesarean delivery and preterm births, by state of residence: United States, each state and territory, final 2019 and provisional 2020 [By place of residence. Data were based on a continuous file of records received from the states] Area Total number of births, 2020 Total cesarean 2020 2019 Low-risk cesarean1 2020 2019 Late preterm2 2020 2019 Preterm3 2020 2019 Percent United States4 3,605,201 31.8 31.7 25.9 25.6 7.39 7.46 10.09 10.23 Alabama 57,634 35.0 34.6 29.0 28.4 9.40 8.99 12.90 12.48 Alaska 9,447 22.9 21.6 18.2 17.1 7.33 7.39 9.73 9.72 Arizona 76,923 28.4 27.8 22.8 21.9 7.13 6.99 9.48 9.37 Arkansas 35,210 33.8 34.5 26.5 27.7 8.56 8.73 11.76 11.93 California 419,612 30.5 30.8 24.0 23.8 6.51 6.62 8.76 8.95 Colorado 61,493 27.2 26.8 22.7 21.4 6.65 7.14 9.15 9.55 Connecticut 33,448 34.1 34.6 27.9 28.9 6.62 6.74 9.17 9.37 Delaware 10,336 31.8 31.5 24.9 24.4 7.48 7.41 10.35 10.70 District of Columbia 8,858 32.3 31.9 27.8 28.0 6.98 7.32 9.81 10.41 Florida 209,612 35.9 36.5 28.7 29.6 7.64 7.61 10.47 10.62 Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine 122,266 33.9 34.3 27.7 28.2 8.18 8.34 11.41 11.69 15,730 26.4 26.8 23.0 23.1 7.56 7.75 10.06 10.57 21,520 23.6 24.0 18.0 19.0 6.19 6.69 8.45 8.77 133,207 30.8 30.6 24.7 24.7 7.63 7.87 10.32 10.70 78,087 30.1 29.3 24.5 23.0 7.66 7.44 10.44 10.15 36,080 30.2 29.6 24.8 23.6 7.54 6.89 9.90 9.48 34,360 30.2 29.7 24.6 24.3 7.38 7.41 9.97 10.10 51,581 34.3 33.6 27.7 26.8 8.32 8.37 11.04 11.30 57,070 36.8 36.7 29.4 28.5 9.33 9.60 12.87 13.12 11,532 29.7 30.2 23.5 25.3 6.87 6.69 8.99 9.02 Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire 68,523 33.7 33.0 28.7 27.6 7.29 7.32 10.12 10.28 66,429 32.4 31.4 26.5 24.8 6.49 6.63 8.77 8.98 103,846 32.5 32.0 27.4 26.5 7.40 7.34 10.23 10.27 63,387 28.5 27.6 24.7 23.8 6.82 6.85 9.11 9.26 35,457 38.2 38.5 30.9 30.7 10.27 10.35 14.20 14.58 69,238 29.3 30.1 23.0 23.9 8.17 7.94 10.98 10.87 10,785 27.6 28.4 21.7 23.2 7.35 7.58 9.82 9.61 24,235 28.8 29.1 21.4 21.2 7.85 7.84 10.49 10.49 33,632 32.9 32.8 27.2 26.8 7.86 7.87 10.69 10.67 11,773 32.2 31.6 27.1 26.0 6.05 6.51 8.41 8.19 New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island 96,543 33.2 33.8 26.2 26.7 6.82 6.96 9.11 9.56 21,316 26.1 26.4 21.0 21.3 6.85 7.25 9.47 10.15 209,172 33.7 33.2 28.7 28.1 6.63 6.62 9.23 9.18 116,674 30.0 29.1 23.6 22.5 7.66 7.60 10.80 10.65 10,059 27.0 26.5 20.3 18.4 7.44 6.91 9.82 9.50 129,071 31.3 31.0 26.3 25.6 7.51 7.49 10.31 10.51 47,393 32.1 32.1 23.9 24.5 8.39 8.64 11.16 11.49 39,792 28.8 28.0 25.0 23.4 6.13 6.21 8.19 8.29 130,562 30.6 30.2 25.4 25.2 7.02 7.13 9.57 9.94 10,102 33.4 32.0 29.2 27.7 6.63 7.20 9.06 9.54 South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 55,693 33.5 33.2 27.4 26.9 8.59 8.09 11.81 11.47 10,952 24.7 24.5 19.7 19.1 7.19 7.24 9.42 9.55 78,659 32.1 31.8 25.9 25.5 7.92 8.19 10.93 11.19 365,857 34.7 34.8 28.2 28.4 7.89 8.06 10.78 11.03 45,702 23.1 23.1 19.4 18.7 7.01 7.47 9.28 9.74 5,117 26.9 25.8 22.7 20.8 5.65 6.14 7.63 8.44 94,391 32.6 31.9 26.8 26.2 6.88 7.12 9.58 9.88 83,067 28.5 27.8 24.0 22.8 6.32 6.36 8.64 8.47 17,159 34.2 34.6 26.9 26.3 8.96 9.39 12.00 12.58 60,491 26.7 26.7 21.7 21.6 7.38 7.37 9.94 10.07 6,118 26.4 26.3 18.1 20.7 7.42 7.46 10.05 9.87 See footnotes at end of table. U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics · National Vital Statistics System 9 Vital Statistics Surveillance Report Table 4. Total number of births, by state of residence, provisional 2020, and percentage of cesarean delivery and preterm births, by state of residence: United States, each state and territory, final 2019 and provisional 2020--Con. [By place of residence. Data were based on a continuous file of records received from the states] Area Total number of births, 2020 Total cesarean 2020 2019 Low-risk cesarean1 2020 2019 Late preterm2 2020 2019 Preterm3 2020 2019 Percent Puerto Rico U.S. Virgin Islands Guam American Samoa Northern Marianas 18,228 48.2 47.0 45.9 42.2 8.52 8.85 11.59 11.78 --- --- --- --- --- --- --- --- --- --- --- 23.0 --- 20.6 --- 9.16 --- 11.51 --- --- --- --- --- --- --- --- --- 538 30.5 26.8 19.9 18.2 7.62 6.60 10.04 8.65 --- Data not available. 1Low-risk cesarean was defined as singleton, term (37 or more weeks of gestation based on obstetric estimate), vertex (not breech) cesarean deliveries to women having a first birth per 100 women delivering singleton, term, vertex first births. 2Births at 3436 completed weeks of gestation based on the obstetric estimate. 3Births before 37 completed weeks of gestation based on the obstetric estimate. 4Excludes data for the territories. SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality. U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics · National Vital Statistics System 10 Vital Statistics Surveillance Report Acknowledgments This report was prepared in the Division of Vital Statistics (DVS) under the general direction of Steven Schwartz, Director; Isabelle Horon, Chief, Reproductive Statistics Branch (RSB); and Joyce A. Martin, Team Leader, RSB Birth Team. Rajesh Virkar, Chief, Information Technology Branch (ITB), and Jasmine N. Mickens, Steve J. Steimel, Annie S. Liu, and Legesse Alemu provided computer programming support and statistical tables. Jasmine N. Mickens, Steve J. Steimel, and Annie S. Liu of ITB prepared the natality file. The Registration Methods and Data Acquisition, Classification and Evaluation Branch staff of DVS evaluated the quality of and acceptance procedures for the state data files on which this report is based. Danielle M. Ely and Anne K. Driscoll of RSB provided content review. Suggested citation Hamilton BE, Martin JA, Osterman MJK. Births: Provisional data for 2020. Vital Statistics Rapid Release; no 12. Hyattsville, MD: National Center for Health Statistics. May 2021. DOI: https:// doi.org/10.15620/cdc:104993. Copyright information All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated. National Center for Health Statistics Brian C. Moyer, Ph.D., Director Amy M. Branum, Ph.D., Acting Associate Director for Science Division of Vital Statistics Steven Schwartz, Ph.D., Director Isabelle Horon, Dr.P.H., Acting Associate Director for Science CS323449 U.S. Department of Health and Human Services · Centers for Disease Control and Prevention · National Center for Health Statistics · National Vital Statistics System 11Adobe PDF Library 15.0