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 Introduction health utilization and maternal and infant risk factors is presented with final birth Objectives—This report presents This report from the National Center data for 2020. provisional 2020 data on U.S. births. for Health Statistics (NCHS) is part Births are shown by age and race and of the National Vital Statistics System Hispanic origin of mother. Data on Rapid Release Quarterly Provisional Methods cesarean delivery and preterm births also Estimates. This series provides The provisional estimates shown are presented. timely vital statistics for public health in this report are collected via the surveillance based on provisional data National Vital Statistics System (4). Methods—Data are based on 99.87% received and processed by NCHS as of Findings are based on all birth records of all 2020 birth records received and a specified date. Estimates (quarterly received and processed by NCHS for processed by the National Center for and 12-month period ending with each calendar year 2020 as of February 11, Health Statistics as of February 11, 2021. quarter) for selected key vital statistics 2021; these records represent nearly Comparisons are made with final 2019 indicators are presented and released 100% (99.87%) of registered births data and earlier years. online through Quarterly Provisional occurring in 2020. Comparisons in Estimates ( https://www.cdc.gov/nchs/ Results—The provisional number of this report are based on the final data nvss/vsrr/natality-dashboard.htm). The births for the United States in 2020 was for 2019 and earlier years (3). Data for series also includes reports that provide 3,605,201, down 4% from 2019. The American Samoa, Guam, and the U.S. additional information on specific topics general fertility rate was 55.8 births Virgin Islands were not available as of to help readers understand and interpret per 1,000 women aged 15–44, down the release of the 2020 provisional birth provisional natality and mortality data. 4% from 2019 to reach another record file. Detailed information on reporting Also, now available are provisional birth low for the United States. The total completeness and criteria may be found estimates developed to monitor health fertility rate was 1,637.5 births per 1,000 elsewhere (4,5). women in 2020, down 4% from 2019 services utilization and maternal and to also reach another record low for the infant outcomes that may be directly Hispanic origin and race are reported nation. In 2020, birth rates declined for or indirectly impacted by COVID-19. separately on the birth certificate. Data women in all age groups 15–44 and were Information is updated quarterly and shown by Hispanic origin include all unchanged for adolescents aged 10–14 is available from: https://www.cdc.gov/ persons of Hispanic origin of any race. and women aged 45–49. The birth rate nchs/covid19/covid-birth.htm. Data for non-Hispanic persons are shown separately for each single-race for teenagers aged 15–19 declined by 8% Using provisional birth data for group. Data by race are based on the in 2020 to 15.3 births per 1,000 females; the 12 months of 2020 (1), this report revised standards issued by the Office rates declined for both younger (aged supplements the Quarterly Provisional of Management and Budget (OMB) 15–17) and older (aged 18–19) teenagers. Estimates for 2020 by presenting longer in 1997 (6). The race and Hispanic- The cesarean delivery rate rose to 31.8% temporal trends in context and more origin groups shown are: non-Hispanic, in 2020; the low-risk cesarean delivery detail (by race and Hispanic origin of single-race white; non-Hispanic, single- rate increased to 25.9%. The preterm the mother and by state of residence). race black; non-Hispanic, single-race birth rate declined to 10.09% in 2020, the Statistics from previous provisional American Indian or Alaska Native first decline in the rate since 2014. reports have been shown to be consistent (AIAN); non-Hispanic, single-race with the final statistics for the year (2,3). Keywords: birth rates • maternal and Asian; non-Hispanic, single-race Native This report presents provisional data infant health • vital statistics • National Hawaiian or Other Pacific Islander on births and birth rates and cesarean Vital Statistics System (NHOPI); and Hispanic. For brevity, text delivery and preterm birth rates for the references to race omit the term “single- United States in 2020. Information on race” (3). prenatal care, low birthweight, and other 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 Birth and fertility rates for the United Figure 1. Number of live births and general fertility rates: United States, final 1990–2019 and States and by maternal race and Hispanic provisional 2020 origin for 2020 were based on population estimates derived from the 2010 census 5 80 as of July 1, 2020 (7). Changes and differences presented in Ra te p te this report are statistically significant at ) Number 70 s e n r the 0.05 level, unless noted otherwise. o 1 i l 4 l ,0 For information and discussion on i 00 m ( Rate w computing rates and percentages and for s h o t r m detailed information on items presented i 60 b en in this report, see “User Guide to the f o a r g e 2019 Natality Public Use File” (4). ed b m 3 1 u 5–44 Beginning with Quarterly Provisional N 50 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 0 levels of completeness of provisional 1990 1995 2000 2005 2010 2015 2020 birth data; the change in weighting had limited, if any, impact on the SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality. provisional birth estimates. Data shown in this report are based directly on the Figure 2. Birth rates for teenagers, by age of mother: United States, final 1991–2019 and counts of all (unweighted) birth records provisional 2020 received and processed by NCHS as of February 11, 2021. 100 Results 80 s e l a Births and birth rates m 18–19 years e f 0 60 Key findings, illustrated in Tables 1–3 0 0 , 1 and Figures 1 and 2, show: r e p ■ e The provisional number of births t 40 15–19 years for the United States in 2020 was Ra 3,605,201, down 4% from the number in 2019 (3,747,540) (Tables 1–3 and 20 Figure 1). This is the sixth consecutive 15–17 years year that the number of births has declined after an increase in 2014, 0 down an average of 2% per year, and 1991 1995 2000 2005 2010 2015 2020 the lowest number of births since 1979 (3,8,9). SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality. ■ From 2019 to 2020, the provisional number of births declined 3% for ■ The provisional general fertility rate ■ GFRs declined for each of the Hispanic women, 4% for non-Hispanic (GFR) for the United States in 2020 race and Hispanic-origin groups white and non-Hispanic black women, was 55.8 births per 1,000 women aged from 2019 to 2020, down 3% for 6% for non-Hispanic AIAN women, 15–44, down 4% from the rate in 2019 non-Hispanic NHOPI women; 4% for and 8% for non-Hispanic Asian women (58.3), another record low for the nation non-Hispanic white, non-Hispanic (Tables 2 and 3). The 2% decline in (Tables 1 and 2 and Figure 1) (3,8,9). black, and Hispanic women; 7% for the number of births for non-Hispanic From 2014 to 2020, the GFR declined non-Hispanic AIAN women; and 9% NHOPI women was not significant. by an average of 2% per year. 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 ■ The provisional birth rate for women Cesarean delivery (TFR) for the United States in 2020 aged 20–24 in 2020 was 62.8 births ■ was 1,637.5 births per 1,000 women, per 1,000 women, down 6% from In 2020, the overall cesarean down 4% from the rate in 2019 2019 (66.6), reaching yet another delivery rate increased to 31.8% (1,706.0), another record low for the record low for this age group (Table 1) from 31.7% in 2019 (Tables 3 and nation (3,9,10). The TFR estimates the (3,8,9). This rate has declined by 40% 4); despite this increase, the rate had number of births that a hypothetical since 2007. The number of births to generally declined from 2009 (32.9%) group of 1,000 women would have women in their early 20s also declined to 2019 (3). See Table 4 for state- over their lifetimes, based on the age- by 6% from 2019 to 2020 (Table 1). specific rates. ■ From 2019 to 2020, cesarean delivery specific birth rate in a given year.