NATIONAL CENTER 

For HEALTH Statistics 

VITAL and HEALTH STATISTICS 

DATA FROM THE NATIONAL VITAL STATISTICS SYSTEM 

Natality


Statistics


PROPEFWY OF THE Analysis WBLKIATIONS i3RANGH 

mmlw- lJmARY 

United States, 1965-1967 

An analytical study of recent fertility trends in 

terms of period and cohort measures. Discusses 

variations in fertility of maior population groups by 

color and place of residence, including Puerto Rico 

and the Virgin Islands (U.S.). Also discusses characteristics of live births, including sex ratio, month 

of birth, attendant at birth, birth weight, period of 

gestation, plurality, and illegitimacy. 

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 

Public Health Service 

Health Services and Mental Health Administration 

Rockville, Md. May 1970 
Public Health Service Publication No. 1000-Series 21-No. 1!3 

For sale by the Superintendent of Documents, U.S. Government Printing Office, Washington, D. C., 20402-Prim 60cents 
.

ONAL CENTER FOR HEALTH STAT STICS 

THEODORE D. WOOLSEY, Director 

PHILIP S. LAWRENCE, SC.D., Associate Director 

OSWALD K. qAGEN, PH. D.,, Assistant Director /or Health Statistics Development 

WALT R. SIMMONS, M. A., Assistant Director /or Research and Scientific Development 

. . .. .. . . , Medical Consultant 

JAMES E. KELLY, D. D. S., Dental Advisor 

EDWARD E. MINTY, Executive O//icer 

MARGERY R. CUNNINGHAM, Information O/ficer 

DIVISION OF VITAL STATISTICS 

ROBERT A. ISRAEL, M.S.,Director 

ROBERT A.ISRAEL.,M.S.,Acting Chic/,Mortality statistics ~rancb 

JOHN E.PATTERSON, Chief,iVatazity Statistics Branch 

LOREN E. CHANCELLOR, Chief, Registration Methods Branch 

ALICE M. HETZEL, Chi~/,Marriage and Divorce Statistics Branch 

ARNE B. NELSON, M.A.,Chief, Vital Records .$urvey Branch 

MICHAEL J.ZUGZDA, Chief, Statistical Resources Section 

Public Health Service Publication No. 1000-Series 21-No. 19 

Library of Congress Catalog Card Number 65-62786 
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CONTENTS 

Introduction


Recent Trends in Fertility


Completed Family Size


Timing of Births


Total Fertility


Contraceptive Pills


Numbers of Births


Fertility of Major Population Groups----,


Fertility byColor


State and Geographic Division


Metropolitan Residence


Characteristics ofBil-ths


Sex Ratio


Month ofBirth


Attendant atBirth


Birth Weight


Gestation Period


Multiple Births


Illegitim~2cy


Puerto Rico and Virgig Islands (U.S.)------------------------------------


Birth Rates and Numbe~-s of Btiths


Birth Rates by Age of Mother ----------------------------------------


Births by Education ofMother


References


Page 

1 

1 

3 

3 

5 

8 

9 

10


11


14 

14 

18 

18 

18 

~o 

24 

26 

27 

29 

34 

34 

36 

36 

38 

[11 
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CONTENTS-Con.


Figure 1.


2.


3.


4. 

5. 

6. 

7. 

8. 

9. 

10. 

Table 1.


2.


3.


4.


5.


6.


7.


8.


9.


10. 

11. 

Cumulative birth rates by exact ages, cohorts of 1875-1948----------


Birth rates by age of mother: 1940.-67--------------------_.---------


Actual and hypothetical secular trends in total fertility rates:


1920-69


Total fertility rates by live-birth order: 1917-67------------------


Observed and hypothetical numbers of births and total fertility


rates: selected years 1930-90---------------------------------------


Fertility rates by color: 1920-67-----------------------------------


Estimated illegitimacy rates by age of mother and color: 1940, 1950, 

and 1955-67-

Birth rates: Puerto Rico,Virgin Island% and United States, 1940-66--


Total fertility’ rates for Puerto Rico, and for the United States 

by color: 1944-66 - - - - -,---

Birth rates by age of mother for Puerto Rico, and for the United


States by color: l966----------`------------------------------------


Live births, birth rates,and fertility rates:,,United States,1909-68--


Total fertility rates: United States, 1917-68------------------------


Birth rates by age of mother, color, and live-birth order: United


States, l967---------------------------------------------------------


Birth rates and percent change:United States,each division and State,


l965-67-------------------------------------------


Birth rates for standard metropolitan statistical areas with popula­


tions of 1,000,000 or more in 1965 and percent change: United States


and each region, l965-67---------------------------------------------


Sex ratio at birth, by specified race: United States, average for


l965-67--------------------------------------------------------------


Sex ratio at birth, by color and plurality: United States, 1965-67---

Sex ratio at birth, by live-birth order and age of mother: United 

States, l967---------------------------------------------------------

Monthly indexes of live births: United States, 1960-67---------------


Monthly indexes of live births and standard deviations, by color:


United States, l965-67-----------------------------------------------


Seasonally adjusted birth and fertility rates,by month of occurrence:


United States, l965-67-----------------------------------------------


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4


5


7


8


10 

12


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34


35


36


Page


2


6


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15


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19


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20 

21 

21 

w 
CONTENTS—Con.


Table 12.


13.


14.


15.


16.


17.


18.


19.


20.


21.


22.


23.


24.


25.


26.


27.


Percent distribution of live births by attendant, according to color


and type of residence: United States, 1950, 1960, and 1967-----------


Percent distribution of live births by attendant, accordinsz to color:


United States and each division, 1967:-------------------------------


Median birth weight and immature live births as percent of total


births, by color and sex: United States, 1960, 1965, 1966, and 1967--


In_mature births as percent of total live births, by color, type of


residence, and metropolitan and nonmetropolitan counties: United


States, 1960, 1965, 1966, and 1967-----------------------------------
 ,.


In-mature live births as percent of total live births in each group,


by color and age of mother: Uni.t,edStates, 1967----------------------


Median birth weight by color and period of gestation: Baltimore, Cal­


ifornia, District of Columbia, New York City, and Rhode Island com­


bined, l966----------------------------------------------------------


Number of live births in plural deliveries and ratio of plural live


births to total live births: United States, 1956-67------------------


Ratio of plural live births to total live births, by color and age of


mother: United States, 1966-------------------------------------------


Median birth weight and percent distribution of live births by birth


weight, according to plurality: United States, 1966------------------


Estimated number of illegitimate live births,by color: United States,


l94O-67--------------------------------------------------------------


Estimated illegitimacy rates by age of mother:United States,1940-67--


Estimated illegitimacy rates, by color and age of mother: United


States, 1960, 1965, 1966, and 1957, and percent change 1960-67-------


Estimated number of illegitimate live births, by color and age of


mother: United States, 1965-67---------------------------------------


Estimated illegitimacy ratios, by color and age of mother: United 

States, l967---------------------------------------------------------

Live births and birth rates: Puerto Rico and Virgin Islands,1940-66--


percent distribution of live-births by educational attainment of


mother: Puerto Rico, 1962 and 1966-----------------------------------


Page


22


23


24


25


26


27


28


28


28


29


31


33


33


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NATALITY RATES AND RATIOS, 1967 

TOTAL NUMBER OF LIVE BIRTHS-3 ,520,959 

CRUDE BIRTH RATE--------- .-------------17.8 SEX RATIO-------------------------------1,O5O 

(per 1,000 population) (males per 1,000 female live births) 

FERTILITY RATE--------------------------87.6 HOSPITAL DELIVERIES--------------------98.3 

(per l,OOOwomen 15-44 years) (per 100 live births) 

CUMULATIVE BIRTH RATE BY AGE OF WOMEN, IMMATURE BIRTHS (2,500 grams orless)-----8.2 

JANUARY1, 1968 (per 100 live births) 

(per 1,000 women) 

15-19 years---------------------------------78 MEDIAN WEIGHTAT BIRTH---------------3,28O 

20-24 years--------------------------------75l (ingrains) 

25-29 years-------------------------------l,923 

30-34 years 2,820 PREMATURE BIRTHS (gestation less than 

35-39 years-------------------------------3,O86 37 weeks)----- ----------------------------6.7 

40-44 years-------------------------------2,969 (per 100 live births) 

45-49 years 2,773 

LIVE BIRTHS IN MULTIPLE DELIVERIES----79.7 

TOTAL FERTILITY RATE------------------2,562 (per 1,000 live births) 

(per 1,000 women) 

ESTIMATED ILLEGITIMACY RATE----------23.9 

ESTIMATED PERCENT COMPLETENESS OF (per 1,000 unmarried women 15-44 years) 

BIRTH REGISTRATION 99.0 

SYMBOLS 

I Data not available I 

] Category nonapplicable . . . / 

Quantity zero -

I Quantity more than O but less than O.05---- 0.0 I 

Figure does not meet standards of 

* reliabilityor precision 

VI 
NOTES TO TABLES 

1. Alaska and Hawaii.— All tables showing time series 

include data for Alaska beginning with 1959 and for 

Hawaii beginning with 1960. 

20 Sm@ng rates. — Data for years prior to 1951 and 

for 1955 are based on the total file of birth records. Except as noted, data for 1951-54 and 1956-66 are derived from 50-percent samples of birth records; data 

for 1967 are based partly on 20-percent and partly on 

50-percent sam’’les. A discussion of sampling procedures and sampling errors for 1.967 may be found 

in the Technical Appendix of Volume 1, Vital Statistics 

@ the Un&xi St.ztes, 196?, 1 

3. Not stated datu.— Beginning with 1964 births with 

age of mother and color not stated were allocated 

during data processing on the basis of characteristics 

of births that were similar to the not stated cases in 

other respects. Before 1964 color not stated was assigned as white. For other characteristics, not stated 

information was distributed in proportion to the known 

information unless otherwise noted in the particular 

table. 

4.	 Adjustment for unde-rregistration of bivths.— Adjustment for unregistered births was discontinued in 

1960, when it was estimated that 98.9 percent of all 

births were registered. However, cohort rates in 

table 2 make allowances for both the underregistration 

of births and the underenumeration of the base popu ­

lation. 

5.	 Po@dation bases.— Except as noted birth rates 

shown in this report are based on populations present 

in the respective areas. Populations for the United 

States exclude the Armed Forces overseas and persons living abroad but include the Armed Forces 

stationed in each area. Rates for 1940, 1950, and 

1960 are based on populations enumerated as of April 1; 

rates for all other years are based on populations estimated as of July 1. 

Vll 
IN THIS REPORT impovtant features of statistics fov bivths in the 

United States during 1965-67 are pvesented and interpreted. The statistics ave based on infovrnation obtained Jvom micvofilm copies of the 

original ce-rtificates of live birth. 

In 1965 the annual number of births fell below 4 million for the fivst 

time ‘since 1953 and by 1967 it had dropped to 3,521,000. Continuing its 

decline from a peak of 25.3 in 1957, the bivth rate fell tO 17.8 in 1967’. 

The recent decline in fevtility was due, in pavt, to changes in the age 

pattern of childbearing. Women who had relatively high birth vates at’ 

youngev ages in the 1950’s weve having relatively low birth rates at 

older ages during the 1960?s. Declines in fevtility at the youngev ages 

(undev 25 yeavs) may have been due to postponement of mamkzge and 

childbearing ov to a reduction in the num bev of childven couples want 

to have altogether. At present it is impossible to determine which of 

these explanations may be move impovtant, but both factors have pvobably been opevating to some extent. 

The decline in the annual numbey of bivths may end in the near future. 

The numbev of women in the childbearing ages is growing vapidly and 

will increase by about 30 pe-rcent by 1980. Unless fertility rates fall 

well below their pvesent levels, this incvease in the num bev of women 

will raise the annual num bev of bivths. 

When the fevtility of white women is compaved with tkat of all othev 

women combined, the latter is highav. Both groups reached peak levels 

of fevtility in 1957 and since then have shown declines in theiv birth 

vates. 

The bin% vate of most States and large metvopoliikm areas declined 

duving the 1965-67 period. 

Move than 98 pevcent of all live births in 1967 weYf classified as having 

been deliveved by physicians in hospitals. The differential in the rate of 

medically attended hospital delivwies by CO1OVhas nmcvowed considerably in vecent yeavs. In 1967, 99 percent of white bivths and 93 percent 

of all other bivths were delivered by physicians in hospitals. 

Slightly more than 8 pevcent of all babies bovn in 1967 were immatuve, 

that is, weighing 2,500 grams (5 pounds 8 ounces) ov less. The pvopovtion immatuve among white bivths was 7.1 pevcent, and among all other 

births, 13.6 percent. 

The estimated ille~”timacy vate in 1967 was 23.9 ille~”timate births pev 

1,000 unmawied women aged 15-44. Although this rate has changed vevy 

little since 1957, the proportion of bivths classified as illep”timate has 

increased considerably, from an estimated 5 pevcent in 1957 to 9 pwcent in 1967. 

Vlll 
NATALITY STATISTICS ANALYSIS, 1965-67


Robert L. Heuser, Stephanie J. Ventura, and Frank H. Godley, Division of Vital Statistics 

INTRODUCTION 

This report presents and interprets important 

features of the 1965-67 birth statistics for the 

United States. More detailed data are shown in 

Volume 1 of Vital Statistics of the United States 

for these years. This report also includes 1955 

and 1966 data for Puerto Rico and the Virgin 

Islands. The National Center for Health Statistics 

did not tabulate 1967 data for Puerto Rico and 

the Virgin Islands, but they are published in the 

respective annual vital statistics reports of the 

Department of Health of the Commonwealth of 

Puerto Rico and the Department of Health of the 

Virgin Islands. 

Birth statistics presented in this report are 

based on information obtained from the birth 

certificates of 54 reporting areas in the United 

States and of Puerto Rico and the Virgin Islands. 

Registrars in these areas send copies of all birth 

certificates to the National Center for Health 

Statistics, where a sample of the certificates is 

selected. The 1965 and 1966 data for the United 

States and Puerto Rico were based on a 50-percent 

sample of the records; the 1967 data for the 

United States were based on a 20-, to 50-percent 

sample. The Virgin Islands data for all years 

were based on 100 percent of the birth certificates. 

Most of the statistics presented here do not 

include an adjustment for births that have not 

been registered. This adjustment was discontinued in 1960, when it was estimated that 98.9 

percent of all births were registered. However, 

the cohort fertility rates which are cited in the 

description of recent trends in fertility make 

allowances for both the underregistration of births 

and the underenumeration of the base population. 

Additional details concerning technical aspects of birth statistics may be found in the Technical Appendix of Volume I of Vital Statistics of the 

United States, which is published each year. 

RECENT TRENDS IN FERTILITY 

The 1930’s marked the end of a long-term 

decline in fertility in the United States. Beginning ti the early “1940’s there was an increase 

in births which grew to massive proportions 

after World War II and reached its peak in 1957. 

Since 1957 fertility has been declining (table 1). 

From 1933 to 1939 the annual fertility rate 

varied between 76 and 79 births per 1,000 women 

15-44 years of age, averaging 77. From this 

level it climbed to a peak of 123 in 1957. By 

1967 it had declined to 88 but was still well 

above the low levels of the 1933-39 period. 

The broth rate (births per 1,000 total population) aIso reached its most recent peak in 

1957 and has since been declining. However, 

unlike the fertiIity rate, the birth rate is no 

longer above the average observed during 1933-

39 (18.7). In 1967 the birth rate was only 17.8. 

Recent birth rates are closer to the prewar 

level than fertility rates because the childbearing 

population (taken as women 15-44 years of age) 

now accounts for a smaUer proportion of the 

total population than before the war. The childbearing population comprised 24 percent of the 

total population in 1936 as compared with 20 

percent in 1967. As a ‘result the higher fertility 

of women in recent years has ordy been sufficient to maintain the birth rate of the total 

population at a level that is somewhat lower than 

that of the 1930’s. 
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Table 1. Live births, birth rates, and fertility rates: United States, 1909-68


Year Live Birth Fertility


births rate rate


Registered births Number 

Rate per

1,000 Rate per 1,000 women ?opulationl aged 15-44 yeara 

l9682------------------------------------------------------------- 3,470,000 17.4 84.8 l967-------------------------------------------------------------- 3,520,959 17.8 87.6 l966-------------------------------------------------------------- 3,606,274 18.4 91.3 l965-------------------------------------------------------------- 3,760,358 19.4 96.6 l964-------------------------------------------------------------- 4,027,490 21.0 105.0 l963-------------------------------------------------------------- 4,098,020 21.7 108.5 l962-------------------------------------------------------------- 4,167,362 22.4 112.2 

1961 4,268,326 23.3 117.2 1960 4,257,850 23.7 11s.0 l959-------------------------------------------------------------- 4,244,796 24.0 118.8 

Births adjusted for underregiatrations


l959-------------------------------------------------------------- 24.3 120.2 l958-------------------------------------------------------------- 24.5 120.2 l957-------------------------------------------------------------- 25.3 122.9 l956-------------------------------------------------------------- 25.2 121.2 l955-------------------------------------------------------------- 25.0 118.5 l954-------------------------------------------------------------- 25.3 118.1 

l953-------------------------------------------------------------- 25.1 115.2 l952-------------------------------------------------------------- 25.1 113.9 1951 24.9 111.5 1950 24.1 106.2 l949-------------------------------------------------------------- 24.5 107.1 

l948-------------------------------------------------------------- 24.9 107.3 l947-------------------------------------------------------------- 26.6 113.3 l946-------------------------------------------------------------- 24.1 101.9 l945-------------------------------------------------------------- 20.4 85.9 l944-------------------------------------------------------------- 21.2 88.8 l943-------------------------------------------------------------- 22.7 94.3 l942-------------------------------------------------------------- 22.2 91.5 1941 20.3 83.4 

1940 19.4 79.9 l939-------------------------------------------------------------- 18.8 77.6 l938-------------------------------------------------------------- 19.2 79.1 l937-------------------------------------------------------------- 18.7 77,L l936-------------------------------------------------------------- 18.4 75.8 l935-------------------------------------------------------------- 18.7 77.2 l934-------------------------------------------------------------- 19.0 7s.5 l933-------------------------------------------------------------- 18.4 76.3 l932-------------------------------------------------------------- 19.5 81.7 

1931 20.2 84.6 

1930 21.3 89.2 l929-------------------------------------------------------------- 21.2 89.3 l928-------------------------------------------------------------- 22.2 93.8 l927-------------------------------------------------------------- 23.5 99.8 

1926 ...”-------------m 24.2 102.6 l925-------------------------------------------------------------- 25.1 106.6 

l924-------------------------------------------------------------- 26.1 110.9 

l923-------------------------------------------------------------- 26.0 110.5 l222-------------------------------------------------------------- 26.2 111.2 1921 28.1 119.8 1920 27.7 117.9 

l9l9-------------------------------------------------------------- 26.1 111.2 

l9l8-------------------------------------------------------------- 28.2 119.8 l9l7-------------------------------------------------------------- 28.5 121.0 

l9l6-------------------------------------------------------------- 29.1 123.4 

l9l5----:--------------------------------------------------------- 29.5 125.0 

l9l4-------------------------------------------------------------- 29.9 126.6 

l9l3-------------------------------------------------------------- 29.5 124.7 

l9l2-------------------------------------------------------------- 25’.8 125.8 1911 29.9 126.3 

1910 30.1 126.8 

l9o9-------------------------------------------------------------- 30.0 126.8 

!For 1917-19 and 1941-46, based On population including Armed Forces abroad.


‘provisional data.


‘:
For 1915-32, figures include adjustments for States not in the registration area; for years prior to


1915, figures are estimates based on the number Of registered births in the 10 original registration States


Estimates for 1909-34 were prepared by P.K. Whelpton. See National Office of Vital


~~g[~~~~~~~~~~~~ ~dl~~;th Rates in the Entire United States, 1909 to 1948, ” Vital Statistic s-SPU


——
 >.>


2 
The reduction in the’ relative size of the 

childbearing population is due in part to the 

increase in the proportion of children in the 

population, which is due in turn to the higher 

fertility of the postwar period. In 1936 the proportion of persons under 15 years of age was 

26.5 percent. In 1967 the comparable proportion 

was 30.3 percent. 

In order to understand recent trends in fer: 

tility, it is necessary to review two other important factors affecting the annual numbers of 

births—completed family size and timing of 

births. 

Completed Family Size 

The increase in births during the 1940’s and 

1950’s was due in part to arise in average family 

size. This may be measured by the cumulative 

fertility rate at exact age 50 (completed fertility 

rate), which is the average number of births that 

a group of women has by the end of the childbearing 

period. The groups of women referred to are 

called “cohorts” and are identified by the year of 

their birth. 

The top line in figure 1 shows completed fertility rates for cohorts of women born during each 

year from 1875 to 1918. A long-term decline from 

3,818 births per 1,000 women in the 1875 cohort 

to 2,230 for the 1909 cohort was followed by an 

increase in the completed fertility of the cohorts 

of 1910-18. Although later cohorts have not yet 

reached age 50, it can be predicted that their 

completed fertility will surpass that of the 1918 

cohort. The cohorts of 1919-38 have already borne 

more children by younger ages than the 1918 

cohort had altogether. Projections based on the 

numbers of future births expected by a national 

sample of married women interviewed in 1960 

suggest that the cohorts of 1931-35 may complete 

their families with as many as 3,500 births per 

1,000 women. 2 Expectations of younger cohorts 

were lower, but they still indicate significantly 

higher completed fertility rates than that of the 

1918 cohort. 

It was the increase in completed fertility of 

the cohorts of 1910-35 (approximately) that was 

responsible in part for the rise in fertility during 

the 1940’s and 1950’s. 

Timing of Births 

A major portion (probably over half) of the 

upward and downward swings in fertility has been 

due to changes in timing, that is, to changes in 

the ages at which women have their children. 

Two overlapping shifts in the age pattern of 

childbearing accounted for much of the rise in 

births during the late 1940’s and the 1950’s. The 

first of these shifts operated in the following way. 

During the 1930’s and early 1940’s many young 

couples postponed marriage and childbearing to 

later ages because of economic conditions and 

World War II. The compensation for this. postponed fertility was greatest after the war, when 

millions of men were released from the armed 

services. In 1946 marriage rates rose to very 

high levels, and this was folIowed by an abrupt 

increase in “birth rates in 1947. Many of these 

marriages and births would probably have occurred earlier if the war had not intervened. In 

effect large numbers of marriages and births were 

shifted from the late 1930’s and early 1940’s to 

the postwar period. This shift resulted in a rise 

in the birth rates for women at the older childbearing ages (fig. 2). 

At the same time a second shift in the age 

pattern of childbearing was in progress. This was 

the trend toward earlier marriage and childbearing that proceeded at a rapid pace during the 

late 1940’s and the 1950’s. It had the effect of 

shifting millions of births that ordinarily would 

have occurred at somewhat later ages to the 

earlier ages of the reproductive period, thus 

raising birth rates for women at the younger 

childbearing ages. The culmination of this trend 

was reached in 1957. 

Since 1957 the women who were having such 

high rates earlier in the 1950’s (the cohorts of 

1925-36, approximately) have been reaching the 

older ages of the childbearing period. Since most 

of them had all the children they wanted to have 

while they were younger, they have been having 

relatively low rates at the older childbearing ages. 

This is part of the reason for the recent decline 

in annual fertility rates. 

The rest of the recent decline is due m lower 

fertili~ at the younger childbearing ages. This 

could reflect a trend toward marriage and child-
4,000 

z 

k! 

5 

3 

0


0


0-


—


E 

w 

n 

U 

~ 

lx 

3,000 1 I 

2,500 

2,000 

1,500 

1,000 

Soo 

20 

0 

1875 18S0 1883 1890 1895 1900 1905 1910 1915 1920 1925 1930 1935 1940 1945 1950 1955 

COHORT 

Figure 1. Cumulative birth rates by exact ages, cohorts of 1875-1946. 

(Rates based on births adjusted for underreg istrat ion for al1 years, including 1960-68, and on population estimates adjusted for underenumerat ion) 
400 

300 — 300 

~ 

0 

_. 

L 

200 

30-34 years 

100


40 

20 20 

40-44 years 

10 I I I I I I 1 1 I I I I I I [ 1 I I I I I I I I 10
 1940 1945 1950 1955 1960 1965 [970 

YEAR 

Figure2. Birth rates by age of mother: 19W-67.


(Rates based on births adjusted for underregistration and on populationestimates adjusted for underenumeration...Semi
log­


arithmic scale)


bearing at later ages or a reduction in the number of children that couples want to have altogether. At present there is no substantial basis 

for determining @ich of these explanations may 

be more important, but the available evidence 

suggests that both factors have been operating 

to some extent. 

Total Fertility


In discussing secular trends in fertili~, the 

total fertility rate is a useful measure because it 

can be compared with the eventual completed fertility of women by the end of the reproductive 

period. 

The total fertility rate states the number of 

births 1,000 women would have i~they experienced 

a given set of age-specific birth rates throughout 

their reproductive ages. It is the sum of the agespecific birth rates for single years of age observed in a given calendar year. It is an ageadjusted rate because it is based on the assumption 

that there are the same number of women at each 

single year of age. 

The total fertili~ rate reached a postwar 

peak of 3,724 in 1957 (table 2). At the time this 

peak was reached, it seemed unlikely that such 

high fertility would be maintained indefinitely 

because it was well above the reproductive norms 

and expectations of American wornen. Interview 

5

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--------------------------

surveysconductedin 1955 and 1960showedthat


no agegroupofwomen wantedorexpected
tohave


as many as 3,724childrenper 1,000women by


theendofthereproductive periodoflife.
 2)3


The solidlinein figure3 shows themajor


trends in the totalfertili~ratesthathave


actuallybeen observed in the UnitedStates


since 1920.This linehas been influenced
both


by changesincompletedfertility
 andby changes


in thetimingof births. The brokenline,
on the


otherhand,is designedto representthehypo­


thetical
trend thatwouldhave been followedif


no changesinageatchildbearing
 hadtakenplace.


Inotherwords,theonlyfactorcausing
thebroken


lineto rise and fallis theaveragenumber of


children
thatwomen haveby theendofthechild­


bearingperiod.Both thedeclinein thebroken


linein the 1930’sand itssubsequentriseare


Table 2. Total fertility rates: United States, 1917-68


[Seenotestotables
 onpageVI~


1 

Rate


Year per 1,000


Rate


Year per 1,000


—.


1968


1967-------------.---...,----


1966 ”--


1965


1964


1963-.-”----


1962 .---.”


1961


1960


1959


1958-.------


1957


1956


1955------.--------.


1954


1953---------


1952-s------ --.-----


1951 ----,---


1950


1949 --.-----


1948 -s-


1947 ---.S---


1946


1945


1944


1943-------”


lp-rovi~i~nal estimate. 

women


12,480


2,562


2,728


2,922


3,197


3,331


3,476


3,620


3,655


3,669


3,654


3,724


3.,634


3,521


3,501


3,378


3,307


3,209


3,030


3,030


3,013


3,158


2,829


2,392


2,466


2,616


1942


1941


1940


1939 --.-----


1938--------------------------
 1937


1936


1935--------------------------
 1934


1933


1932


.1931


,1930


1929 :-------


1928---------


1927--------


1926


1925 ----,.
 .-.


1924--------


1923 .-


1922 .------- .-


1921 -------.


1920


1919


1918


1917--------------------------


women


2,5$2


2,314


2,214


2,154


2,200


2,147


2,119


2,163


2,205


2,149


2,288


2,376


2,509


2,524


2,656


2,826.


2,910


3,027


3,144 ,:


3,116 :


3,125


3,349


3,273


3,078


3,313


3,332


NOTE: The total fertility rate is the sum of age-specific birth rates for single


years of age for women 14-49 years of age. The birth rates for single years of age


used to compute total fertility rates are based on births adjuated for underregistra­
 tion for all years (including1960-68) and on population estimates adjusted for under­


enumeration.Hence they are not precisely comparable to birth ratesand fertility rates


shown in table 1. For method of adjusting the population bases, see the Methodological


Appendix in National Office of Vital Statistics, “Fertility Tables for Birth Cohorts


of American Women,” by P.K. Whelpton and A.A. Campbell, Vital Statistics-Special Re-


Dorts. Vol. 51. No. 1. 1960.
 -. 

6

--

4,000 I r 

�.. -+ Projected 

X 3,000 J::m 

z ‘%,,,,,, ,,,,,, n,,,,,,,,, ''`nna81'tn'``` '```' ''''' `'1'` ''to*''''','',,:"* 

�* ~ “%,,,,,, inn*,s,n,,,,,,,,,,,,,,,,l na*~~*’’’”” o 

s 2,000 

z 

~ 

0. b-’- _ Actual 

~ 1,000 .,I,,,,,u,,,B,v Hypothetical: roles that would hove been observed if the timing 

Of tirths within cohorts had remained coms!ont 

I 01 

I I I I I I I I I I I 

1920-24 [925-29 1930-34 1935-39 [940-44 1945-49 1950-54 1955-59 1960-64 1965-69 

I YEARS 

Figure 3. Actual and hypotheticalsecular trends in total fertility rates: 1920-69


“\. 

cons;$erably gentler than the corresponding 

changes in actual fertility. 

The effects of changes in the timing of births 

are indicated by the contrast between the broken 

line and the solid line since the difference between the two lines is due solely to the influence 

of timing. This comparison suggests that more 

than half of the postwar rise in fertility resulted 

from shifts in timing, but it must be regarded 

as an approximation, for it was necessary to 

estimate the completed fertility of many of the 

women still in the reproductive ages in order to 

extend the broken line beyond the 1935-39 period. 

It is important to note that trends in the 

average number of children per couple and in the 

timing of births have operated in such a way as 

to reinforce each other. This has made the upward and downward swings in fertili~ much wider 

than they would have been if only one of these 

factors had been changing. 

Figure 4 shows total fertiliqr rates by livebirth order from 1917 to 1967. These rates are 

the sums of the birth rates for each order by 

single years of age in a given year. Sums of the 

total fertility rates of all orders are the rates 

shown in table 2. 

The trends in figure 4 show that the waves 

of births by order follow each other in succession. 

The early decline in the birth rates by order was 

ended first by the first-birth rate in 1933. This 

was followed by lows in the rates for second births 

in 1935, third births in 1937, and fourth births in 

1939. The declines in the higher birth orders 

were very long, not ending until the 1940’s. The 

subsequent increases from these low rates also 

tended to be in succession by birth order. The 

first-birth rate reached a peak in 1947 which was 

followed, by a high plateau from 1951 to 1957. This 

was followed by high levels in the rates for second 

births in 1957, third births in 1957-60, and fourth 

and higher order births in 1961. The recent declines in the third and higher order birth rates 

have been much more rapid than those during the 

1920’s and 1930’s. 

One of the most striking features of figure 4 

is the fact that first-birth rates for 1946-49 and 

1951-57 were above 1,000, indicating more than 

1,000 first births per 1,000 women. This anomaly 

reflects the unusual overlapping of the two shifts 

in the age pattern of childbearing that has been 

described earlier. First-birth rates were very’ 

high for older women as well as for younger 

women during these periods. Such high rates for 

first births obviously could not be experienced by 

an actual cohort of women, and they had to fall 

after the temporary effects of the overlapping 

shifts in timing had diminished. The decline in 

the rates for first births began after 1957, but 

it now appears to have ended and that an upturn 

may be beginning. This would tend to confirm the 

hypothesis that the recent decline in birth rates 

for younger women has resulted, at least in part, 

7

4,000 I 4,00 

3,000 

2,000 

E 

w 400 n. 

200 

100 

80 ~. . 

60 — 

50 1111111 Ill Ill 11111 II I 

1920 1930 1940 1950 1950 1970 

YEAR 

Figure 4. Total ferti 1ity rates by 1ive-bi rth order: 1917-67. 

(Rates based on births adjusted for underregistration and on population est i~tes adjusted for underenumerat ion for al 1 

years. SemiIogari thmi c seal e) 

from a tendency to delay childbearing until somewhat later ages. 

Contraceptive Pills 

There has been some speculation that the 

recent decline in fertility has been brought about 

by the increasing use of highly effective contraceptive pills. It is impossible to determine exactly what effect the pill has had, but there are 

certain considerations that must be taken into 

account in arriving at an informed opinion concerning its impact on the birth rate. 

The pill was not licensed for general use as 

a contraceptive until 1960 and probably did not 

come into wide use until a year or more later. 

This means that if it has had any major influence 

on the birth rate, it would not have been detectable 

until 1962 at the earliest, when children conceived 

in 1961 were born. The decline in fertility, how8 
ever, started in 1“958, so it is not possible for 

the pill to have initiated the downward trend or 

to have contributed to its early progress. 

After 1960 the number of women using the 

pill rose to an estimated 3,815,000 in 1965.4 This 

was 13 percent of all women 15-44 years of age. 

In the same period the total fertil.i~ rate declined 733 births per 1,000 women 15-44 years 

of age, from 3,655 in 1960 to 2,922 in 1965. This 

was a decline of 20 percent. 

Data from the 1965 National Fertility Survey 

permit comparison of year-by-year declines in 

total fertility with the rise in the percent of married women using oral contraceptives during the 

1960-65 period. This comparison shows that the 

increase in the percent of women using the pill 

did not keep pace with the decline in fertility.s 

Although the pill did not initiate the decline 

in fertili~, it probably did have some effect upon 

the decline during the 1960’s. The incidence of 

unintended pregnancies may be regarded as a 

function of three variables: the strength of couples’ 

desire to prevent pregnancy, the effectiveness of 

the methods they use, and the convenience or 

acceptability of the methods. The pill is more effective than other methods in common use and is 

generally regarded as more convenient. Therefore 

substitution of the pill for other methods of family 

limitation would reduce the incidence of unintended 

conceptions without any necessary increase in the 

strength of the couple’s motivation to prevent 

pregnancy. 

Inasmuch as many unintended conceptions are 

simply conceptions that occur somewhat sooner 

than they are wanted, we may also speculate that 

one of the pill’s major effects may be to help 

couples delay births for longer periods of time. 

If so, part of the recent shift toward childbearing 

at later ages may be aided hy widespread use of 

the pilI. 

From the National Fertility Survey of 1965 

Ryder and Westoff conclude 

It is our hunch that what has been happening 

to fertility in the 1960’s would have happened 

in direction if not in degree even if the oral 

contraceptive had not appeared on the scene, 

although the tempo of decline most recently 

can probably be attributed in part to the 

availability of this highly efficient and apparently highly acceptable method of fertility regulation.c 

Numbers of Births 

Thus far discussion of the trends in fertility 

has been mainly in terms of rates. Now let us 

look at what has happened and what may happen 

to the numbers of births. 

From 1930 until 1967 the numbers of births 

and the total fertility rates followed about the 

same pattern (fig. 5). Between 1933 and 1939 

there were 2.3-2.5 million births annually. From 

this level the number climbed to a peak of 4.3 

million in 1957 and then declined to about 3.5 

million in 1967. 

Between 1967 and 1980 the number of women 

in the childbearing ages will increase about 30 

percent according to projections prepared by the 

U.S. Bureau of the Census.~ In the ages that 

commonIy account for the largest numbers of 

birtlw (20-29 years) the increase will be even 

greater (about 48 percent). Unless fertility rates 

fall well below their present levels, the increase 

in tie number of women will soon tend to raise 

the annual numbers of births. 

The first part of figure 5 shows that in order 

for the annual number of births to remain constant at the present Ievel of about 3.5 million, 

the total fertility rate would have to fall from 

2,562 in 1967 to less than 2,100 by 1975 and less 

than 1,800 by 1985.” A decline of this magnitude 

would represent a marked departure from past 

experience, for such low fertility rates are well 

below the reproductive norms of any cohort of 

American. women that has yet reached ‘the end 

of the reproductive period. 

The part of figure 5 on page 11 indicates 

that if the total fertility rate were to remain 

constant at the present level of about 2,500, the 

annual number of births would rise to almost 

4.2 million by 1975 and more than 4.9 million 

by 1985. If the actual total fertility rates are 

higher, then the numbers of births will also be 

higher. 
............

5 kssumpt ion I-future annual number of births constant at 3.500.(XX 5,000 

[ 1 

u-l 

z 

o


z	

-1 

. :1/J+17:: \ [right scale) 

:2I I.lJ 

F­ . .. . a .. 

.. . u ...’ .. .. 

2 . . .. 2,000 ~ .. . / -1 . . . . . . . . . . . . . . . . 

lE 

u 

IA 

— Observed 

I . . . . . . . . . . Hypothetical: generol trend in fertility that would 

“J 1,000 : 

occur if the annual number of births were to P 

remain constant at 3,500,000, 

0 I 1 I 1 I I I I 1 I I o 

1930 1940 1950 1960 1970 1980 1990 

YEAR 

Figure 5. Observed and hypothetical numbers of births and total fertility rates: selected years lgso-~o 

Assumption l—future annual number of births constant’at 3,500,000


FERTILITY OF	 MAJOR POPULATION 

GROUPS 

The foregoing section deals with fertility 

trends in the United States as 

section attention will be directed 

tility. of certain major population 

The kinds of groups available 

analysis are necessarily limited 

a whole. In this 

toward the fergroups, 

for comparative 

by the informstion collected on birth certificates. Consequently 

comparisons of the fertili~ of certain important 

groups in our society cannot be made. For 

example, it is impossible to discover from birth 

registration data whether fertility is declining 

10 

more rapidly among low-income families than 

among moderate- and high-income families. Nor 

is it possible to investigate trends in fertility 

among women classified by educational attainment, The latest revision of the U.S. Standard 

Certificate of Live Birth, effective on January 1, 

1968, includes items on the education of the mother 

and father, but data from these items are not 

yet available. 

At present the only major population groups 

whose fertility can be studied on the basis of 

information collected on birth certificates are 

those identified by race and residence. This section compares fertility in the white and nonwhite 
5– Assumption ---

4 – 

3 – 

2 – 

. . . . . . . . . . 

I – 

0 1 

I I-future total ferti 1Ity rate constant at 2.500 -. . . ..- 5,000 .. .. ... .. . ... . 

.. z .. Lil .. 

4,000 s 

3 

1 0 

Number of births o 

0-

—


j , 3,000	 & 

Q 

w
 ................................ ‘r


a 

E 

Total fertility rate 

(right stole] ~ , 2,000 c 

-1 

i= 

m 

Observed w 

IL 

Hypothetical trend that would occur in the -1 

number of births if the total fertility rate 

were g to remain constant at 2,500. { I,000 

iI I I I I 1 I I I I 0 

1930 1940 1950 1960 1970 1980 1990 

YEAR 

Figure 5. Observed and hypothetical numbers of births and total fert i 1i ty rates: selected years 1930-90—Con. 

Assumption 11—f utu re total fert i 1i ty rate constant at 2,500 

populations and presents data ‘for States, geographic divisions, and the largest meIxopolitan 

areas. 

Fertility by Color 

Fertility of nonwhite women in the United 

States has followed about the same pattern as 

that of white women since 1950 but has been 

consistently higher (fig. 6). 

Between 1960 and 1965 the white fertility 

rate declined more rapidly than the nonwhite 

rate, so the difference between the two rates 

increased; in 1960 the nonwhite rate was 36 percent higher than the white rate, and in 1965 it 

was 46 percent higher. Since 1965, however, the 

nonwhite fertil.iq rate has dropped somewhat more 

rapidly than the white rate. This reversal was due 

to a lower rate of decline in the white fertili~ 

rate and a bigher rate of decline in the nonwhite 

rate during 1965-67 as compared with the 1960-

65 period. As a result the difference between the 

white and nonwhite fertility rates decreased 

slightly to 44 percent in 1967. 

Color differences in fertiliq vary by age”of 

mother and live-birth order of the child, but in 

all cases the fertility of nonwhite women is 

higher (table 3). By age of mother, the differences are relatively larger for the younger and 

the older women. The rates are closest in the 

11 
age group 25-29 years, where in 1967 the nonwhite rate was only 11 percent higher than the 

white rate. The largest differences are at ages 

15-19 (136 percent) and 40-44 (71 percent). 

The lower rate of decline in the white fertility rate between 1965 and1967 was due to the 

slower decline in the rates for women 15-24 

years of age. On the other hand, there was a 

higher average annual percent decline in the 

0


0


0
_.


a 

w 

n. 

“ 100 

80 

,:L[ ~ k-f 

T T 

1920 1930 1940 

rates for all nonwhite women over 20 years of 

age during 1965-67 than in the 1960-65 period., 

With the exception of first births the higher 

the live- birth order thegreater therelativedifference between the white and nonwhite birth rates. 

In 1967 the nonwhite second-birth rate was only 17 

percent higher than that of white women, while for 

eighth and higher orders, the nonwhite rate was 5 

times greater than the white rate. 

111 

1950 1960 1970 

YEAR 

Fig ure 6. Ferti1ity rates by color: 1920-67 

(Beginning in 1959 trend 1ines are based on registered 1ive births; trend 1ines for 19%59 are based on 1ive births s.djusted for underregistration) 

12

-----------

----------

-----------

----------

-----------

---------------

-----------

----------

-----------

----------

-----------

---------------

-----------

----------

-----------

----------

-----------

---------------

Table 3. Birth rates by age of mother,color,and live-birth order: United States, 1967


Color and


live-birth order


Total


All birth orders-­


First child


Second child


Third child


Fourth child


Fifth child


Sixth and seventh


child


Eighth child and over-


White


All birth orders-­


First child


Second child


Third child


Fourth child


Fifth child


Sixtxl;nd seventh


Eighth child and over-


Nonwhite


All birth orders-­


First child


Second child


Third child


Fourth child


Fifth child


Sixth and seventh


child


Eighth child and over­


. 

[See notestotables on page VI~ 

Age of mother


10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 

years years years years years years years years 

t 

Rate per 1,000 women 

87.6 0.9 67.9 174.0 142.6 79.3 38.5 10.6 0.7 

30.8 

22.6 

0.8 

0.0 

51.1 75.3 26.5 

13.6 59.5 40.2 12: 2.2 0.5 

0.8 

0.0 

0.0 

13.9 0.0 2.7 25.0 34.4 17.1 2:: 1.3 0.1 

9.4 20.4 15.3 6.7 u ::: 3.4 10.6 10.7 5.6 ::: ::; 

4.5 0.0 8.3 11.2 2.1 0.1 

2.7 0.0 ::? 2.1 6.2 n 2.9 0.3 

83.1 0.3 57.3 168.8 140.7 76.5 36.6 9.8 0.6


29.7 0.3 45.3 76.6 27.4 2.2 0.5 0.0 

22.1 10.3 59.2 41.9 1;:; 0.8 0.0 

13.5 M 22.7 35.4 17.7 %! 1.3 0.1 

$; 7.4 19.8 15.6 6.9 1.6 0.1 

R 0.0 2.1 9.3 10.4 5.6 1.4 0.1 

3.7 0.0 0.7 5.9 9.7 6.8 2.0 0.1 

1.8 0.0 0.1 1.0 3.9 4.9 2.2 0.2 

119.8 4.1 135.2 212.1 155.9 99.1 52.4 16.8 1.2


38.4 4.0 88.2 65.6 20.2 2.0 0.5 0.0 

25.9 0.2 34.1 61.7 28.1 1%; 0.8 0.1 

16.8 0.0 10.1 41.2 27.8 12.8 ::; 

11,5 2.3 23.9 24.8 13.2 5.4 H ): 8.1 0.4 12.1 20.1 12.6 5.5 1.3 0.1 

10.1 25.2 21.4 10.7 0.1


9.0 %: ;:; 9.7 22.3 20.0 H 0.7


‘Rates computed by relating total births regardless of age of mother to women aged


15-44 years.


13,

--------

--------

--------

--------

Between 1960 and 1965 the greatest average 

declines in the white birth rates were for the 

third and fourth birth orders, but between 1965 

and 1967 the greatest average declines were for 

fifth and higher orders. The white first-birthrate 

declined during the 1960-65periodbut roseduring 

the 1965-67 period. The shift in the pattern of 

decline in birth rates by order wasnot as great 

for the nonwhite population. The largest average 

declines during the earlier period were in the 

fourth through seventh order births. During the 

later period the largest average declines were 

in the fifth and higher orders. During both the 

1960-65 and the 1965-67 periods the nonwhite 

first-birth rate increased. 

Comparisons of certain characteristics of 

white and nonwhite births such as sex ratio, 

attendant at birth, birth weight, and illegitimacy 

are presented in later sections of this report. 

State and Geographic Division 

Between 1960 and 1967 there was a year-toyear decline in the birth rates of most States. 

With this drop there was also a slight convergence 

of rates for the States. This means that declines 

were, in general, greatest for States with the 

highest rates. The decline in the coefficient of 

variation-the. ratio of the standard deviation of 

an array of rates to the arithmetic mean of that 

array, expressed as a percent—shows this convergence. In 1960 the coefficient of variation was 

10.2 percent and in 1967 it was 8.6 percent as 

shown below: 

Us. Coefficient of 

Year birth rate variation among 

States 

1960 23.7 10.2 

1965 19.4 9.1 

1966 18.4 8.4 

1967 17.8 8.6 

Between 1965 and 1967 the birthrate for the 

United States declined 8.2 percent (table 4). Four 

of the nine geographic divisions had greater decreases than the United States. They were the 

West North Central (10.2 percent), East South 

Central (9.5 percent), South Atlantic (9. Opercent, 

and Middle Atlantic (8.8 percent). 

By State, the highest birth rates in 1967 

were in Alaska (23.1), Utah (22.4), New Mexico 

(21.3), and Louisiana (20.6). The lowest rates 

were in I<ansas (15.4), Oregon (15.8), Oklahoma 

(16.1), Missouri (16.2), and Pennsylvania (16,2). 

By division, the Mountain Division hadthehighest 

birth rate, 19.4, andthe Middle Atlantic Division 

had the lowest, 16.6. 

The birth rate per 1,000 population shows the 

impact of the number of births on population 

growth but has limitations as a measure of the 

level of fertility, or the number of births per 

woman. Differences in birth rates by State and 

geographic division may be due to differences 

in the age-sex composition of the populations as 

well as to differences in the level of fertility. 

The ratio of the number of children under 5 

years of age per 1,000 women 15-49 years of 

age is probably a better measure of fertility than 

the birth rate per 1,000 total population as it is 

affected much less by differences in age-sex 

structure. Such ratios for 1967 are, however, 

available only for the four geographic regions.8 

They show a somewhat different picture than the 

birth rates. The North Central Region had the 

highest ratio (419) and the Northeast had the lowest (372). Although the South had the highest birth 

rates in the 1965-67 period, its ratio of children 

under 5 to women 15-49 ranked third (385) in 1967. 

This can be explained primarily by the fact that 

the South’s population included a larger propor ­

tion of, young adults in the childbearing ages and 

was thus more favorable for high birth rates than 

that of the North Central Region. 

Metropolitan Residence 

In 1965 there were 30 standard metropolitan 

statistical areas (SMSA‘s) with a population of 1 

million or more. For the years 1965-67 this group 

of SMSA’s had a slightly higher birth rate per 

1,000 population than the United States as a whole. 

Birth rates for each of the SMSA’S with a 

population of 1 million or more are shown by 

geographic region in table 5. In the North Central 

and South Regions the birth rates for these 

SMSA’S are higher than in the balance of the 

region. However, in the Northeast and West 

14 
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------------------------- -------------

--------------------------------------------- -----------------------------------------

-----------------------------------------

---------------------------------------------------

------------------------------------------ ----

----------------------------------------------- --------------- ------- ---

---------------------------------------------- ----------------------------------------

------------------------------------------------

---------------------------------------------------

-------------------------------------------------

------------------------------------------------

-------------- ---------------------

----------------------------------------------------

---------------------------------------------------

--------------------------------------------------

-------------------------------------------------- ------------- -----

--------------------------------------------------- -------------- ------- -----

----------------------------------------------- ----------------------------------- ------- --

-----------------------------------------------------

Table 4. Birth rates and percent change: United States,each division and State,1965.67


[See notes to tables on page VII. By place of residence] 

Division and State


United States


Geographic division


New England----"--------------------------------------------


Middle Atlantic ----”-- ------..-.----


East North Central


West North Central -----”


South Atlantic


East South Central


West South Central


Mountain


Pacific ---..----


New England


Maine.---------.---.--.--------------....---.---------------


New Hmpshire


Vzrmont -------.,------- ------..-----.-


Massachusetts


Rhode Island ------.


Connecticut


Middle AtlantCc


New York


New Jersey


Pennsylvania


East North Central


Ohio -“---------.-- -e----


Indiana --------..“---.---------.--------------.--e---------


Illinois


~Lchigan


Wisconsin


West North Central


Minnesota


Iowa --------.-------------------.-------..


Missouri


North D&kota ------..------. s------


South Dakota


Nebraska ----.--


Kansas


Percent IE1967 1966 1965 change 

1965-67 

Rate per 1,000


population


17.8 18.4 19.4 -8.2 

17.6 18.3 19.1 -7.9 

16.6 17.4 18.2 -808 

18.3 19’1 19.7 -7.1 

16.8 17.6 18.7 -10.2 

18.2 18.8 20.0 -9.0 

18.2 18.7 20.1 -9.5 

18.8 19.2 20.2 -6.9 

19.4 19.6 20.8 -6.7 

17.6 17.9 19.1 -7.9 

18.6 13.9 20.0 -7.0


18.3 18.4 19.4 -5.7


18.5 19.5 20.1 -8.0


17.5 18.1 18.8 -6.9


17.6 18.2 19.4 -9.3


17.1 18.2 19.2 -10.9


16.8 17.6 18.5 -9.2


16.6 17.5 18.5 -10.3


16.2 17.0 17.7 -8.5


17.7 18.5 19.1 -7.3


18.8 19.5 20.0 -6.0


18.0 18.8 19.6 -8.2


19.1 19.9 20.1 -5.0


18.1 19.3 20.0 -9.5


18.1 18.7 19.9 ~;.: 

17.2 17.8 18.5 

16.2 17.3 18.1 -10:5 

17.0 18.7 20.2 -15.8 

17.0 18.4 20.2 -15.8 

16.9 17.6 19.0 -11; 1 

15.4 16.1 17.5 -12.0 

15

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---------------

--------------------------------

---------------------------------------------

----------------------------------------------------

-----------------------------------------------------

---------------------------------------------------

---------------------------------------------------

---------------------------------------------------- -------------------------------- --------

---------------------------------------------------

--------------------------------------------------

---------------------------------------------------

------------------------------------------------------

----------------------------------------------------

------------------------------------------------------

----------------------------------------------------

---------------------------------------------------

-------------------------------------------------

----------------------------------------------------

-------------------------------------------------------

-----------------------------------------------------

-------------------------------------------------

-----------------------------------------------------

-------------------------------------------------

-----------------------------------------------------

-----------------------------------------------------

Table 4. Birth rztes and percent change: United States, each division and


State, 1965167—Con.


[Seenotes to tables 011page VII. By place of residence] 

Division and State 

South Atlantic


Delaware


Maryland


District of Columbia


Virginia .-----------------------


West Virginia ---------------.-.-------------

North Carolina -.--------.---


South Carolina


Georgia


Florida


East South Central


Kentucky


Tennessee


Alabama


Mississippi ------.-


West South Central


Arkansas


Lollisiana


Oklahoma


Texas


Mountain


Montana


Idaho


Wyoming


Colorado


New Mexico


Arizona


Utah


Nevada


Pacific


Washington


Oregon


Califonia


Alaska


Hawaii


Percent 

1967 1966 1965	 change 

1965-67 

Rate per 1,000 

population 

19.3 20.1 21.2


18.8 19.9 20.9


19.7 20.4 22.5


18.2 18.8 20.1


16.4 16.8 17.7


18.4 18.6 19.8


19.2 19.6 20.8


19.2 20.1 21.5


16.7 17.3 18.4


17.7 18.2 19.4


17.5 17.8 19.0


18.3 18.9 20.3


19.8 20.6 22.7


;;.: 17.7 18.9


21.5 22.4


16:1 16.3 17.5


19.1 19.4 20.4


17.2 18.0 19.4


18.3 18.7 19.3


17.8 18.0 19.9


17.8 17.7 18.9


21.3 21.8 24.0


19.8 20.1 21.5


22.4 22,5 22.4


19.3 19.9 21.8


17.8 17.4 17.8


15.8 16.6 17.0


17.6 17.9 1.9.3


23.1 24.1 26.5


20.0 20.9 23.0


-9.0


-10.0


-12.4


-9.5


-7.3


-7.1


-7.7


-10.7


-9.2


-8.8


-7.9


-9.9


-12.8


,-10.1 

-8.0


-8.0


-6.4


-11.3


-5.2


-10.6


-5.8


-11.2 :


-7.9


-11.;


-7.i


-8.8


-12.8


-13.0


16

-------------------------------------- ---------------------

-------------------------------

----------------------------------------- -----------------------------------------------

--------------- --

---------------------------------------

--------------------------------------

------------------------------------- -----------------------------------------------

-----------------------------------------

-----------------------------

--------------------------------------

----------------------------------------

--------------------------------

---------------------------

--------------------------------------

--------------------------------------------- -------------------------------------------- ---

------------------------------

--------------------------------------

----------------------------------------------

----------------

------------------------

---------------

-------------------------------------

-------------------------

---------------------------------------- --------------------------------------

Table 5. Birth rates for standard metropolitan statistical areas with populations of


1,000,000 or more in 1965 and percent change: United States and each region, 1965-67


[See rrotesto tables on page VII. By place of residence. SMSA’Sareascurcentlv defined by the Bureau of the Budget and used 

by the Bureau of the Census] “ 

Area


United States


30 SMSA’S -------.-----------


Balance of country


No;t~~~~sRegion


Bos~on-Lowell-Lawrence, Massl,,--------


Buffalo, N.Y-----------------------------------------


New York, N.Y----------------------------------------


Newark, N,J------------------------------------------


Patterson-Clifton-Passaic, N.J-----------------------


Philadelphia, Pa-------------------------------------


Pittsburgh, pa


Balance of region


No;t;M~fi~ral Region


Chicago, 111 

Cincinnati, Ohio-Ky, -Ind 

Cleveland, Ohio 

Detroit, Mich 

Indianapolis, Ind------------------------------------

Kansas City, Mo.-Kans 

Milwaukee, Wis---------------------------------------

Minneapolis-St. Paul, Mien 

St. Louis, Mo.-I11-----------------------------------

Bala~ce of region


So;t~~R;~~on


Atlanta, Ga------------------------------------------


Baltimore, MdT---------------------------------------


Dallas, Tex------------------------------------------


Houston, Tex-----------------------------------------


Miami, Fla-------------------------------------------


New Orleans, La--------------------------------------


Washington, D.C.-Md.-Va


Balance of region


West Region


7 SMSA's-----------------------------------------------


Anaheim-Santa Aria-Garden Grove, Calif


Denver, Colo----------------------------=------------


Los Angeles-Long Beach, Calif


San Bernadino-Riverside-ontario, Calif


San Diego, Calif


San Francisco-Oakland, Calif


Seattle, Wash


Balance of region


1 

Percent


1967 1966 1965 change


1965-67
 II

Rate per 1,000


population


17.8 18.4 19.4 -8.2


17.9 18.6 19.5 -8.2


17.7 18.3 19.4 -8.8


16.9 17.6 18.5 -8.6


16.7 17.6 18.5 -9.7


17.7 18.3 19.0 -6.8


17.4 18.3 19.1 -8.9


16.8 17.7 18.6 -9.7


16.4 17.6 18.3 -10.4


15.3 16.3 17.1 -10.5


17.0 17.8 18.9 -10.1


15.1 16.2 16.9 -10.7


17.1 17.7 18.6 -8.1


17.8 18.5 19.4 -8.2


18.7 19.6 20.3 -7.9


19.0 19.7 20.4 -6.9


18.5 19.3 20.3 -8.9


17.4 18.3 18.9 -7.9


18.8 19.7 20.0 -6.0


19.8 20.4 21.2 -6.6


17.5 18.6 20.0 -12.5


18.9 20.4 20.7 -8.7


20.3 20.6 21.7 -6.5


18.0 19.1 20.2 -10+9


17.2 17.9 18.8 -8.5


18.3 18.9 20.1 -9.0


19.2 20.0 20.8 -7.7


19.9 20.7 21.6 -7.9


18.2 19.4 20.0 -9.0


19.8 19.9 20.5 -3.4


19.9 20.3 20.7 -3.9


15.2 16.4 16.5 -7.9


20.4 21.5 22.5 -9.3


20.2 21.0 22.5 -10.2


18.1 18.7 19.9 -9.0


18.0 18.4 19.5 -7.7


18.0 17.9 19.1 -5.8


18.8 19.4 21.1 -10,9


18.4 18.4 19.2 -4.2


17.9 18.0 19.3 -7.3


L7.4 18.3 19.8 -12.1


18.1 17.8 19.4 -6.7


17.7 16.8 18.3 -3.3


18.5 17.7 17.6


18.1 18.8 19.8 -2:;


‘lfassachusettsstate Economic Area C. 17.

--------------------

--------------------------

-------------------------

----------------------- --------------------------

Regionsrates for the SMSA’S as a group are


lowerthanfortheremainderoftheregion.


Exceptionstothegeneraldecline
infertility 

over the1965-67 period may be seen in the West 

Region. One SMSA (Seattle, Washington) showed 

an increase in its birth rate between 1965 and 

1966, and three SMSA’S showed increases from 

1966 to 1967. 

Differences in the age-sex composition of 

the populations must also be considered when 

comparing the birth rates of metropolitan areas. 

Areas with a large proportion of young married 

couples tend to have high birth rates. From table 

5 it appears that the SMSA’S have slightly higher 

fertility than the rest of the country. Ratios of 

children under 5 to women 15-49, however, indicate that the metropolitan areas of the United 

States have somewhat lower fertility than the nonm&ropolitan areas. The respective ratios were 

384 and 412 per 1,000 in 1967. 

CHARACTERISTICS OF BIRTHS 

The following sections deal with certain 

characteristics of births for which all or most 

registration areas provide information. The 

characteristics discussed include sex ratio, month 

of birth, attendant at birth, birth weight, gestation, 

plurality, and illegitimacy. 

Sex Ratio 

The sex ratio for live births in 1967 was 

1,050 males per’ 1,000 females. Since 1940 this 

ratio has changed very little, ranging between 

1,047 and 1,058. The ratios for the two major 

color groups also have varied little in this 

period—between 1,052 and 1,063 for white births, 

and between 1,011 and 1,033 for nonwhite births. 

During 1965-67 the sex ratio for white births 

averaged 1,055 males per 1,000 females; the ratio 

for Negro births was considerably lower, averaging 1,022. For the smaller racial groups the 

ratios varied widely, between 1,066 for the 

Chinese and 1,036 for the American Indians 

(table 6). 

A comparison of the sex ratios for single 

and plural births during 1965-67 indicates that 

there was a significantly higher proportion of 

males in single than in plural deliveries (table 7). 

Table 6. Sex ratio at birth,by specified


race: United States,average for 1965-67


[See notes to tables cm page VII] 

Males per 

Race 1,000 

females 

Total


+


White 

Negro--------------------------
 Indian


Chinese------------------------
 Japanese


Other


1 

1,050 

1,055 

1,022 

1,036 

1,066 

1,049 

1,062 

This was true also for white and nonwhite births 

considered separately. However, regardless of 

plurality, the sex ratio for white births was 

higher than the ratio for nonwhite births. 

Sex ratios calculated for births in 1967 

classified by live-birth order and age of mother 

are shown in table 8. In general the ratios decrease with age of mother and with each successively higher birth-order group. However, 

there is no consistent pattern in the ratios for 

any single birth order cross -classified with any 

age-of-mother group. 

Month of Birth 

The occurrence of lirths is not uniform 

throughout the year. In recent years, as in previous years, the distribution tends to be birnodal 

with the major peak in September and the minor 

peak in February. The months with the smallest 

proportions of births are generally April and 

May. Table 9 shows the monthly indexes of live 

births for the United States since 1960. These 

indexes are the ratios of the actual number of 

births in a month to the average monthly number 

for the calendar year multiplied by 100 and adjusted for the varying number of days per month. 

The seasonal patterns of white and nonwhite 

births are about the same. However, the degree of 

seasonality, as measured by the standard devia-, 

18

--------------------------------------------

-----------------------------------------------

-----------------------------------------------

--------------------------------------------

-----------------------------------------------

-----------------------------------------------

--------------------------------------------

-----------------------------------------------

-----------------------------------------------

---------------------

------------------------

------------------------

------------------------

------------------------

------------------------

------------------------

Table 7. Sex ratio at birth, by color and plurality: United States, 1965.67


[See notes to tables on page VII] 

Color and plurality


-

Males per 1,000 

Total females 

All live births 1,051 ===k=-

Single live births 1,051 1,049 1,052 

Plural live births 999 1,019 1,023 

White


All live births 1,056


Single live births 1,057 1,054 1,056


Plural live births 1,007 1,023 1,033


Nonwhite


All live births 1,028


Single live births 1,021 1,026 1,029


Plural live births 969 1,005 986


Table 8. Sex ratio at birth,by live-birth order and age of mother: United States, 1967


[See notes to tables on page VII] 

Live-birth order


Age of mother


Total 1 2 3 4 5 6 and


births over


Males per 1,000 females


All ages 1,050 1,060 1,049 1,048 1,046 1,035 1,026

-

15-19 years 1,053 1,052 1,058 1,044 1,091 “1,141 1476 

20-24 years 1,053 1,061 1,046 1,046 1,058 1,032 i,o12 

25-29 years 1,050 1,072 1,057 1,058 1,027 1,021 1,019 

30-34 years 1,048 :,;:: 1,027 1,051 1,073 1,045 1,017 

35-39 years 1,043 1,068 1,019 1,032 1,053 1,048 

49-44 years 1,007 1; 10: 969 I970 967 1,025 1,021

~’Ratiobased on fewer than 1,000 births.


19

-------------------

---------------------- -------------------------

--------------------------

-------------------------- ------------------------ --------------------- -----------------------

----------------------

----------------------

Table 9. Monthly indexes of live births: United States, 1960-67 

[See notes to tables on pageVII] 

Month of occurrence 1967 1966 1965 1964 1963 1962 1961 1960 

Monthly index 

Total 100.0 100.0 100.0 100.0 100.O1 100.0 

.Ta.nuary ----------------------- 98.0 95.9 97.9 97.4 97.5 97.2 97.5 95.8 

February 99.5 99.0 99.9 99.8 98.9 99.5 100.0 97.7 

March 99.3 99.1 99.4 97.4 97.8 99.1 99.4 97.0 

April ------------------------- 93.5 96.8 94.9 94.9 95.9 95.7 95.5 93.8 

May--------------------------- 97.2 95.6 96.0 95.9 96.0 94.7 94.5 92.4 

June 100,2 98.7 99.7 100.7 98.6 95.8 97.5 95.3 

July 103.5 101.4 104.2 105.0 103.6 102.6 103.0 103.8 

August 104.8 104.9 105.4 104.0 105.5 107.1 106.3 108.8 

September 106.6 107.7 107.9 107.7 108.4 107.7 1D7.6 111.0 

October 101.4 102.2 100.4 102.1 102.5 102.7 102.1 102.7 

November 98.2 100.0 97.7 98.0 97.6 98.9 98.8 100.2 

December 97.7 98.7 96.5 97.0 97.7 98.8 97.8 101.4 

NOTE: Index ia ratio of number of births in month to average monthlv number for 

the year multiplied by 100. Adjustment has been made for vary%g numbe; of days per 

month. 

tion of the monthly indexes, is greater for the 

nonwhite than for the white births.Table lOshows 

the monthly indexes and standard deviations by 

color for 1965-670 

By removing the seasonalcomponent fromthe 

monthly series of birth and fertility rates, the 

underlying trend can be seen more easily. Seasonally adjusted birth and fertility ratesforl965-

67 are shown intable 11. The declineduring 1965 

was fairly well distributed throughout the year. 

During 1966 and 1967, however, there was a 

greater decline in the first half of the year than 

in the latter half. 

A more complete discussionofseasonal variation may be foundinSeasonul VaviationofBiYths, 

United Stites, 1933-63.9 

Attendant at Birth 

In 1967, 98.3 percent of all live births were 

classified as having been delivered by physicians 

in hospitals. The corresponding percentages for 

white and nonwhite births were 99.4 and 92.9, 

respectively. According to this classification deliveries by “physicians in hospitals’’ ’include all 

births in hospitals or institutions and thosebirths 

attended by physicians in clinics. 

For the white population the most rapid increase in the proportion of medically attended 

hospital deliveries occurred during the early 

1940’s. The percentage of white births delivered 

by physicians inhospitals rose from 59.9in 1940 

to84.3 in1945. Since 1948 thisproportionhas been 

over 90 percent. 

In contrast, substantial gains continue inthe 

proportion of hospital deliveries for nonwhite 

births. In19400nly 27 percent ofnonwhite births 

were delivered by physicians in hospitals. By 

1950 this proportion had more than doubled, 

increasingto 57.9 percent.Byl 967thepercentage 

had reached 92.9. 

The proportion of births deliveredby physicians in places other 

has declined steadily 

to only 0.4 percent in 

proportions for white 

than hospitals or clinics 

from 7.1 percentin 1950 

1967. The corresponding 

and nonwhite births have 

20 
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--------------------------------------- -------------- ---------------------------

----------------------------------------

---------------- ----------------

-------------------------------------- ------- --------------

-------------------------------------

------------------------------------

------------------------------------

-------------- -------

-----------------------------------

---------------------------------- ---------------- ---------------- -----

-------------------------------------

---------------- -------- --------------

-------------------------------------- ---------------- -------- ------------

---------------------------------

-----------------------------------

-------- -----------------

----------------------------------

Table 10. Monthly indexes of live births and standard deviations, by color: United


States, 1965-67


[See notestotables orI
pageVIJ]

Month of occurrence


Total


January-------------------;-----------------


February


March


April


May


June


July -.------


August


September ---.-----”----


October


November


December


Total ------. -.---


1967 1966 1965


White Non - White Non-


white white


T


Monthly index


100.0 100.0 100.0 100.0 100.0 100.0 

97.3 101.6 94.6 102.4 97.1 101.9


99.2 100.9 98.2 103.2 99.8 100.4


99.8 96.7 99.3 97.8 100.2 95.1


94.6 88.4 97.5 93.1 95.8 90.2


98.5 90.7 96.4 91.9 96.8 92.3


100.7 97.9 99.5 94.7 100.4 96.6


102.7 107.7 101.0 103.3 103.7 106.6


104.0 108.3 104.3 107.8 104.9 108.2


106.3 108.1 107.7 107.7 107.7 109.0


101.5 101.3 102.6 100.0 100.2 10J.;


98.0 99.2 100.2 99.3 97.3 

97.5 99.0 98.7 99.0 96.1 98:7 

Standard deviation 

3.2 6.3 3.6 5.2 3.8 6.() 

NOTE : Index is ratio of number of births in month to average monthly number for 

the year multiplied by 100. Adjustment has been made for varying number of days per 

month.


Table 11. Seasonally adjusted birth and fertility rates, by


United States, 1965-67


[Seenotestotables 011
page VII]

Birth rates


Month of occurrence


~


January


February


March


April


May---------------------------------------


June


July


August


September


October


November -.------ -


December


Rate per 1,000


population


18.4 18.6 20.0


18.2 18.7 19.9


18.1 18.7 19.8


17.7 19.0 19.6


18.1 18.5 19.6


18.0 18.3 19.6


17.7 17.9 19.4


17.6 18.2 19.3


17.5 18.2 19.2


17.5 18.3 18.9


17.4 18.4 18.9


17.4 18.2 18.8


month of occurrence:


Fertility rates


~


Rate per 1,000 women


15-44 years of age


90.9 92.4 99.7


89.8 92.8 99.0


89.5 93.0 98.8


87.7 94.3 97.4


89.6 91..7 97.5


88.5 90.9 97.6


87.0 88.7 96.6


86.6 90.3 95.9


85.9 90.3 95.5


86.2 90.3 93.8


85.5 90.8 93.9


85.7 90.2 93.4


21


.

--

---------------

------

------------------------

--------

------ ------------------------

--------

---------------

---------

------ ------------------------

--------

also declined to very low levels: 0.3 and 1.1 

percent, respectively, in 1967 (table 12). 

The proportion of births attended by midwives in 1967 was 1.1 percent, or less than onefourth of the proportion in 1950. Births attended 

by midwives have declined considerably for both 

the white and nonwhite populations. Within the 

nonwhite group, for example, the proportion of 

such births declined from 26.1 to 5.4 percent between 1950 and 1967. 

Table 12 shows that type of residence is an 

important factor in the distribution of nonwhite 

births by attendant. In fact, much of the whitenonwhite differential in medically attended hos ­

pital deliveries would disappear if births occurring only in urban places were considered. In 

1967, 99.4 percent of white births and 97.6percent 

of nonwhite births in urban places with populations of 10,000 or more were delivered by 

physicians in hospitals. In cormrast, 99.4 percent 

of white births and 82.6 percent of nonwhite 

births in places with populations of less than 

10,000 were deliv~fed by physicians in hospitals. 

The differential by &pe of residence in the 

rate of hospital utilization within the nonwhite 

group has declined considerably since 1950. In 

that year the rate was 82.4 percent in urban 

places with populations of 10,000 or more and 

3ZG1 percent in the other areas (tabie 12). Proportions of nonwhite births delivered by midwives 

‘fable 12. Percent distributim OE live births by attendant, according to color and type of residence:


United States, 1950, 1960, and 1967


[sw notes to rabl.s o.PW?C,
VU]

Year and type of residence


1967 1:,~
,] 1950
 Color and attendant


United Urban Other United Urban Other


States places] areas States placesl areas


Total Percent distribution


All births 100.0 100.0 100.0” 100.0 100.0 LOO.O 100.0 100.O	 100.0 

_ 

Physician in hospital ~--------- 98.3 99.0 97.4 96.6 98.3 94.7 88.0 95.7 80.0


Physician not in hospital 0.4 0.3 0.5 1.2 0.8 1.6 2.6 11.7


Midwife 1.1 0,5 1.9 2.0 0.8 1:: 7.7


Other and not specified 0.2 0.2 0.2 0.2 0.2 ;:; 0.4 ::; 0.6


White


All birth s--------------- 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100,0 100,0 

Physician in hospital~--------- 99.4 99.4 99.4 98.8 99.1 98.3 92.8 97.9 87.5 

Physician not in hospital 0.3 0.2 0.3 0.7 0.5 5.9 10.4 

Midwife g.; 0.2 0.3 ;:: i:; 1.7 

Other and not specified ::? 0.1 ::: 0.1 0.2 ::; 0.1 0.4 

Nonwhite


All births 100.0 100.0 100.0 ioo.o 100.O 100.0 100.0 100.0 100.0 — 

Physician in hospitals 92.9 97.6 82.6 85.0 94.5 68.0 57.9 82.4 32.1


Physician not in hospital 0.7 3.5 2.3 5.4 14.3 9.3 19.7


N!idwife ;:: 1.2 1::; 11.0 2.8 25.7 26.1 7.2 46.0


Other and not specified 0.6 0.5 0.9 0.5 0.3 0.8 1.7 1.2 2.2


lplaces Of Io,oGO or more residents.


21ncludes all births in hospitals or institutions and births attended by physicians in clinics. A


very large proportion of births in hospitals are attended by physicians,


22 
---------

--------------

----------------

--------------

----------------

--------------

----------------

. 

-k. 

also differ greatly by type of residence. However, 

regardless of type of residence, the proportion of 

births attended by midwives has declined substantially since 1950. In that year 7.2 percent of 

nonwhite births in urban places with populations 

of 10,000 or more and 46.0 percent of nonwhite 

births in other areas were delivered by midwives. 

By 1967 these proportions had declined to 1.2 and 

14.6 percent, respectively. 

Table 13 shows that in six of the nine geographic divisions of the United States at least 99 

percent of all births were delivered by physicians 

in hospitals in 1967. In the three divisions of the 

South Region, however, rates of hospital utilization ranged only from 92 to 97 percent. Geographic differences in the proportions of births 

occurring in hospitals are considerably wider 

for the nonwhite population than for the white 

Table 13. Percent distributionof live births by attendant,accmding to color: United States


and each division, 1967


[Seenotes totables
 onpageVII]


Geographicdivision


I I I I
 United Color and attendant States New Middle East West South East West 

North North At- South south Moun- PaEng- At- Cen- Cen- Cen- Cen- tain cific
 land lantic tral ~ra~ lantic ~
 tral tral


I I I 

Total Percent distribution


All births 100.0 100.0 100.0 100.30 100.0 100.0 100. O 100.0 10000 100.0 —-

Physician in hospitall - 98.3 99*9 99.6 99.4 99.6 96.7 92.4 96.2 99.0 99.4 

Physician not in 

hospital 

Midwife 

0.4 

1.1 

0.1 0.3 

0.0 

0.3 

0.0 

0.2 

0.1 

0.6 

2.5 R 

0.4 

3.0 

0.4 

0.2 

0.4 

0.0 

Other and not 

specified------------- 0.2 0.0 0.1 0.2 0.1 0.2 0.3 0.4 0.4 0.2 

White


All births---------- 100.0 100.0 100.0 100.0 Loo.0 100.0 100.0 100.0 100.0 100.0


Physician in hospitall- 99.4 99.9 99.7 99.6 99.7 99.6 99.1 97.3 99.2 99.4


Physician not in


hospital 0.1 0.2 0.2 0.2 0.4 0.3 0.4


Midwife ::; 0.0 ::: 0.0 0.2 0.4 2.2 0.2 %:


Other and not


specified------------- 0.1 0.0 0.1 0.1 0.1 0.1 0.1 0.3 0.3 0.1


Nonwhite


Midwife 

All births--------- 100,0 100.0 100.0 100.0 100.0 100.0 10000 100.0 100.0 100.0 

Physician in hospitall- 92.9 99.8 99.2 98.3 98.2 89.6 75.2 92.2 97.7 

Physician not in 

hospital 0.2 0.7 0.7 0.7 1.6 0.8 0.5 ;:; 0.0 0.0 0.9 8.3 2::: 6.0 0.3


Other and not


specified------------- 0.6 0.2 1.0 0.2 0.5 0.7 1.0 106


l~ncludes all births in hospitals or institutions and births attended by physicians in clinics.


A very large proportion of births in hospitals are attended by physicians.


23

------------------------ ------

----------------------------

-------------- -------

------------------

-----------------------------

population. Within the white group the rate of 

hospital utilization falls below 99 percent only 

for the West South Central Division (97.3 percent). In contrast, within the nonwhite group the 

proportion of births occurring in hospitals varies 

substantially, from only 75.2 percent in the East 

South Central Division to 99.8 percent in the New 

England Division. Large numbers of births are 

attended by midwives within those divisions with 

low proportions of medically attended hospital 

deliveries. For example, slightly more than onefifth of all nonwhite births in the East South Central Division were delivered by midwives in 1967. 

Numbers of births classified by attendant 

for States and certain local areas are shown in 

Volume I of the annual report Vitul Statistics o~ 

the United States. 

Birth Weight 

Almost 92 percent of the babies born in 1967 

were mature in terms of birth weight, weighing 

more than 2,500 grams (5 pounds 8 ounces). The 

remaining 8.2 percent were immature (2,500 

grams or less) according to the birth weight criterion. The proportion of babies that are immature is a good index of future health because 

of the high level of morbidity and mortality in 

this low-birth-weight group. 

This report emphasizes differentials in birth 

weight and gestation by color, sex, age of mother, 

and live-birth order, with some discussion of 

changes between 1960 and 1967. A thorough discussion of the data on birth weight and period 

of gestation describing trends since 1950, the 

Table 14. Median birth weight and immature live births as percent of total births, by 

color and sex: United States, 1960, 1965, 1966, and 1967 

[See notestotables cm page VII] 

Median birth weightl


Color and sex


1967 1966 1965 1960


Total Weight in grams I 

Both sexes------------------ 3,280 3,280 3,290 3,310 — — 

Percent of live


births immature


EEEIEIE


Percent 2,500 grams


or less


Male


Female


White


Both sexes------------------


Male ------------------------------ Female ------.


Nonwhite


Both sexes 

Male ------------------------------

3,340 3,340 3,350 3,370 

3,220 3,220 3,230 3,250 

3,310 3,310 3,320 3>340 

3,380 3,370 3,380 3,400 

3,250 3,250 3,260 3,280 

3,120 3,120 3,130 3,150 

3,170 3,180 3,180 3,210 

Female , 3,070 3,060 3,070 3,100 

8.2 I 8.3


701 7.2


6.6 6.7


7.7 7.8


t 

13.6 13.9 

12.4 12.5 -F
 14.8 15.2

8.3 7.7


;:: ;:;


7.2 6.8


6.6 6.3


7.8 7.4
 T

13.8 12.8


12.4 11.6 

15.1 14.1 

lComputed to nearest 10 grams on basis of exact conversion of interval limits from


pounds and ounces. 

NOTE: An immature birth is one weighing 2,500 grams (5 lb. 8 OZ.) or less. 

24

----------------

first year for which these data were collected, 

may be found in Natality Statistics Analysis, 

Un<ted States, 1962. 

The differentials in birth weight between 

white and nonwhite infants are significant. In 

1967 the median weight for nonwhite babies 

(3,120 grams) was 190 grams less than that for 

white babies (3,310 grams), reflecting a considerably higher incidence of immaturity among 

nonwhite infants (13. 6 percent) than among white 

infants (7.1 percent). 

Birth weight varies by sex of the child. Male 

babies weigh more, on the average,than femaIe 

babies regardless of color, as can be seen in 

table 14. However, the median weight of white 

female infants is greater than that for nonwhite 

babies of either sex. 

Between 1960 and 1967 the median birth 

weight for all babies declined IYom 3,310 grams 

to 3,280 grams. There was also an increase in 

the proportion of immature births, from 7.7 percent in 1960 to 8.2 percent in 1967. The trends 

in median birth weight and immaturi~ for male 

and female babies within each color group followed 

quite similar patterns. 

The proportion of infants weighing 2,500 

grams or less is higher among babies born to 

mothers residing in metropolitan than in nonmetropolitan counties, regardless of color, as 

shown in table 15. Between 1960 and 1967 the 

incidence of immaturi~ increased in both metropolitan and nonmetropolitan counties, but the 

relative increase was somewhat greater within 

the nonmetropolitan counties. 

The proportion of immature infants varies 

considerably with age of mother. In 1967 the 

.meatest incidence of immaturity was among births 

to young mothers less than 20 years of age and 

to a lesser extent to older mothers 35-44 years 

of age (table 16). Variation within each color group 

Table 15. Immature births as percent of total live births,by color,type of residence, and metropolitan and nonmetropolitan counties: United States, 1960, 1965, 1966, and 1967 

Type of county


and year


United States


p:------------------ ..-

1965------------------


1960------------------


Metropolitan counties


1967------------------


1966------------------


1965------------------
 1960------------------


Nonmetropolitan


counties


1967------------------


1966------------------


1965------------------


1960------------------


[See notes to tablesonpageVIfl


Color and type of residence


Total White Nonwhite


All Urban Other All Urban Other All Urban Other
 areas placesl areas areas placesl areas areas placesl areas


Percent immature


8.2 8.9 7.4 6.8 13.6 14.3 12.0 

8.3 9.0 x 13.9 14.7 12.0 

8.3 8.9 E 7.2 ::; 13.8 14.6 12.1 

7.7 8.3 7.0 6.8 6.5 12.8 13.9 11.0


8.4 9*O 7.1 7.2 6.7 14.2 14.4 12.4


7.3 7.3 6.8 14.6 14.8 13.0
 ::: R 703 14.5 14.8 12.9


8.0 8.4 6.8 ::; ::: 13.7 14.0 12.1


7.8 8.1 7.6 7.0 6.9 12.2 13.5 11.8 

8.4 7.7 7.1 6.9 12.3 14.2 11.7 R 8.3 6.9 12.2 13.4 11.8 

7.3 7.7 H R 6.6 11.1 13.1 10.6 

‘Places of 10,000 or more residents.


NOTE: An immature birth is one weighing 2,500 grams (5 lb. 8 oz.) or less.


25

-------

----- --------

--------

--------

--------

--------

-------- --

-----------

-------- -----------

-----------

----------- -------------- -----------

----------------

was similar to the variation for all births except 

that for the nonwhite group the rise in the rate 

of immaturity at ages over 34 was less pronounced. 

Within each age-of-mother group the incidence of 

immaturity was higher among nonwhite births than 

among white. 

Variations in the proportion of immature 

births by age of mother are related to the differences in birth-order dismibutions within each 

age group. The highest percents of immature 

births are among high-order births to young 

mothers and low-order births to older mothers. 

Birth weights appear to be most favorable when 

the age of mother and live-birth order are highly 

correlated, that is, for lower -order births to 

younger women and higher-order births to older 

women. This can be illustrated by a comparison 

of the white and nonwhite data for 1967. For 

example, the percent of immature births to nonwhite mothers 35 years and “over was comparatively 1ow—13.0 percent—about 0.6 of a percentage point less than the proportion immature 

for all nonwhite births. On the other hand, the 

proportion of immature births to white mothers 

of this age was relatively high—8.4 percent as 

compared with 7.1 percent for all white births. 

These differing patterns in relative levels of 

immaturity may be explained at least in large 

part by differences in birth-order composition. 

That is, 71.5 percent of the births to nonwhite 

mothers 35 years and over were fifth and higher 

order compared with only 49.3 percent for white 

mothers of comparable age; but the proportion of 

first and second order births to the nonwhite 

mothers was just 10.1 percent compared with 

15.4 percent for the white mothers. These findings 

suggest that both timing of births and size of 

family are important in determining the proportion of immature births in both major color 

groups. 

Gestation Period 

The length of the gestation period is an important factor in determining the weight of an 

infant at birth. The most reliable method developed so far to determine the length of pregnancy 

is to measure it from the first day of the mother’s 

last normal menstrual period (LMP). In 1966 

five of the 54 registration areas required the reTable 16. Imnature live births as percent of total live births in each group, 

bv color and age of mother: United 

S&ates, 1967 -

[See notes to tables on page VII] 

Age of mother 

II 

Percent immature 

All ages 13.6 

Under 15 years 17.2 12.5 19.5 

15-19 years 10.5 8.5 15.7 

20-24 years 7.7 6.7 13.2 

25-29 years 7.2 6.5 11.8 

30-34 years 12.6 

35-39 years ;:? R 13.3 

40-44 years 9.6 9.1 12.2 

45 years and over 8.6 8.1 10.7 

II 

NOTE: An immature birth is one weighing

2,500 grams (5 lb. 8 oz. ) or less. 

porting of this date on their birth certificates: 

Baltimore, California, the District of Columbia, 

New York City, and Rhode Island. 

Data on gestation for the other registration 

areas are based on the physician’s estimate of 

the length of pregnancy. Consequently the data 

for the entire United States are not as accurate 

as the data from the five LMP reporting areas. 

The following tabulation compares the distribution 

of births in 1966 by gestation period for the areas 

reporting the date of LMP with that for the United 

States as a whole: 

Gestation period 

Total 

Under 20 weeks 

20-27 weeks 

28-31 weeks 

32-35 weeks 

36 weeks 

37-39 weeks 

40 weeks -=------------ 41-42 weeks 

43 weeks and over 

Areas United report ing States LM?. 

100.0 100.0 

0.0 0.0 

0.6 0.7 

0.8 1.2 

2.5 

2.9 ;:: 

17.3 38.9 

66.4 22.6 

8.1 21.8 

1.5 6.3 

26 
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The most important limitation of the data for the 

United States as a whole is the very heavy concentration of births at 40 weeks of gestation 

(66.4 percent in 1966). It is likely that most 

normal babies weighing 6 to 9 pounds are considered full term and the period of gestation is 

therefore often reported as 40 weeks. However, it 

is not likely that such a large proportion of infants actually arrive exactly “on time.” The margin of error is probably about 2 weeks in either 

direction 

The more reliable data from the five LMP reporting areas support this contention. Accwrdingto 

these data only 22.6 percent of all babies were 

born at gestations of exactly 40 weeks. In addition 38.9 percent were born at 37-39 weeks, and 

21.8 percent at 41-42 weeks. 

Table 17. Median birth weight by color 

and period of gestation: Bal”ti,lnore, 

California, District of Columbia, New 

York City, and Rhode Island combined, 

1966 

[See notes to tables cm page VD] 

Period of 

gestation Total White ‘O?­ whxte

I 

1[ I 

Median birth weight 

in grams2 

All periods 3,256 3,291 3,103 

20-27 weeks 904 878 939 

28-31 weeks 1,784 1,733 1,881 

32-35 weeks 2,639 2,634 2,643 

36 weeks 2,865 2,880 2,822 

37-39 weeks 3,184 3,210 3,077 

40 weeks 3,353 3,373 3,246 

41-42 weeks 3,439 3,465 3,297 

43 weeks and over-- 3,419 3,455 3,266 Ir 

‘The period of gestation is measured 

menstrual ‘rem ‘he ‘irst period. ‘ai%A~;fp~$od;;s;n~~; 

not stated period of gestation, which is 

not distributed. 

2Computed to nearest gram on basis of 

exact conversion of interval limits from 

pounds and ounces. 

Beginning with the 1968 data year 37registration areas are requesting information on the 

date of themotier’ slastnormalmenstrual period 

on their birth certificates. This will make it 

possible to analyze more precisely thereIationships betweenlengthofgestationmdotier characteristics of births for a substantial part of the 

United States. 

Tlielength ofgestation is also usedto define 

prematuri~. Babies born before 37 weeks of 

gestation are considered premature. For the 

LMP reporting areas 10.3 percent ofthe infants 

born in 1966 were premature. The comparable 

proportion for the United States asa whole was 

6.8 percent. 

In general the period of gestation and the 

infant’s birth. weight are closely associated. 

Table 17 shows the median weight ateach gestation interval for births in 1966 inthefive LMP 

reporting areas. The median birth weight increased at each gestation interval through 41-42 

weeks. For babies born after aperiodofgestation 

of 43 weeks or more there tended tobea slight 

decline in median weight. 

Ithas,been shown thatnonwl&e babies weigh 

less at birthon theaveragethan whitebabies. For 

babies born in the LMPreporting areas in1966, 

this was true only forinfantsbom after35 weeks 

of gestation. Nonwhite infants born before the32d 

week of gestation weighed somewhat more than 

white babies. This finding has been corroborated 

by other investigators, some of whom havehypothesized that at these early gestation intervals 

thenonwhite fetus matures more rapidly.l”,ll 

Multiple .Births 

The rate ofoccurrence ofmuhiplebirths may 

be measured by the ratio of the number oflive 

bir’ths in multiple deliveries per 1,000 total live 

births. In 1967 this ratio was 19.7. There has 

been only a slight decline in this ratio since the 

late 1950’s (see table 18). 

The proportion of live births that were part 

of a multiple delivery has been greater for the 

nonwhite population than for the white. Among the 

nonwhite births in 1966 the multiple birth ratio 

was 24.6, while for white births it was 18.8. The 

multiple birth ratio rises with age of mother to 

27 
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Table 18. Number of live births in plural


deliveries and ratio of plural live


births to total live births: United


States, 1956-67


[See notes to tables on page VII] 

Number of


live births Ratio per


Year 1,000 live


Table 19, Ratio of plural live births to


total live births, by color and age of


mother: United States, 1966


[Seenotestotables
 onpage‘~’11]


Age of mother 

All ages


15-19 years


20-24 years


25-29 years


30-34 years


35-39 years


40-44 years


Ratio per 1,000


total live births


19.8


12.4


17.5


22.0


26.5


29.1


22.0


18.8 I 24.6 

11.6 I 14.8 

16;6 22.8 

20.6 30.1 

24.9 35.2 

27.4 37.7 

21.8 22.8 

in plural births
 deliveries


69.365 19.7


71;312 19.8


75,606 20.1


80,156 19.9


81.158 19.8


81;306 19.5


86,100 20.2


86,684 20.4


87.654 20.6


86;610 20.6


87,158 20.5


88,816 21.3


1967------------


:%;------------


i964------------


1963------------


1962------------


1961------------


1960------------


1959------------


1958------------


1957------------


1956------------


Table 20. Median birth weight and percent distribution of live births by birth weight,


according to plurality: United States, 1966


[See notes to tablee on page VII] 

Birth weight


Total


Total


2,500 grams or less


2,501-3,000 grams


3,001-3,500 grams


3,501-4,000 grams


4,001-4,500 grams


4,501-5,000 grams


5,001 grams or more


Plurality


I I


Median	birth weight


in grams


3,2901 2,420 I1,71O


Percent distribution


100.0 100.0 100.0 

7.4 55.4 ‘9.0.0


19.6 29.2 7.7


38.9 12.9


25.8 2.3 ;:;


6.8 0.2 0.2


1.2 0.0


0.2 0.0” 0.2,


28 
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the 35-39 age group -and then declines slightly. 

At ages 35-39 the chances of plural births were 

nearly 2%times as great as at ages 15-19 in 1966. 

This relationship holds for both white and nonwhite births (table 19). 

A more detailed analysis of the occurrence 

of multiple births by age of mother, live-birth 

order, and color may be found in a recent 

report.lz” 

Live births occurring in twin and higher multiple deliveries have lower birth weights and 

larger proportions with periods of gestation of 

less than 37 weeks. In 1966 over half of the twins 

and over three-fourths of the ~iplets and infants 

in other multiple deliveries weighed 2,500 grams 

or less at birth (table 20). A similar relationship 

with plurality is seen for the proportion of births 

with gestation periods of less than 37 weeks. The 

percentages in 1966 were 6.3 for single live 

births, 31.7 for twins, and 64.4 for other plural 

live births. 

Illegitimacy 

fie number of illegitimate births in the 

United States in 1967 was estimated at 318,100, 

accounting for about 9 percent of the 3,520,959 

live births recorded in that year. 

National estimates of the number of illegitimate births have been prepared annually since 

1938. These estimates are based on information 

entered on the birth certificates of the States 

which require the reporting of legitimacy status. 

In 1967, 34 States and the District of Columbia 

required this information. In making estimates 

for the United States as a whole, the States are 

grouped into nine geographic divisions. The ratio 

of illegitimate births to total Iive births for the 

residents of States. reporting legitimacy status 

in each division is then applied to all live births 

occurring to residents of that division. This 

yields an estimate of illegitimate births for the 

geographic division. This estimating procedure 

is done separately for white and nonwhite births, 

which are subsequently added. The sum of these 

estimates for the nine geographic divisions makes 

up the estimate for the United States. 

The number of illegitimate births estimated 

for the entire United States has risen annually 

since 1940 with only one exception. During the 

period 1940-67 the estimated total increased by 

3?4 times, from 89,500 in 1940 to 318,100 in 1967 

(table 21). 

T’rends in the number of illegitimate births 

are influenced by (1) changes in the “risk” that 

an unmarried woman will bear an illegitimate 

child (as measured by the illegitimacy rate) and 

(2) changes in the number of unmarried women in 

the reproductive ages. 

Table 21. Estimated number of illegitimate live births, by color: United 

States, 1940-67 

[See notes’to tables cm page VIil 

Year. Total White Nonwhite 

Est i.mated number 

1967 318,100 142,200 175,800 

1966 --------- 302,400 132,900 169,500 

1965 291,200 123,700 167,500 

1964 275,700 114,300 161,300 

1963 259,400 104,600 154,900 

1962 

1961 

245,100 

240,200 

94,700 

91,100 

150,400

~49 ,100 

1960 224,300 82,500 141,800 

1959 220,600 79,600 141,100 

1958 208,70!2 74,600 134,100 

1957 201,700 70,800 130,’300 

1956 193,500 67,500 126,000 

1955 183,300 64,200 119,200 

1954 176,600 62,700 113,900 

1953 160,800 56,600 104,200 

1952 150,300 54,100 96,200 

1951 

1950 

146,500 

141,600 

52>600 

532500 

:;, :(); 

1949 133,200 53,500 79;700 

1948 129,700 54,800. 74,900 

1947 131,900 60,500 71,500 

1946 125,200 61,400 63,800 

1945 117,400 56,400 60,900 

1944 105,200 49,600 55,600 

1943 98,100 42,800 55,400 

1942 96,500 42,000 54,500 

1941 95,700 41,900 53,800 

1940 89,500 40,300 49,200 

NOTE: Due to ro-unding esti.rnates to the 

nearest hundred. figures by color may not 

add to totals. -

29 
Table 22 presents trends in the illegitimacy 

rate (illegitimate births per 1,000 unmarried 

women 15-44 years of age) by age of mother. 

The estimated illegitimacy rate for women 15-44 

years old increased from 7.1 in 1940 to 23.9 in 

1967. The most sustained increase in the rate 

occurred between 1940 and 1957; this increase 

accounted for most of the rise in the nunzbev of 

illegitimate births during those years. Since 1957, 

however, the illegitimacy rate has changed relatively little from year to year. In other words, 

the rising number of illegitimate births since 

1957 can be attributed principally to the increasing 

numbers of unmarried women rather than an increased risk. 

The risk of bearing an illegitimate child 

varies with age. The illegitimacy rate for teenagers 15-19 years old was 18.6 in 1967. Women 

20-24 and 25-29 years of age had rates more than 

twice as high as the rates for ~heteenagers. Rates 

for women 25-29 have been the highest since 1958. 

Until 1964 rates for these women were also rising 

more sharply than the rates for other women. 13etween 1964 and 1967, however, for the first time 

in many years, the rate for these women declined 

considerably, from 50.2 to 41.4. 

Estimated illegitimacy rates by color and age 

of mother are graphically presented in figure 7 

for selected years from 1940 to 1967. The illegitimacy rate for nonwhite women was 35.6 in 1940, 

or about 10 times greater than the rate for white 

women. During the 1940’s the color differential 

increased until by 1950 the nonwhite rate was 

nearly 12 times higher than the white rate. Since 

1950 the differential has been decreasing; in 1967 

the white illegitimacy rate was 12.5 and the rate 

for nonwhite women was 89.5, about 7 times higher. 

The declining differential was due both to the more 

rapid increase in the rate for white women during 

the 1950’s and to the decline in the rate for nonwhite women after 1960. From 1960 to 1967 the 

illegitimacy rate for nonwhite women declined 

9 percent, while the rate for wtite women increased 36 percent. 

Recent trends in illegitimacy rates by color 

and age are shown in table 23. The figures indicate that during the period 1960-67 there were 

reductions in the illegitimacy rates for nonwhite 

women in every age group except for girls 15-19 

years. In contrast, the rates for white women of 

all ages increased over this period. 

Table 23 shows that the decline in the ille@­

imacy rates for all women except for girls 15-19 

years. in the more recent period 1965-67 was 

due principally to the considerable reduction in 

the rates for nonwhite women. The rate for nonwhite women 25-29 years old, for example, declined from 164.7 in 1965 to 118.4 in 1967. In 

addition rates for white women 25 years and over 

declined slightly. 

The declines noted above in the rates for nonwhite women between 1965 and 1967 have been 

large enough to have resulted in reductions in 

the num bev of nonwhite illegitimate births for all 

ages over 24, in spite of the continued increase 

in the number of unmarried women (table 24). 

This has tended to slow down the increase in the 

total number of illegitimate births. 

The illegitimacy ratio, that is, the number of 

illegitimate births per 1,000 live births, is the 

appropriate measure to use for discussing the 

proportion of births classified as illegitimate. 

This measure is often used for other purposes 

because it is easier to compute than the illegitimacy rate (the necessary population figures for 

unmarried women are difficult to obtain). However, it has numerous shortcomings when used as 

an analytic tool. The numerator and denominator 

of the illegitimacy ratio are affected. by two independent sets of factors. The numerator, the 

number of illegitimate births, is determined by 

the rate of illegitimacy and the number of unmarried women. The denominator, the total number of births, is influenced primarily by factors 

which affect the level of marital fertility, such as 

changes in timing and completed family size. If 

these factors change, the ratio will change even 

if the numerator remains the same. 

During the period 1960-67, for example, the 

illegitimacy ratio increased substantially, by 71.3 

percent. Although the illegitimacy rate remained 

fairly stable during this period, the number of unmarried women increased and therefore the number of illegitimate births increased. Simultaneously there was a general decline in total fertility 

associated with the reduction of births to married 

women. In other words, the increase in the illegitimacy ratio in this period was related princi30 
-------------------------------

Table 22. Estimated illegitimacy rates by age of mother: United States, 1940-67


[Seenotestotables m page VII] 

Age of mother


Year


40-44


years2


~


Rate per 1,000 unmarried women


1967------------------------------- 23.! 18.6 38.3 41.4 29.2 15.4 4.0 

1966------------------------------- 23.L 17.5 39.1 45.6 33.0 16.4 4.1 

1965------------------------------- 23.! 16.7 39.9 49.3 37.5 17.4 4.5 

1964------------------------------- 23.( 15.8 39.9 50.2 37.2 16.3 4.4 

1963---------------2--------------- 22.: 15.2 40.3 49.0 33.2 16.1 4.3 

1962------------------------------- ‘21,: 14.8 40.9 46.7 29.7 15.6 4.0 

1961------------------------------- 22.; 15.9 41.7 46.,5 28.3 15.4 3.9 

1960-------------------------------

1959-------------------------------

21.(

21.5 

15.3 

15.5 

39.7 

40.2 

45.1 

44.1 

27.8 

28.1 

14.1 

14.1 

3.6 

1958------------------------------- 21.2 15.3 38.2 40.5 27.5 13.3 ;:2 

1957------------------------------- 21.C 15.8 37.3 36.8 26.8 12.1 3.1 

1956------------------------------- 20.4 15.6 36.4 35.6 24.6 11.1 2.8 

1955------------------------------- lg.? 15.1 33.5 33.5 22.0 “lo.5 2.7 

1954------------------------------- 18.7 14.9 31,4 31.0 20.4 10.3 2.5 

1953------------------------------- 16.9 13.9 28.0 27.6 17.3 9.0 2.4 

1952------------------------------- 15.8 13.5 25.4 24.8 15.7 ;.; 1.9 

1951------------------------------- 15.1 13.2 23.2 22.8 14.6 . 2.2 

1950------------------------------- 14.1 12.6 21.3 19.9 13.3 2.0 

1949 13.3 12.0 21.0 18.0 11.4 M 

1948------------------------------- 12.5 11.4 19.8 16.4 10.0 5.8 ::: 

1947------------------------------- 12.1 11.0 18.9 15.7 9.2 5.6 1.8 

1946------------------------------- 10.9 9.5 17,3 15.6 7.3 4.4 1.8 

1945------------------------------- 10.1 9.5 15.3 12.1 7.1 4.1 

1944--------------------------------

1943 -----------------------4------- 9.0 

8.3 ::: 

13.1 

11.4 

10.1 

8.8 ::; 

4.0 

3.8 

;:: 

1.3 

1942------------------------------- 8.0 8.2 11.0 8.4 6.3 1.2


1941------------------------------- 7.8 8.0 10.5 7.8 6.0 2:;


1940------------------------------- 7.1 7.4 9.5 7.2 5.1 3.4 :::


1 

Rates computed by relating total illegitimate births regardless of age of mother 

to,0unmarried women 15-44 years. 

‘Rates computed by relating illegitimate births to mothers aged 40 and over to un­


married women aged 40-44 years.


NOTE : The illegitimacy rates shown in this table for the years 1951-67 differ


from those published in various issues of Vital Statistics of the United States. The


rates shown here are based on a smoothed series of population estimates for unmarried


women, by color and age, which were not available when the previously published rates


were computed.


31

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1,000 I


800


600


400


I 9nn 1-

,00( 

300


500


?00


?00 

00 

30


50


40


20


10


B 

6


4


2


I 

100 

80


60


40


20


10


8


6


4~


,


2


Nonwhite, 20-24 years 

Nonwhite, 23-29 years 

Nonwhite, 30-34 years 

Nonwhite, 15-44 yeors 

Nonwhite, 15-19 years 

Nonwhite, 35-44 years 

White, 20-24 years 

White, 25-29 years 

White, 30-34 years 

White, 15-44 years 

White, 15-19 years 

White, 35-44 years 

1 I I I I I I I [ I I I I I I I I I 

I940 I950 1955 1960 1965 1970


YEAR 

Figure7. Estimated illegitimacyrates by age of mothersnd color: 1940, 1950, and 1955-67.


(Semilogarithmicscale)


32

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Table 23. Estimated illegitimacyrates, by color and age of mother: United States,


1960, 1965, 1966, and 1967, and percen~ change 1960-67


[%.note. totables
 on page VII],


Percent


Color and age of mother 1967 1966 1965 1960 change


1960-67


Rate per 1,000 White unmarried women 

All ages, 15-44 years --------------------- 12.5 12.0 11.6 9.2 +35.9 

15-19 years-------------------------------------- 9.0 +36.4 

20.24 y~ars--------------------------------------23.1 2;:: 2;:? 1::: +26.9 

25-29 years--------------------------------------22.7 23.5 24.3 18.2 ;;:.; 

30-34 years------- 14.0 15.7 16.6 10.8 

35-44 yearns 4.7 4.9 4.9 3.9 +20:5 

Nonwhite


All ages, “15-44years --------------------- 89.5 92.8 97.6 93.3 -9.0
 —


15-19 years--------------------------------------80.2 76.9 75.8 76.5


20-24 years--------------------------------------
128.2 L39.4 L52.6 166.5 -z:: 

25-29 years 118.4 L43.8 L64.7 171.8 -31.1 

30-34 years--------------------------------------97.2 L19.4 L37.8 104;0’ -6.5 

35-44 years2-------------------------------------28.9 33.8 39.0 35.6 -18.8 

I“Ratescomputed by relating total illegitimatebirths regardless of age of mother


to unmarried women aged 15-44 years.


p

Rates computed by relating illegitimatebirths to mothers aged 35 and over to un- married women aged 35-44. 

Table 24. Estimated number of illegitimate live births, by color and age of mother: United States,
 1965-67


E.. nciestotables
onpageVII]


1967 1966 1965
 I


Age of mother


Total White Non - Total White Non -
 white whit e


Estimated number


All a.zes 318,100 142,200 175,800 302,400 132,900 169,500 291,200 123,700 167.500
 .-


Under 15 years 6,900 1,700 5,200 6,200 1,400 4,800 6,100 1,400 4,600 15-19 years 

15-17 yesrs 

144,400 

70,900 

60,300 

24,800 

84,000 135,800 

46,100 65,900 h 57,500 

23,400 

78,300 

42,500 

123,100 

61,700 

50,700 

21,500 

72,400 

40,200 18-19 years 73,500 35,600 37,900 69,900 34,000 35,800 61,400 29,200 32,200 20-24 years 

25-29 years 

101,600 

34,500 

52,500 

15,200 

49,100 92,500

19,3(30 35,500 

45,800 

14,900 

46,700 

20,700 

90,700 

36,800 

43,400 

14,900 

47,300 

21,900 

30-34 years 17,300 6,800 10,500 18,400 7,300 11,100 19,600 7,200 12,400 35-39 years 10,100 4,200 5,900 10,500 4,5’30 6,100 11,400 4,500 6,900 40 yea:s and Over-- Ir3,300 1,500 1,700 1 3,400 1,500 1,900 3,700 1,600 2,000 ‘“
 II 

NOTE : Due to rounding estimates to the nearest hundred, figures by color may nmt add to totals. 

33

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--

pally to factors which do not themselves directly 

determine the incidence of illegitimacy, that is, 

to the rising numbers of unmarried women (affecting the numerator) and to the decline in total, 

mainly marital, fertility (affecting the denominator). 

In 1967 the illegitimacy ratio was 90.3 illegitimate births per 1,000 live births, The ratios for 

white and nonwhite births were 48.7 and 293.8, 

respectively. In recent years the differential by 

color in the ratio has been declining just as it has 

in the illegitimacy rate, as a result of the more 

rapid increase in the ratio for the white population. 

Differentials by age of mother in 1967 follow 

essentially the same pattern as in previous years. 

The highest illegitimacy ratios are found for births 

to mothers under 20 (table 25). There is a decrease 

in the ratios for each successively higher age 

group through 30-34 and then a slight increase 

among women 35 and over. The high ratios for 

the youngest mothers can be attributed primarily 

to the small proportion of teenagers married and 

thus in a position to have legitimate children. In 

contrast, a large proportion of women 20 years 

of age and over are married and having legitimate 

children. Although the older unmarried women 

Table 25. Estimated illegitimacy ratios, 

by color and age of mother: United 

States, 1967 

[See notes to taldm on page VII] 

Age of mother 

All ages 

Under 15 years 

15-19 years 

15-17 years 

18-19 years 

20-24 years


25-29 years


30-34 years


35-39 years


40 years and over- ­


Ratio per 1,000 

total live births 

90.3 48.7 293.8 

803.0 615.7 891.6 

242.1 138.5 521.1 

376.7 210.1 656.7 

180.1 ‘112.2 416.5 

77.5 47.0 253.2 

39.8 20.3 164.4 

39.4 18.4 151.5 

44.4 22.2 155.3 

46.3 25.7 133.0 

50 I 

Virgin Islands 

40 —.. ‘8?’%,,,,,, 

z *., 

0 

~ A&/v/ % n,,,,,, , f: 

-1 

‘%,,, “, Puerto Rico

~ ‘i’ ‘%,,,,,,”+ 

~ 30 �* 0. +.. 

0 ~ 0 

0 

K 20 n. \ 

u 

% 

E 

[0 

o	 I I I I I I I I I I I I I I I I t“ I t I I I I 1 I 

1940 1945 1950 r955 1960 1965 1970 

YEAR 

Fi gure d. Birth rates: Puerto Rica, Virgin Islands, and 

united States, 19%66. 

have a higher risk of bearing illegitimate children than do teenagers, they account for onlya 

small proportion of all births to women 20 and 

over. The illegitimacy ratios for the two color 

groups show variations by age of mother similar 

to those for all women. 

A more detailed analysis of trends and differentials in illegitimacy is presented in the 

recent report Tvends in Ille@”timacy.13 

PUERTO RICO AND 

VIRGIN ISLANDS (U. S.) 

Birth Rates and Numbers of Births 

The birth rate in Puerto Rico declined from 

42.2 per 1,000 population in 1947 to 30.2 in 1965 

and then fell sharply to 27.6 in 1966a (fig. 8 and 

table 26). A similar decline in the total fertility 

rates shown in figure 9 indicates that the downward trend in the birth rate was not mainly an 

a1966 is the latest year for which the National Center for 

Health Statistics has tabulated data for Puerto Rico and the 

Vir@ Islands. 

34 
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artifact of shifts in the age composition of the 

Puerto Rican population. The total fertility rate is 

not affected by changes in age structure (see 

Total Fertility in second section of this report). 

In recent years the level of fertility in 

Puerto Rico has been quite similar to that of the 

nonwhite population in the United States. By 1957 

the totaI fertility rate of Puerto Rico had dropped 

enough to reach the lower level of that of the 

Table 26. Live births and birth rates: 

Puerto Rico and Virgin Glands, 1940-66 

[See notes to tables on page VII. Rates per 1,OC’Ototal 

population in each area except as noted] 

Virgin Puerto Rico Islands* 

Year


Number Rate Numbe: Rate 

1966 --------- 73,630 27.6 1,956 39.5 

1965 79,608 30.2 1,998 46.0 

1964 78,956 30.6 1,762 43.4 

1963 --------- 1962 --------- 77,440 

76,596 

30.7 

31.1 

1,513

1,375 

38.1 

39.4 

196?---------- 75,418 31.3 1,193 34.8 

1960 76,314 32.5 1,180 36.8 

19.59 75,104 32.3 1,107 35.7 

1958 76,298 33.2 1,129 37.6 

1957 76,058 33.7 1,038 35.3 

1956 --------- 78,284 34.8 977 34.4 

1955 77,830 34.6 913 33.1 

1954 77,832 35.2 879 32.3 

1953 77,754 35.3 871 32.4 

1952 80,438 36.1 862 30.9 

1951 --------- 84,076 37.6 953 34.4 

1950 --------- 86,038 38.9 894 33.5 

1949 85,625 39.0 886 33.2 

1948 87,809 40.2 826 30.7 

1947;-------- 91,,305 42.2 876 32.2 

1946” 88,421 41.6 917 34.0 

1945:---------- 86,680 4i.9 984 37.4 

1944; 82,534 $0.6 1,059 40.4 

1943; 77,304 38.7 931 37.4 

1942” 889 35.8 

19412 829 32.6 

1940--------- 756 30.4 

lData are based on 100 percent of the 

birth records. ~ 

Rates are based on civilian popula­ tion in each area. 

6,000


..*,,Puerto Rico 

,*.,+ ** %4,.$,, *,,. . 

5,000 

!3 ; a R. ?


F
.# J ~,,~h~,e
women \


“2,000


0 I I I 1 I I I I [ I 1 ! I I I I 1 I 

1945 1950 1955 1960 . 1965 

YEAR 

Figure 9. Total fertility rates for Puerto Rico, and for


the United States by color: 19!4-66.


U.S. nonwhite population, andthetwo rates have 

since declined at about the same pace. The drop 

in the total fertility rate in Puerto Rico was 

sizable, from about 5,500 per 1,000 women in 

1947 to 3,700 in 1966. This long-term decline 

suggests a shift from a norm of large families 

to one of moderate-sized families, assuming 

that it reflects more than changes in the timing 

of births. Nevertheless Puerto Rico’s total fertility rate is still well above the level of 2,600 

of the U.S. white population in 1966. 

Although Puerto Rico’s fertility rates have 

been falling almost continuously since 1947, the 

trend in the annual number of births has been 

irregular. There was a general tendency toward 

an annual decline in the number of births from 

1948 to 1960 but asteady increase from 1961to 

1965. Between 1965and1966, however, thenumber 

of births declined by7.~ percent. 

The birth rate inthe Virgin Islands has been 

among the world’s highest and set anew record 

of 46.0 per 1,000 population in 1965. The rate 

declined by 14 percent the next year, however, 

falling to 39.5 (fig. 8 and table 26). 

35 
The total fertility rate inthe Virgin Islands 

is also high. In 1966it was about 5,500 per 1,000 

women, near the level observed in Puerto Rico 

about 20 years ago. At a level of 5,500 the total 

fertility rate of the Virgin Islands was approximately twice as high as that of the United States 

in 1966. This implies that large families of five 

or six children are still the norm in the Virgin 

Islands, assuming a stable rate and timing pattern 

of births by age over the past 20 to 30 years. 

In 1966 there were 2 percent fewer births 

in the Virgin Islands than in 1965; this modest 

decrease was about half the percent decrease in 

births that occurred in the United States during the 

same period. 

Birth Rates by Age of Mother 

Recent age-specific birth rates are not available for the Virgin Islands. Those of Puerto Rico in 

1966 are compared with those of U.S. white and 

nonwhite women in figure 10. The age-specific 

rates of Puerto Rico, like the total fertility rates, 

are quite close to those of nonwhite women in the 

United States. Both rates peak at about the same 

level at ages 20-24. The Puerto Rican rates are 

somewhat lower than the U.S. nonwhite rates at the 

younger ages but are higher at ages 35 and over. 

The higher rates for Puerto Rican women as compared with U.S. nonwhite women at the older childbearing ages are reflected in higher birth rates 

at birth orders eight and over. The rate of eighth 

and higher order births was 14.5 per 1,000 women 

aged 15-44 in Puerto Rico as compared with 10.7 

for nonwhite women in the United States in 1966. 

It has been suggested that in a society in 

which birth control is in the process of becoming 

widely adopted, it will first be used by couples 

who have already had what they consider a sufficient number of children. 14 Thus older couples 

are more motivated by the reality of family size 

than younger couples to adopt birth control and 

use it effectively. The trend in age-specific birth 

rates indicates that this explanation may apply 

to Puerto Rico. During the 1944-66 period the 

Puerto Rican rates at ages 15-19 increased somewhat, while rates at all other ages decreased, 

especially at ages 30 and over. The result has 

been a greater concentration of annual total fertility at the younger childbearing ages. In 1966 

women under age 30 accounted for 67 percent of 

the total fertility rate as compared with 58 percent in 1944. 

Births by Education of Mother 

It is possible to obtain some measure of 

socioeconomic differentials in fertility in Puerto 

Rico because the educational attainment of the 

mother has been reported on the Puerto Rican 

birth certificates since 1962. As in the United 

States, 1 through 8 years of schooling represent an 

elementary school level, 9 through 12 represent 

a secondary level, and 13 or more a college level. 

Educational attainment of the mother is highly 

correlated with the father’s occupational status 

and income and hence with the overall socioeconomic standing of the family. In Puerto Rico, 

300 

US. nonwhite women 

R 200


z


!?


0 

0 

0_. 

~ 

n 

: 

E 100 

0


15-19 20-24 25-29 30-34 35-39 40-44 45-4 

AGE OF MOTHER IN YEARS 

Figure 10. Birth rates by age of mother for Puerto Rico, 

and for the United States by color: 1966. 

36

----------------

------- -------------- --

------------------

--------

-----------------

-------------------------- --

as in the United States, there is an inverse relationship between fertility and the educational 

attainment of the mother. Birth rates by age and 

educational attainment of the mother are, however, 

available only for 1962 and have been analyzed in 

more detail in an earlier report;!5 

Between 1962 and 1966 there was an increase in the proportion of births occurring to the 

better educated women. As shown in table 27, 

women with some college education accounted for 

7.9 percent of all births in 1966 as compared with 

6.0 percent in 1962. There were similar increases 

in the percentages for women with an education 

at ,tie secondary leve~ but declines occurred in 

the percentages for women with less than 9 years 

of schooling. This change can probably be attributed primarily to a general rise in the level 

of education in Puerto Rico rather than to an increase in the fertility of the better educated 

women. Census data show that between 1950 and 

1960 the proportion of women who had completed 

at least 9 years of school rose from 10 to 20 

percent. 16 

With rising levels of education in Puerto 

Rico annual fertility rates and the average size 

of family can be expected to continue to fall. 

Calculations from the 1960 census show an 

average of 2.6 children ever born per evermarried woman (including consensually married) 

at ages 35-44 who had completed at least 9 years 

of school. The corresponding average for those 

who had completed less than 9 years of school 

was S.9. ~7 

Table 27. Percent dis tribut ion of live 

births by educational attainment of 

mother: Puerto Rico, 1962 and 1966 

[See notes to tables cm page VU] 

Years of school completed 1966 1962


by mother


Percent


distribution


Total 100. O J 100.0” 

I 

None


1-4 years 1?:: 2::: 

5-8 years ---------= 32.3 32.5 

9-11 years 18.7 15.6 

12 years 16.4 12.1 

13 years and over 7.9 6.0 

37 
REFERENCES


lNational Center for Health Statistics: Vital Statistics of 

the United States, 1967, Vol. I. Public Health Service. Washington. U.S. Government Printing Office, 1969. 

2~helpton, p. K., Campbell, A. A., and Patterson, J. E.: 

Fertility and Family Planning in the United States. Princeton, 

N.J. Princeton University Press, 1966. table 210, pp. 392-393. 

3Freedman, R., Whelpton, P. K., and Campbell, A. A.: 

Family Planning, Sterility, and Population Gr-owth. New York. 

McGraw-Hill i300k Co., 1959. table 10-7, pp. 356-357. 

4f.lyder, N. B., and Westoff, C. F.: Use 0[ oral contraception in the United States, 1965. Science 153(3741):1200, Sept. 

1, 1966. 

5Ryder, N. B., and Westoff, C. F.: The United States, the 

pill” and the birth rate, 1960-1965. Studies in Family P2anning, 

No. 20. New York. Tine Population Council. June 1967. p. 2. 

61bid., p. 3. 

7U.S. Bureau of the Census: Projections of the population. 

of the United States, by age, sex, and color to 1990, with extensions of population by age and sex to 2015. Cufrent POprJ: 

lation Reports, Population Estimates, Seriee P-25, No. 381. 

Washington. U.S. Government Printing Office, Dec. 18, 1967. 

8u. s. Bureau of the Census: Women by number of own 

children under 5 years old, 1968 and 1967. Crment Population 

Reporte, Population Cha?actenstics, Series p.20, No. 184. 

Washington. U.S. Government Printing Office, June 16, 1969. 

9National Center for Health Statistic: Seasonal variatimr 

of birtbs, United States, 1933-63. Vital and Health Statistics. 

PHS Pub. No. 1000-Series 21-No. 9. Public Health Service. 

Washington. U.S. Government Printing Office, May 1966. 

—000 

10 Shapiro, S.: Influence of birth weight, eex and plurality 

on neonatal loss in the U.S. Am.J,Pr@.H.eaZth 44:1142-1153, 

1954. 

llBaumgartner, L., and othe:e: Weight in relation to fetal 

and newborn mortality–influence of color and sex. Pedjatrice 

6:329-342, 1950. 

12National Center for Health Statistics: Multip]e births, 

United States, 1964. Vita7 and HeaJt7~ Statistics. PHS pub. 

No. 1000-Series 21.-No. 14. Public Health S’ervice. Washington. 

U.S. Governm&t Printing Office, Oct. 1967. 

13National Center for Health Statistics: Trends in illegitimacy, United Statee, 1940-1965. Vital and Heai2h Statistics. 

PHS Pub. No. 1000-Seriee 21-No. 15. Public Health Service. 

Washington. U.S. Government Printing Office, Feb. 1968. 

14 Freedman, R., Takeshita, J. Y., and Sun, T. H.: Fertility 

a;d family planning in Taiwan–a case study of the demographic transition. Am. J. SocioZ. LXXX:27, July 1964. 

15National Center for Health Statistics: Fertility and educational attainment, Puerto Rico, 1962. Vital and H,eaZth. Statistics. PHS Pub. No. 1000-Series 21-No. 12. Public Health 

Service. Washington. U.S. Government Printing Office, Sept. 

1967. 

16u.s. Bureau of the Ceneus: U.S. Census of Popu~ation, 

1960, General Social and Economic Characteristics, PueWo 

Rico. Final Report PC(l) -53C. Washington. U.S. Government 

Printing Office, 1962. table42, p. 53-120. 

17u.s. Bureau of the Ceneus: U.$. Census Of POpU?czti@t; 

1960, Detaized Characteristics, Puerto Rico. Final Eeport 

PC(l)-53D. Washington. U.S. Government Printing Office, 1962. 

table 95, p. 53-277. 

* u. s. GOVERNMENT pRltiTING OFFICE - 1970— 396-244 P. 0. as 

38 
OUTLINE OF	 REPORT SERIES FOR VITAL AND HEALTH STATISTICS 

Public Health Service Publication No. 1000 

SeTies 1. 

Series 2. 

Series 3. 

SeYies 4. 

Series 10. 

Se7ies 11. 

Series 12. 

SeYies 13. 

Series 14. 

SeTies 20. 

SeYies 21. 

SeYies 22. 

Proflams and collection procedures.— Reports which describe the general programs of the National 

Center for Health Statistics and its offices and divisions, data collection methods used, definitions, 

and other material necessary for understanding the data. 

Data evaluation and methods research. —Studies of new statistical methodology including: experimental tests of new survey methods, studies of vital statistics collection methods, new analytical 

techniques, objective evaluations of reliabili~ of collected data, contributions to statistical theory. 

Analytical studies. —Reports presenting analytical or interpretive studies based on vital and health 

statistics, carrying the analysis further thap.the expository types of reports in the other series. 

Documents and committee Yepoyts. — Final reports of major committees concerned with vital and 

health statistics, and documents such as recommended model vital registration laws and revised birth 

and death certificates. 

Data j?om the Health Interview Survey. -Statistics on illness, accidental injuries, disability, use of 

hospital, medical, dental; ancj other”services, and other health-related topics, based on data collected 

in a continuin~ national household interview survey. 

Data @om the Health Examination Suruey.— Data from direct examination, testing, and measurement of national samples of the population provide the basis for two types of reports: (1) estimates 

of the medically defined prevalence of specific diseases in the United States and the distributions of < 

the population with resjpect to physical, physiological, and psychological characteristics; and (2) 

analysis of relationships among the various measurements without reference to an explicit finite 

universe of persons. 

Data from the Institutional Population Survey s.- Statistics relating to “the health characteristics of “ 

persons in institutions, and on medical, nursing, and personal care received, based on national 

samples of establishments providing these services and samples of the residents or patients. 

Data from the’ Hospital Discharge .Swvey. —Statistics reIating to discharged patients in short-stay 

hospitals, based on a sample of patient records in a national sample of hospitals. 

Data on health ~esouyces: manpower and facilities. —Statistics on the numbers, geographic distribution, and characteristics of health resources including physicians, dentists, nurses, other health 

manpower occupations, hospitals, nursing homes, and outpatient and other inpatient facilities. 

Data on mortality .- Various statistics on mortality other than as included in annual or monthly 

reports —special analyses by cause of death, age, and other demographic variables, also geographic 

and time series analyses. 

Data on natality, marvkzge, and divoyce. -Various statistics on natality, marriage, and divorce other 

than as included in annual or monthly reports— special analyses by demographic variables, also 

geographic and time series analyses, studies of fertility. 

Data fyom the National Natalit>, and Moytaliiy .9wueys. -Statistics on characteristics of births and 

deaths not available from the vital records, b&ed on sample surveys stemming from these records, 

including such topics as mortality by socioeconomic class, medical experience in the last year of 

life, characteristics of pregnancy, etc. 

For a list of titles of reports published in these series, write to: Office of Information 

Nation-al Center for Health Statistics 

U.S. Public Health Service 

Rockville, Md. 20852