U.S. fertility rates have fallen to to 1.617 births per woman, the lowest level in a century

The fertility rate in the United States has been on a downward trend for decades, and a recent report reveals that a further decline in births in 2023 has brought the rate to its lowest point in over a century.

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According to provisional data from the US Centers for Disease Control and Prevention’s National Center for Health Statistics, there were approximately 3.6 million babies born in 2023, equating to 54.4 live births for every 1,000 females aged 15 to 44.

After a significant drop in the first year of the Covid-19 pandemic, the fertility rate has been fluctuating. However, the 3% decline between 2022 and 2023 brought the rate just below the previous low recorded in 2020, which stood at 56 births for every 1,000 women of reproductive age.

Dr. Brady Hamilton, a statistician with the National Center for Health Statistics and lead author of the report, noted, "We’ve certainly had larger declines in the past. But decline fits the general pattern."

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The report shows a decrease in the birth rate among most age groups between 2022 and 2023.

The teen birth rate reached another record low of 13.2 births per 1,000 females aged 15 to 19, which is 79% lower than the most recent peak in 1991. However, the rate of decline was slower compared to the past decade and a half.

Hamilton explained, "The highest rates have, over time, been shifting towards women in their 30s whereas before it used to be with women in their 20s... For older women, the option of waiting is not as viable."

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Additionally, births continued to trend towards older mothers, with older age groups experiencing smaller decreases in birth rates. The highest birth rate was among women aged 30 to 34, with approximately 95 births for every 1,000 women in this age group in 2023. Women aged 40 and older were the only group to see an increase in the birth rate.

While these annual reports provide a snapshot of the current situation, rates can vary significantly depending on the unique circumstances of each year.

The provisional data does not show geographic trends, which may mask some effects of state abortion bans on state-level birth trends. However, an analysis from November indicated that states with abortion bans had an average fertility rate 2.3% higher than states where abortion was not restricted in the first half of 2023, resulting in approximately 32,000 more births than expected.

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As maternal mortality rates continue to rise in the US, so do rates of cesarean deliveries, which Hamilton noted are "major abdominal surgeries."

According to the new CDC report, nearly a third of all births (32.4%) were C-sections, the highest share in a decade. C-sections are also becoming more common among low-risk births, such as those among women having their first birth with pregnancies that have reached term and single fetuses that are facing head-first.

The provisional births data is based on birth records received and processed by the National Center for Health Statistics as of January 25. While trends capture more than 99% of all birth records for the year, the data is subject to change once all records are reviewed.

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