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Health Status > Maternal Health
Live Births
According to preliminary data, there were 4.1
million births in the United States in 2004, nearly 1 percent more
than the number in 2003. The number of births rose among Hispanic,
Asian/Pacific Islander, and American Indian women, while it remained
the same for non-Hispanic Black women and declined slightly among
non-Hispanic White women. Because the total population rose as well,
the 2004 birth rate of 14.0 births per 1,000 people represents a
slight decrease from the rate reported in 2003.
In 2004, according to preliminary data, 29.1
percent of births took place by cesarean section, the highest rate
ever reported. Healthy People 2010 includes as a goal for the nation
the reduction of the cesarean section rate among low-risk women,
defined as those whose babies are born at full term, are not twins
or other multiples, and are positioned facing downward in the birth
canal. An analysis of birth data from 1990 through 2003 showed,
however, that even among low-risk women, cesarean section rates
are rising, both for women giving birth for the first time and those
who have had cesareans in the past. For example, in 1990, 23.9 percent
of all first births and 21.0 percent of first births among low-risk
women took place by cesareans. In 2003, these percentages were 27.1
percent and 23.6 percent, respectively. Likewise, the percent of
women who have vaginal births after a previous cesarean, a procedure
known as VBAC, is declining among low-risk women as well as the
population as a whole. In 1990, 19.9 percent of women, and 20.8
percent of low-risk women, with a previous cesarean had a VBAC;
in 2003, the VBAC rate was 10.6 percent among all women and 11.3
percent among low-risk women with a previous cesarean.
Overall, 99 percent of births took place in hospitals,
a rate that has not changed substantially in many years. Of the
remainder, the majority took place at home and a small percentage
took place in free-standing birthing centers.
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TABLE: Live Births per 1,000 Women, by Age and Race/Ethnicity,
2004
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LINE Chart: Cesarean Section Rates and VBAC Rates,
for All Women and Low-Risk Women, 1990-2003
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