NCHS Data Brief ■ No. 287 ■ September 2017

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Births in the United States, 2016

Joyce A. Martin, M.P.H, Brady E. Hamilton, Ph.D., and Michelle J.K. Osterman, M.H.S.

Key findings 

Data from the National 

Vital Statistics System

● The U.S. general fertility

rate declined to 62.0 births per

1,000 women aged 15–44 in

2016, down 1% from 2015.

● Birth rates declined among

women under age 30 in 2016,

and rose for women aged

30–44.

● The cesarean delivery rate

continued to decline in 2016,

down to 31.9% of all births.

● The preterm birth rate rose

for the second straight year to

9.85% in 2016.

● The 2016 rate of triplet and

higher-order multiple births 

was 48% lower than the 1998 

peak.

This report presents several key demographic and maternal and infant health 

indicators using 2016 final birth data. Trends in the general fertility rate (the 

number of births per 1,000 women aged 15–44), age-specific birth rates, 

cesarean delivery, preterm, and triplet and higher-order multiple birth rates are 

presented by age of mother. For each indicator, data for 2016 are compared 

with 2015, and also with a year representing a recent high or low rate.

Keywords: fertility rates • preterm births • triplets • National Vital Statistics 

System

Birth rates for women under age 30 declined in 2016, 

whereas rates for women 30 and over rose.

● The general fertility rate declined 1% in 2016, to 62.0 births per 1,000

women aged 15–44. The rate is down 11% since 2007, the most recent

high (Figure 1).

Figure 1. General fertility and age-specific birth rates, by age of mother: United States, 2007–2016

1

Significant decreasing trend for 2007–2016 (p < 0.05). 2

Significant decreasing trend for 2007–2011; significant increasing trend for 2011–2016 (p < 0.05). 3

Significant decreasing trend for 2007–2010; significant increasing trend for 2010–2016 (p < 0.05). 4

Significant increasing trend for 2007–2016 (p < 0.05).

NOTES: Rates are plotted on a logarithmic scale. The general fertility rate is the number of births per 1,000 women aged 15–44; 

the age-specific birth rate is the number of births per 1,000 women in the specified age group. Access data table for Figure 1 at: 

https://www.cdc.gov/nchs/data/databriefs/db287_table.pdf#1. 

SOURCE: NCHS, National Vital Statistics System, Natality. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
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● The birth rate for teens aged 15–19 declined 9% from 2015 to 2016, to 20.3 births per 1,000 

women. The rate has declined 51% since 2007.

● Birth rates for women in their twenties declined from 2015 to 2016, down 4% for women 

aged 20–24 (to 73.8 per 1,000 births) and 2% for women aged 25–29 (to 102.1). 

● Birth rates for women in their thirties and early forties rose from 2015 to 2016, up 1% for 

women aged 30–34 (to 102.7), 2% for women aged 35–39 (to 52.7), and 4% for women 

aged 40–44 (to 11.4). Since 2007, the rate has risen 19% for women in their early forties, 

2% for women in their early thirties, and 11% for women in their late thirties. 

The cesarean delivery rate dropped below 32% in 2016.

● The cesarean delivery rate declined to 31.9% in 2016, from 32.0% in 2015. The rate is down 

3% from the peak of 32.9% in 2009 (Figure 2).

● Cesarean delivery rates decreased slightly (about 1%) from 2015 to 2016 for all maternal 

age groups. 

● In 2016, rates were down 13.0% for mothers aged 20 and under (to 20.2), 6% for those aged 

20–29 (28.5%), 5% for those aged 30–39 (36.3%), and 3% for women aged 40 and over 

(47.9%) from the 2009 peaks. 

Figure 2. Cesarean delivery rates, by age of mother: United States, 2009, 2015, and 2016

NOTES: Significant differences in rates for all years for all age groups (p < 0.05). Access data table for Figure 2 at: 

https://www.cdc.gov/nchs/data/databriefs/db287_table.pdf#2.

SOURCE: NCHS, National Vital Statistics System, Natality.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
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The preterm birth rate rose for the second straight year in 2016.

● The preterm birth rate rose 2% in 2016 to 9.85%, from 9.63% in 2015, continuing the 

increase observed from 2014 (9.57% and a recent low) to 2015 (Figure 3).

● Most of the increase from 2014 to 2016 was among infants born late preterm, up 4% from 

2014 to 2016 (6.82% to 7.09%). The early preterm birth rate was essentially unchanged 

(2.76% in 2016).

● Increases in late preterm birth rates occurred among all age groups from 2015 to 2016 and 

from 2014 to 2016. For 2014–2016, late preterm rates rose 5% for births to women under 

age 20, 4% for births to women in their twenties, 3% for births to women in their thirties, 

and 6% for births to women aged 40 and over. 

Figure 3. Preterm birth rates, by age of mother: United States, 2014–2016

1

Significant increasing trend (p < 0.05). 

NOTES: Figures may not equal totals due to rounding. Access data table for Figure 3 at: https://www.cdc.gov/nchs/data/databriefs/db287_table.pdf#3.

SOURCE: NCHS, National Vital Statistics System, Natality. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
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Triplet and higher-order multiple births continued to decline in 2016.

● The 2016 rate of triplet and higher-order multiple births was 101.4 per 100,000 total births, 

a non-statistically significant decline from 2015 (103.6). The 2016 rate declined 48%, to 

nearly one-half of the 1998 peak, 193.5 per 100,000 (Figure 4).

● Declines in triplet and higher-order multiple birth rates were seen for each group aged 20 

and over from 1998–2016, with the largest declines among women aged 30–39 (down 64%) 

and women aged 40 and over (down 55%). 

● For 2015–2016, the rate declined significantly for women aged 30–39 (from 146.4 to 135.3 

per 100,000); changes for other age groups were not statistically significant. 

Figure 4. Triplet and higher-order multiple birth rates, by age of mother: United States, 1998, 2015, and 2016

1

Significant difference in rate from 1998 (p < 0.05). 2

Significant difference in rate from 2015 (p < 0.05).

NOTE: Access data table for Figure 4 at: https://www.cdc.gov/nchs/data/databriefs/db287_table.pdf#4.

SOURCE: NCHS, National Vital Statistics System, Natality. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
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Summary

Birth certificate data for the United States in 2016 show a continuation of recent trends for 

several key natality measures. The general fertility rate continued to fall, with record lows in teen 

childbearing and for women in their twenties (1,2). In contrast, rates for older women continued 

to rise, resulting in a higher birth rate for women aged 30–34 than for women aged 25–29 for the 

first time since 1940 when these data became available (2). The cesarean delivery rate declined 

3% from the record high in 2009 and was under 32% in 2016 for the first year in a decade 

(31.8% in 2007) (1). The rate for triplet and higher-order multiple births has been on the decline 

since 1998, the record highest year for this rate, and was the lowest in more than two decades 

(since 1992) (1). For both measures, declines were observed for most or all age groups. The rate 

of preterm birth had been on the decline in the United States (from 10.44% in 2007 to 9.57% in 

2014) (1). Although the recent upturn in the preterm birth rate is of shorter duration (2014–2016) 

than the other measures presented in this report, it is of concern—infants born prior to full term 

(39–40 completed weeks of gestation) are at higher risk of morbidity and mortality than those 

born at a later gestational age (3). Provisional data indicate an extension of the upward trend in 

this rate through the first quarter of 2017 (4).

Definitions

General fertility rate: Number of births per 1,000 women aged 15–44.

Age-specific birth rate: Number of births per 1,000 women in the specified age group.

Cesarean delivery rate: Number of births delivered by cesarean per 100 births. 

Preterm birth rate: Number of births delivered before 37 completed weeks of gestation per 100 

births. Gestational age is based on the obstetric estimate of gestation (5).

Early preterm birth rate: Number of births delivered before 34 completed weeks of gestation per 

100 births. 

Late preterm birth rate: Number of births delivered at 34–36 completed weeks of gestation per 

100 births.

Triplet/+ birth rate: Number of triplet and higher-order multiple births per 100,000 total births.
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Data source and methods

This report is based on data from the Natality Data File from the National Vital Statistics System 

(NVSS). The vital statistics natality file is based on information derived from birth certificates and 

includes information for all births occurring in the United States. This data brief accompanies the 

release of the 2016 natality public-use file (6). A more detailed analysis of the topics presented 

in this report and many others, including births to unmarried women, prenatal care, tobacco use 

during pregnancy, source of payment for delivery, pregnancy risk factors, receipt of Women, 

Infants, and Children (WIC) food, maternal morbidity, and breastfeeding, is possible by using 

the annual natality files (6). Data are not presented separately in this report for women aged 15 

and under or age 45 and over. For 2016 information on these age groups, see “Births: Provisional 

Data for 2016” (7).

References to increases or decreases in rates or percentages indicate that differences are 

statistically significant at the 0.05 level. Trends in rates for Figure 1 were evaluated using the 

Joinpoint Regression Program. Trends in rates for Figures 2–4 were assessed using the 

Cochran-Armitage test for trends, a modified Chi-squared test. Computations exclude records for 

which information is unknown. 

About the authors

Joyce A. Martin, Brady E. Hamilton, and Michelle J.K. Osterman are with the National Center for 

Health Statistics, Division of Vital Statistics, Reproductive Statistics Branch.
NCHS Data Brief ■ No. 287 ■ September 2017

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References

1. Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for 2015. National vital 

statistics reports; vol 66 no 1. Hyattsville, MD: National Center for Health Statistics. 2017.

2. National Center for Health Statistics. Vital statistics of the United States, 2003, Volume I, 

Natality. 2003. Available from: https://www.cdc.gov/nchs/products/vsus/vsus_1980_2003.htm. 

3. Born too Soon Executive Summary Group. Writers Kinney MV, Howson CP, McDougall 

L, Lawn JE. Executive Summary for Born too Soon: The global action report on preterm birth. 

March of Dimes, PMNCH, Save the Children, World Health Organization. 2012.

4. Rossen LM, Osterman MJK, Hamilton BE, Martin JA. Quarterly provisional estimates for 

selected birth indicators, 2015–Quarter 1, 2017. National Center for Health Statistics. National 

Vital Statistics System, Vital Statistics Rapid Release Program. 2017.

5. Martin JA, Osterman MJK, Kirmeyer SE, Gregory ECW. Measuring gestational age in vital 

statistics data: Transitioning to the obstetric estimate. National vital statistics reports; vol 64, no 5. 

Hyattsville, MD: National Center for Health Statistics. 2015.

6. National Center for Health Statistics. Natality public-use file and CD-ROM. Hyattsville, MD: 

National Center for Health Statistics. Published annually. Available from: https://www.cdc.gov/

nchs/data_access/VitalStatsOnline.htm.

7. Hamilton BE, Martin JA, Osterman MJK, et al. Births: Provisional data for 2016. Vital 

statistics rapid release; no 2. Hyattsville, MD: National Center for Health Statistics. 2017.
NCHS Data Brief ■ No. 287 ■ September 2017

Suggested citation 

Martin JA, Hamilton BE, Osterman MJK. 

Births in the United States, 2016. NCHS 

data brief, no 287. Hyattsville, MD: National 

Center for Health Statistics. 2017.

Copyright information 

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Vital Statistics

Delton Atkinson, M.P.H., M.P.H., P.M.P., 

Director

Hanyu Ni, Ph.D., M.P.H., Associate Director 

for Science

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