Health Aspects

of Pregnancy

and Childbirth

United States, 1982

Statistics collected in 1982 are presented on

the timing of the first prenatal visit, the

source of prenatal care, smoking and

alcohol use during pregnancy, low birth

weight, and how delivery was paid for. The

data are shown by characteristics of the

mother and the pregnancy.

Data From the National Survey of

Family Growth

Series 23, No. 16

DHHS Publication No. (PHS) 89-1992

U.S. Department of Health and Human

Services

Public Health Service

Centers for Disease Control

National Center for Health Statistics

Hyattsville, Md.

December 1988
Copyright Information

All material appearing In this report IS in the public domain and may be

reproduced or copied wl!hout permission; c!tatlon as to source, however, IS

appreciated.

Suggested Citation

National Center for Health Statistics, E. R. Pamuk and W. D. Mosher. 1988.

Health aspects of pregnancy and childbirth: United States, 1982. Vita/ and

/-fea/#r Statisf/cs. Series 23, No. 16. DHHS Pub. No. (PHS) 8%1992. Public

Health Serw$e, Washington: U.S. Government Printing Office.

Library of Congress Cataloging-in-Publication Data

Pamuk, Elsie.

Health aspects of pregnancy and chlldb!rth, United States, 1982. p. cm. —

(Series 23, Data from the national survey of femdy growth ; no. 16) (DHHS

publication : no. (PHS) 89-1992)

Bibhography: p.

ISBN O&8406-0398-7

1. Prenatal car+United States—Stat!stlcs. 2. Pregnant women—Unled

Slates—Drug use-Statistics. 3. Bwth weight, Low—United States—Statistics.

4. Chlldblrlh-Economic aspects—United States—Statistics. 5. Health

survey e-United States—StatWcs. 6. Statistics, MedicaW_lnited States. 1.

Mosher, William D. Il. National Center for Health Statstics (U.S.) Ill. Nahonal

Survey of Family Growth (U.S.) IV. Title. V. Series. VI, Series: Vital and health

statistics. Series 23, Data from the national survey of family growth ; no. 16.

[DNLM: 1. Labor—United States—statistics. 2. Pregnancy—United States—

statistics. 3. Prenatal Car&Unlted States—statistics. W2 A N148VW no. 16]

RG960.P36 1988 362.1 ‘982’00973-dcl 9

DNLM/DLC

for Library of Congress 88–1 6406

CIP

—
National Center for Health Statistics

Manning Feinlcib, M.D., Dr.P.H., Director

Robert A. Israel, Deputy Director

Jacob J. Feldman, Ph.D., Associute Director for Analysis

and EI]idemiologs

Gail F. Fisher, Ph.D., Associate Directorfor Pkmning and

.Extmnural Programs

Pet er L. Hur]ey, Associate Director for Wal and Health

Stf7tistics $wtenzs

Stephen E. Nieberding, Associate Director for Management

George A. Schnack, Associate Direclor for Data Processing

and Sen’ices

Monroe G. Sirken, Ph.D., Associate Director for Research

and Methodology

Sandra S. Smith, Information Officer

Division of Vital Statistics

John E. Patterson, Director

James A. Weed, Ph. D., Deputy Director

William F. Pratt, Ph. D., Chiej Family Growth Survey

Branch

Joseph D. Farrell, Chiej Systems and Programming

Branch

Mabel G. Smith, Chie$ Statistical Resources Branch

Coopexmkg Agexcks

Cycle 111of the National Survey of Family Growt~ 19S3 was supported in

pmt by the Nntiorml Institute of Child Health mrd Hummr Development, Natiorrd

Imtitutes of Health, and the Office of Population Affoirs, Office of the Assistnnt

Secrekuy of Health. Both of these ngencies afso participated in the questionnaire

and sumey design.
Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Summary ofprincipal findings.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Source and limitations ofthe data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Comparisonswith other data.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Timing ofthefirst prenatal visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

First source ofprenatal care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cigarette smoking duringmost recent pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Alcohol consumption duringrnost recent pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Low birth weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Source ofpayment fordelivery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Trends in sourceof payment fordelivcry 1973-82 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

List ofdetailed tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Appendixes

I. Technical notch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11. Definitions oftcrms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

III. Itcmson thc1982Nationa lSurvey of Family Growth questionnaire rclatcd to health aspects ofpregnancy and

childbirth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

List oftext figures

1.

2.

3.

4.

5.

6.

7.

8.

Pcrccnt of mothers receiving prenatal care in the first trimester, by race and marital status: United States,

197!)-82 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent ofwomenwhorcceived prenatal care for a pregnancy endingin 1979-82 whoscfirst prenatal care was

from a private physician, by race and mari(al status of mother at outcome: United States, 1982 . . . . . . . . . . . . . .

Percent ofever married women whosrnokcd 150r more cigarettes pcr day during their most rccentprcgnancy,

by race ancleducation: United States, 1982. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent ofever pregnant women who drank alcoholic beverages oncc aweek or more during their most rcccnt

pregnancy, byrace and education: United States, 19S2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent ofsingle Iivebirths towomen 15–44yearsofage that wcrelowbirth weight, byraccaml marital statusof

mothcra ttimeofbirth :United States, 1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Pcrccnt ofmost recent live births toevcrprcgnant w’omcn15+lycars ofagelhatwerc lowbirthwcight, hyrace

of mothcrand numberofcigarettcs srnokedpc rdayduri ngpregnancy:United S(atcs, 1982 . . . . . . . . . . . . . . . . .

Percent of live births in 1979–82 that were paid for, in whole or in part, from specified sources, by race of mother:

United States, 19S2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent distribution of most rccen( live births bysourcc ofpayrnen tfordclivery: women 15+lyears ofage who

ever had alive birth: Unitul States, 1973 and 1982..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . .

List oftext tables

A. Number ofpregnancics ending in alivcbirth in January 1979 orlatcrtowomcn 15A4ycars ofagcanclpcrccnt

distribution by months pregnant when prenatal cwtbcgan,according to race, origin, and age aml marital status

at birth: Unitccl States, 1982.. . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

3

8

9

11

11

15

16

19

21

22

25

26

28

6?

67

71

3

3

4

5

5

5

6

6

12

...

Ill
B. Number of pregnancies ending in live births or spontaneous loss in January 1979 or later to women 15-44 years

of age, percent receiving prenatal care, and percent distribution of pregnancies receiving care by source of care at

first visit, according to race, origin, and age and marital status at pregnancy outcome United States, 1982 . . . . . 1.4

c. Percent of women 15–44 years of age whose most recent pregnancy ended in live birth or spontaneous loss not

smoking cigarettes and not consuming any alcoholic beverages during the most recent pregnanq, by race, origin,

and selected characteristics: United States, 1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

D. Number of women 15–44 years of age whose most recent pregnanq ended in live birth or spontaneous loss and

percent distribution by average number of cigarettes smoked per day during the pregnancy, according to race of

woman andyear ofoutcome: United States, 1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

E. Number of women 15–44 years of age whose most recent pregnancy ended in live birth or spontaneous loss and

percent distribution by average frequency of alcoholic beverage consumption during the pregnancy, according to

race ofwoman andyear of outcome: United States, 1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

F. Percent of single live births that were low birth weight, by race, origin, and marital status of mother at time of

birth:Unite dStates ,1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

G. Number of live births in January 1979 or later to women 15-44 years of age and percent paid for from specified

sources, by race, origin, and selected characteristics: United States, 1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Symbols

--- Data not available

. . . Categow not applicable

Quantity zero

0.0 Quantity more than zero but less than

0.05

z Quantity more than zero but less than

500 where numbers are rounded to

thousands

* Figure does not meet standards of

reliability or precision (see Technical

notes)

iv
Health Aspects of

Pregnancy and

Childbirth

by Elsie R. Pamuk, M.A. and William D.

Mosher, Ph. D., Division of Vital Statistics

Introduction

In 1900, the infant mortality rate in the Uniter-1States

was about 100 infant cleat11sper 1,000 live births (Shapiro,

Schlesinger, and Ncsbitt, 1968). At that time, more than

half of infant deaths were postneonatal (after the first 27

days of life) and were due primarily to the infant’s environment, especially infections causing diarrhea and respiratory

illnesses (McCormick, 1985; NCHS, 1986a; Shapiro, Schlesinger, and Ncsbitt, 1968). Between 1900 and 1950, infant

mortality rates declinccl by about 70 percent, to 29 per

1,000 births. In 1950, about two-thirds of infant deaths

were neonatal (during the first 27 days of life) (NCHS,

1986a). Between 1950 and 1982, the infant mortality rate

fell from 29 to 11.5 per 1,000 live births, but neonatal

deaths still made up two-thirds of infant deaths. The major

causes of neonatal death stcm from conditions that develop

during pregnancy (Brown, 1985; McCormick, 1985;

Shapiro, Schlesinger, and Ncsbitt, 1968). Low birth weight

was a factor in two-thirds of neonatal deaths in 1982, just as

in 1950 (Brown, 1985; McCormick, 19S5; Shapiro,

Schlcsingcr, and Ncsbitt, 1968; Shapiro ct al., 19S0).

Infant mortality for births to white women has been

substantially lower than for births to women of other races

in the 20th century (NCHS, 1986a; Shapiro, Schlesinger,

and Ncsbit t, 1968). Further, the 1982 rate was higher in the

United Sta(cs than in a number of other industrialized

countries (Shapiro ct al., 1980). Progress in reducing infant

mortality probably will depend on reducing neonatal mortality and the conditions in pregnancy that cause it

(Behrman, 1985; Brown, 1985; Institute of Medicine, 1985;

McCormick, 1985; NCHS, 19S1a; Shapiro et al., 19S0).

Accordingly, this report presents the first eomprchcnsive

analysis of the data from the National Survey of Family

Growth on health aspects of pregnancy and childbirth.

These measures of health may bc useful in assessing the

risk of infant mortality among various groups in the United

States.

The National Survey of Family Growth (NSFG), a

periodic survey conducted by the National Center for

Hcahh Statistics, is designed to provide information on

fertility, family planning, and aspects of maternal and infant

health that are closely related to chiklbcaring. This report

presents a wide range of data from the survey on health

aspects of pregnancy and childbirth, including

●

●

●

●

●

●

●

The number of months women had been pregnant

when they began receiving prenatal care for that pregnancy (tables 1–6).

Whether they rcceivcd their prenatal care for that

pregnancy from a private doctor, a hospital clinic, or

another kind of clinic (tables 7–12).

Whether women smoked during their most recent

pregnancy, and if so, how much they smoked (tables

13-18).

Whether women drank alcoholic beverages during

their most recent pregnancy, and if so, how often

(tables 19-24).

The proportion of babies weighing 5% pounds or lCSSat

birth (tables 25 and 26).

How deliveries were paid for (sources of payment,

tables 27–32).

Trends in sources of payment for delivery of live births

in 1973 and 19S2 (table 33).

Note that the measures of health in this report arc

arranged in temporal orclcr-that is, the order in which

they usuaIIy occur: from first prenataI visit (tables 1–12) to

smoking and drinking during pregnancy (tables 13–24) to

birth weight (ttibles 25 and 26) to sources of payment for

the birth (tabIcs 27–33). These data arc shown separately

for pregnancies of women of all races, of white women, and

of black women, in rcIation to

● The mother’s age and marital status when the pregnancy ended.

. Birth order or pregnancy order.

. Whether the pregnancy had been wanted by the mo[hcr

at the time of conception.

The data arc also shown by selcctccl characteristics of

the woman at the date of interview, including geographic

region, education, most recent occupation, income (as a

percent of poverty level), whether shc had rcccivcd Medicaid, and rcsidcncc (mctropoli[an or nonmctropolitan). The

sample size was not large enou@ to study pregnancies of

Hispanic women in the same amount of detail as for white

and for black women, but data arc shown for Hispanic

women in the text tables.

1
In tables 1–12 and 25–33 of this report, data are

presented on prenatal care, low birth weight, and how

delivery was paid for. In these tables, the unit of analysis is

the pregnancy or birth. Women who had more than one

pregnancy arc included once for each pregnaney, and

women who had never been pregnant are excluded entirely.

For example, a woman who had her first birth in 1979 at

agc 19 and her second birth in 1981 at age 21 would bc

countccl twice in tables 1–12 and 25-33. For convenience in

writing, the word “women “ is sometimes used in the text

when discussing data in tables 1–12 and 25–33, but the

reader should note that these tables refer to pregnancies or

births.

The range and richness of the data shown here are not

matchccl in any other source of national information. For

example, this report contains data on miscarriages and

stillbirths as well’ as live births. This report also contains

information on income, occupation, and receipt of Medicaid, which is not available in other published reports based

on national data sources.

The data shown here may be useful for measuring the

adequacy of medical care during pregnaney, the sources

women use to obtain and pay for prenatal and obstetric

services, certain health practices during pregnaney, and

birth weight, one important measure of pregnaney outcome.

Certain other measures related to pregnancy outcome

were analyzed in a previous report (NCHS, 1987a); those

measures included infertility, surgical sterilization, pelvic

in flammato~ disease, spontaneous prcgnaney loss, and

cesarean section.
Summary of principal

findings

There are large differences by race and Hispanic origin

in many aspects of the health of women during pregnancy

and in the health of their infants. This is why data are

presented separately for pregnancies of white, black, and

Hispanic women. One major finding of this report is that

the large race differences observed in timing of the first

prenatal visit, in rates of low birth weight, and in sources of

payment for delivery were limited primarily to ever married

women.

Timing of the first prenatal visit-BIack women were

less likely to receive early prenatal care than white women.

Nearly 70 percent of white women began prenatal care in

the first trimester of pregnancy, compared with only 53

pcrccnt of black women (figure 1). However, the percents

receiving early prenatal care were similar by race in the

highest cat egories of education, income, and occupational

status.

For both white and black births, prenatal care was less

likely to begin in the first trimester if the mother was a

‘w

All women

u

72

82 r

Never married Ever married

Marital status of mother at lime of birth

Figure 1. Percent of mothers receiving prfmabd care frrthe fkst trfrnester,

by race and marital status United Stateq 1979-82

teenager, had never married, had not finished high school,

had never worked, had a low income, was receiving Medicaid, or if her pregnancy was unwanted at conception

(figure 1).

Births to Hispanic women were more likely to have

received prenatal care only after the fifth month of pregnancy, or not at all, than were those to non-Hispanic white

women. About 7 percent of all pregnancies received no

prenatal care at all, but fewer than 2 percent of pregnancies

ending in live birth received no care at all.

First source of prenatal care-For about 80 percent of

pregnancies of white women, first prenatal care was by

private doctors, compared with only 48 percent of pregnancies of black women (figure 2). Among both black and

white women, pregnancies to teenagers and never married

women were less likely to receive prenatal care from

90-

ao70-

60-

so- 48

g

e

l? do

,,’:, :.,

20- .,:

.,.,,

,, .,’

... ,

lo- : :,’:;:.

,,,:,.,,:

~:,:,.,:

0

80

—

All pregnancies

53

i

37

,.-

.,

., :,,’

.,:

,:. :

,.

,.,:

.:, ,

,,

,,

.: .”.

.,,

Never married

Mari!al status at outcome

❑ Back

H Wh,te

84

60

,,.

,,

,.,

,,

‘::. ,

,,, .

.,.

,,,’

,.

:,

‘,.

Ever marriet

Fgure 2. Percent of women who received prenatal care for a fxegnancy

ending m 197W2 whose first prenatal care was from a private physicia~

by race and marital status of mother at outcome United Stateq 1982

.
private physicians than pregnancies to older women and

ever married women.

For a given pregnancy, women who received early and

continuous prenatal care (that is, who began care in the

first trimester and had a visit at least once a month thereafter) were less likely to have attended a clinic for their first

visit than women who received later or discontinuous care.

Smoking during pregnanq—About 69 percent of

women did not smoke at all during their most recent

pregnancy. The proportion of women not smoking at all

was similar for white and black women. However, white

women were more likely to have smoked 15 or more

cigarettes per day lhan were black women (16 percent

versus 10 percent), especially younger, less-educated, and

never married women (figure 3).

White women with less than 12 years of education were

almost three times as likely to have smoked 15 or more

cigarettes per day during their most recent pregnancy than

were college-educated women (26 percent versus 9 percent,

figure 3). Heavy smoking declined as education increased

among black women, as well, although not as sharply.

For both white and black women, those whose pregnancies ended in spontaneous loss were more likely to have

smoked than were women whose pregnancies ended in live

birth.

Dlinking during pregnancy-About 12 percent of

women drank alcoholic beverages at least once a week during their most recent pregnancy, and the proportions were

similar for black and white women. For both races, alcohol

consumption increased with the age of the pregnant

Women whose most recent pregnancy ended in spontaneous 10SSwere almost twice as likely to have ccmsumed

alcohol once a week or more (19 percent) as were women

whose pregnancy ended in live birth (11 percent). This

difference was found for both white and black women.

In contrast to cigarette smoking, alcohol consumption

during pregnancy was more common among white women

with some college education than among those with less

education (figures 3 and 4). The proportion of white

women who drank alcohol once a week or more during

their most recent pregnancies was more than twice as large

for women with some college education (17 percent) as for

those having less than 12 years of schooling (8 percent), but

for black women the reverse was true (8 percent versus 17

percent, figure 4).

Hispanic women were more likely to have abstained

from smoking than non-Hispanic white women (83 percent

versus 67 percent), and more likely to have abstained from

drinking alcohol during their most recent pregnancy than

non-Hispanic white women (69 percent versus 50 percent).

Low bi)fh weight—The proportion of babies who were

low birth weight was twice as high for black as white

mothers (12 percent versus 6 percent). For never married

mothers, however, there was no significant difference by

race in the percent of low birth weight (figure 5).

Babies born to mothers who had smoked 15 or more

cigarettes a day during pregnancy had about three times the

incidence of low birth weight (13 percent) seen for babies

born to molhers who had not smoked at all (4 percent). An

increased risk of low birth weight was found for both white

woman. and black women who smoke~ (figure 6).

301 26

0-11years 12 years 13 years 0-11 years 12 years 13 years

or more or more

White women Black women

Education

Fgure 3. Percent of ever married women who smoked 15 or more cigarettes par day during their most recent pregnancy, by race and education:

United States, 1982

4
20

15

10

5

0

12

9

8

17

CM 1 years 12 yeara

11

17

8

13 years

or more

Total

Education

0-11 years 12 years

Black women

8

13 years

or more

Figure 4. Percent of ever pregnant women who drank akoholic beverages once a week or more during their mosl recent pregnancy, by race and

educatbn: United Stateq 1982

15 7

❑ Black

❑ White

10

5

0

All births Never married Ever married

Marital status at time of birth

Figure 5. Percent of single live births to women 1544 years of age thst

were bw bhlh weigh~ by race and marital status of mother at t-me of

birth United States, 1982

20 7 18,6

None Less 150r None Leas 150r

than 15 more than 15 more

Whtie women Black women

Number of cigarettes smoked per day during pregnancy

F~re 6. Percent of most recent Eve births to ever pregnant wornen

IW years of sge that ware Iew birth wei~h by race of mother and

number of cigarettes smoked per day during pregnancy

United States 1982
Sources of pqment for deIivery-About 68 percent of black women were paid for by Medicaid about four times as

deliveries to white women used private medical insurance often as were births to white women (30 percent versus 7

as a source of payment for delivery, compared with only 38 percent, figure 7). Black births were also nearly twice as

percent of deliveries to black women (figure 7). Births to likely as white births (15 percent versus 8 percent) to be

80?

70-

60-

50-

;

Q 40-

2

30-

24

44

—

Self, family,

or friends

68

38 r

Private medical

insurance

@ Bla.k

❑ White

Medicaid Other government All other

Source of payment for delivery

F~ure 7. Percent of live births in 1972-62 that were paid for, in whole or in pa~ from specified sourceq by race of mother: United States 19!32

40-

35-

30-

25-

E

g

20-

5

n

i 5-

10-

5-

o—

22

1973

10

1

1982

28

Own income

only

38

1973 1982

Privafe medical

insurance only

32

1973

25

10

9

7

8

6

5

i 982 1973 1982 1973 1982 1973 1982

Own income Medicaid Other government All other

and insurance

Source of payment for delivery

Figure 8. Percent distribution of most recent live births by source of payment for delive~ women 1544 yeare of age who ever had a live birth

United States+ 1973 and 1982

6
paid for by other government sources. Race differences in private medical insurance, declined (figure 8). The proporsource of payment for delivery were not significant for tion of births paid for by Medicaid or other government

never married women. sources did not change significantly overall, but the proporBetween 1973 and 1982, the proportion of live births tion paid for using government funds other than Medicaid

paid for entirely by private medical insurance increased. increased for black women, women who had not finished

The proportion paid for out of pocket, with or without high school, and women with low incomes.

7
Source and limitations

of the data

Cycle III of the National Survey of Family Growth

(NSFG) was based on personal interviews with a multistage

area probability sample of 7,969 women 15-44 years of age

in the civilian noninstitutionalized population of the conterminous United States. For the first time, women were

eligible for interview regardless of their marital status.

Between August of 1982 and February of 1983, 4,577

white women, 3,201 black women, and 191 women of other

races were interviewed. Black women and women 15–19

years of age were sampled at higher rates than others, to

increase the reliability of statistics from these groups. Each

interview was conducted in person and focused on the

respondent’s marital and pregnancy history, her use of

contraception, whether each pregnancy had been planned

at the time of conception, her use of family planning and

infertility services, her physical ability to bear children, and

a wide range of social and economic characteristics. Questions were also asked about prenatal care, the weight of

each child at birth, smoking and drinking during the last

pregnancy, and sources of payment for delivery of live

births. Interviews were conducted by trained female interviewers and lasted an average of 1 hour.

Characteristics such as race, origin, parity, education,

and geographic region refer to the woman who was

interviewed. For convenience in writing, in this report,

expressions such as “black births” refer to births to black

women, regardless of the race of the father. Similarly,

women living in families with incomes below 150 percent of

the poverty level are referred to as low-income women, and

women living in families with higher incomes are referred

to as high-income women.

The statistics cited are estimates for the national population from which the sample was drawn. Because the

estimates are based on a sample, they are subject to

sampling variability. Further, nonsampling errors may have

been introduced during interviewing, data processing, and

analysis, although quality control measures were used at

each stage to minimize error. Further discussion of the

survey design, definition of terms, and sampling variability

can be found both in the appendixes and in a detailed

report (NCHS, 1985a) on the design of the survey.

In this report, the term “similar” means that any

observed difference between two estimates being compared

is not statistically significant; terms such as “greater,”

“less,” “larger,” and “smaller” indicate that the observed

differences are statistically significant at the 5-percent level

using a two-tailed t-test with 39 degrees of freedom. Statements about differences that are qualified in some way (for

example, “the data suggest”) indicate that the difference is

significant at the 10-percent but not at the 5-percent level.

The following sections include comparisons with other

data and detailed descriptions of survey findings on when

prenatal care began, the source of prenatal care, smoking

and alcohol use during pregnancy, birth weight, and sources

of payment for delivery of live births. Appendix I contains

technical notes on how the survey was designed and conducted; appendix II, definitions of technical terms used in

the report; and appendix III, the survey questions on the

topics covered in this report.
Comparisons with

other data

The data in this report are from the 19S2 National

Survey of Family Growth. The NSFG is the only source of

reliable national data on the source of prenatal care (private doctor, hospital clinic, or other clinic—tables 7–12)

and on the sources of payment for delivery of live births

(insurance, Medicaid, and so forth-tables 27-33).

LOWbhfh w@hf-Data on birth weight are published

each year from the birth registration system for the United

States and for each State, by such characteristics as race,

age and education of the mother, birth order, and month of

the pregnancy for which prenatal care began. It is important to emphasize that the birth registration data are based

on com,plcte counts of all births and refer only to births in a

particular calendar year, but the data in this report are

based on a sample of births and refer to births in several

calendar years up to 1982. In addition, the data on low birth

weight-5 pounds S ounces (2,500 grams) or less—in this

report refer only to single live births, not all births. The

following table shows a sample comparison–the percent of

single live births that were low birth weight by race, from

the 1982 NSFG and the 1981 data on registered births

(NCHS, 1985b):

NSFG Registered

Race (*2 standartierrors) birihs,1961

All races . . . . . . . . . . . . . . 6.6 (* 1.0) 5.9

white . . . . . . . .. ~...... 5.6 (3 1.0) 4.8

Black . . . . . . . . . . . . . . . . 12.2 (*1.7) 11.3

The numbers in parentheses after the NSFG figures

show two standard errors around the NSFG estimate. In

each case, the NSFG data and the data from the registered

births are within two standard errors of each other; that is,

the NSFG estimates do not differ significantly from the

birth registration data.

Another source of data on low birth weight is the 1980

National Natality Survey (NNS), which was based on a

sample of about 10,000 births in 1980. Questionnaires were

sent by mail to mothers and health care providers to obtain

additional information about the births (Placck, 1984).

Timing of the jkrt prenafal \’isit—In the NSFG, the

mother was asked the following question for each birth that

occurrecl in 1979-S2: “During this pregnancy, did you ever

visit a doctor or clinic for prenatal care?” If the mother

answered “yes,” shc was asked: “How many months pregnant were you when you first visited a doctor or clinic for

prenatal care?”

On the birth registration certificate, the entry reads

“month of pregnancy prenatal care began” (first, second,

etc.). This was obtained either from the mother herself or

from physician records.

Differences between the wording of these questions

and those asked on the certificate of live birth and the NNS,

as well as differences in methods of data collection, the

time refere~ce of the questions, and sampling error, account for variation among the three data sources in the

observed percents of women who began care within a

specified period.

In general, a smaller proportion of respondents to the

1982 NSFG than of mothers in the NNS or of those in the

vital records reported beginning care in the first trimester;

76.3 percent of 19S0 birth certificates reported care in the

first trimester of pregnancy (Forrest and Singh, 1987), but

NSFG data show 65.9 percent of live births occurring

between 1979 and the date of interview as receiving tirsttrimcster care (table 1). These differences are important,

because they give different estimates of the amount of

progress that has been made toward the goal of timely

prenatal care for all mothers and babies. It is not clear

which source—the birth certificates, the NNS, or the

NSFG—gives lhe most accurate estimate of the true Ievel

of first trimester prenatal care, and further methodological

research is ncccssary to answer this question (Forrest and

Singh, 1987). However, all three sources– the NSFG, the

1980 NNS, and the vital statistics—show that black, unmarried, teenage, and less educated women get first-trimester

prenatal care less often than do others (Forrest and Singh,

19S7; Ingram, Makuc, and Kleinman, 1986; NCHS, 1978a).

This strengthens confidence in the NSFG findings for variables not contained in the NNS or vital statistics.

Smoking and alcohol consump~ion duringpwgnancyThese data are not available from the birth registration

system. They me available for married mothers from the

19S0 NNS (Prager et al., 1984). Thus the NSFG data on

smoking and alcohol use during pregnancy for never married and formerly married mothers are not available from

any other reliable national source.

Other dijf2wnccs—The NSFG contains a number of

variables that were not collected in the birth registration

statistics in the early 1980’s. These include the following:

● Income.

. Current receipt of Medicaid.

. Most recent occupation.
● Wontedness of the pregnancy. edness, and smoking and alcohol use. Therefore, the data

● Sources of payment for births. for unmarried mothers by income, occupation, and wanted-

. Smoking and alcohol use during pregnancy. ness and the data on smoking and drinking during preg-

. Type of provider of prenatal care. nancy for unmarried mothers are not avaiIabIe from any

Of these, the following were collected in the 1980 NNS,

other national source.

but only from married mothers: income, occupation, want10
Timing of the first prenatal visit

In numerous studies, mothers receiving prenatal care

have been shown to have better birth outcomes than have

mothers receiving no care. In these studies, prenatal care

has been associated with a lower incidence of low birth

weight, lower neonatal mortality, less need for neonatal

intensive care, and lower hospital costs (Moore et al., 1986;

Kotelcheck et al., 19S4; Heins et al., 1983; Leveno et al.,

1985). Further, most studies show that the impact of prenatal care is greatest for adolescent, unmarried, Hispanic,

black, and other high-risk women (Kotelcheck et al., 1984;

Greenberg, 1983; Peoples and Siegel, 1983).

Prenatal care is important because most interventions

to improve pregnancy outcome must occur in the context of

prenatal care (Institute of Medicine, 1985; NCHS, 1981a).

Prenatal care makes it possible to offer counseling on

nutrition, smoking, and alcohol and drug consumption

during pregnancy; to identifj medical conditions such as

high blood pressure and diabetes; to assess the risk of

problems such as preterm cielivcry, premature rupture of

membranes, and low birth weight; and to manage these

problems appropriately (Brown, 19S5; Institute of Mcclicine, 1985; NCHS, 1981a; Bchrman, 19S5; Moore et al.,

1986; Heins et al., 1983; Leveno et al., 19S5).

The timing of the beginning of prenatal care is widely

used as a convenient, if imperfect, indicator of the adequacy

of care. Recognizing its importance, the Surgeon General

of the United States in 19S0 set a goal that by 1990, at least

90 percent of women in all counties and of every racial and

ethnic group would bc obtaining prenatal care during the

first trimester (Koontz, 1984). The data in this section will

help to reveal the status of prenatal care in various social

groups in the United States near the beginning of the

1980’s.

Data on the timing of the first prenatal visit are shown

for live births in tables 1-6 in order to compare pregnancies

of approximately equal length. For example, most pregnancy losses occur early (LericJon, 1977); thus ~vhen older

women (who have more prcgmmcy Iosscs) arc compared

with younger women (who have fewer losses), more olclcr

than younger women would be cxpcctcd to have receif’ed

no care, because more of their pregnancies did not last 9

months. In fact, as shown in table 7, women who hod

pregnancy losses arc much more likely than mothers of live

births to rcccive no prenatai care at all, apparently because

many women do not know they are pregnant until a miscarriage occurs or miscarry shortly after they find out. Thus, a

woman who has a miscarriage in the first trimester, before

beginning prenatal care, would be classified as receiving no

care, largely because the pregnancy ended before she had a

chance to seek prenatal care. To avoid this problem, miscarriages are excluded from tables 1–6. Stillbirths are excluded because there were too few in the survey to study

separately and because limiting the data to live births

makes the data more comparable to the other data on live

births in this report and to those in the tables based on the

birth registration system.

Characte)isfics of the pregnarrq~-Data from the NSFG

show that the timing— and by implication the adequacy—of

prenatal care varies considerably by age (table 1). Less than

half (46 pcrccnt) of births to teenaged mothers receivccl

early care, compared with three-quarters of births to

women aged 25-29 years. About 17 percent of births to

adolescent mothers received care only after the fiflh full

month of pregnancy or not at all, three times the proportion

among births to mothers aged 25–29. Second births were

sorncwhat more likely to receive care in the first trimester

(73 pcrccnt) than were first births or third or higher-order

births (63 and 60 percent, respectively). These findings by

age and birth order arc consistent wi[h those reported by

Ingram et al. (19S6) and by Taffel (NCHS, 1978a), based

on vital statistics data.

Births to never married women were much lCSSlikely

to have rcccivcd care early in the pregnancy than were

births to ever married women (table 1). Only 44 percent of

bir[hs to never married mothers had care initititccl in the

first trimester, compared with 71 pcrccnt of births to ever

married women. Births to never married women were

much more likely to get late prenatal care or no care than

births to ever married women. These findings arc consistent

with those from other national data sources (Forrest and

Singh, 1987; Ingram, Makuc, and Kleinman, 19S6; NCHS,

1978a). Similarly, only half (50 percent) of all unwanted

births and only 56 percent of mislimcd births rcccived

first-trimester care, compared with 73 pcrccnt of births that

were wanted at the time they were conceived (’\vanlccl

then” in table 1).

Comparing tables 2 and 3 reveals large diffcrcnccs in

the timing of prcnat al care by race. White molhcrs reported

that prenatal care began in the first 3 months of pregnancy

for 69 pcrccnt of their births between 1979 and the date of

11
interview; this compares with only 53 percent of those of

black women (figure 1). Much of this difference was made

up in the fourth or fifth month of pregnancy-37 percent of

black births had had prenatal care beginning in the fourth

or fifth month, compared with 24 percent of white births.

The percents in the last timing category are similar by race

(tables 2 and 3).

The pattern of variation in the timing of the first

prenatal visit by age, birth order, marital status, and wontedness status for both white and black births is generally

consistent with the pattern just described for all races

combined. For example, the difference in the percent of

births receiving prenatal care in the first trimester between

those with mothers aged 25–29 and those with teenaged

mothers was approximately 26 percentage points for both

white and black women; and births to never married

women were much less likely to get early care in each racial

group (figure 1). The data suggest, however, that the

difference in the timing of prenatal care between unwanted

births and those that were appropriately timed was larger

for black (28 percentage points) than for white women (19

percentage points).

Hispanic o]ig”n —The timing of prenatal care for births

to Hispanic women is shown in table A according to age

and marital status. These data are compared with those for

non-Hispanic white and non-Hispanic black births separately, because the differences between white and black

non-Hispanic births are so large that using an overall

“non-Hispanic” category for comparison would be misleading (Ingram, Makuc, and Kleinman, 1986; Felice et al.,

1986; Chavez et al., 1986; Williams et al., 1986).

The data in table A suggest that age and marital status

differences in the timing of prenatal care for Hispanic

births are considerably different from the general pattern

(NCHS, 1978a). For example births to Hispanic teenagers

were more likely to have received first-trimester care than

births to non-Hispanic white teenagers (64 percenl versus

45 percent). In contrast, births to Hispanic women aged 20

years and older were much less likely to receive firsttrimester care than births to non-Hispanic white women

(46 percent versus 66 percent at 20-24 years of age).

Another contrast between Hispanic and other births is

shown in the data by marital status in table A. Births to

never married non-Hispanic white women were much less

likely to receive early prenatal care than births to ever

married non-Hispanic white women (39 percent versus 74

percent). The same was true for non-Hispanic black women

(43 percent versus 63 percent). However, among Hispanic

Table A. Number of pregnancies ending in a live birth in January 1979 or later to women 15-44 years of age and percent distribution by

months pregnant when prenatal care began, according to race, origin, and age and marital status at birth: United States, 1982

[Statistics are based on a sample of the household population of the conterminous United Stales. See appendixes I and II for discussion of the sample design,

sampling variability, and definitions of temrsi

Monfhs pregnant when prenatal care began

Number in Less than 3or4 5 months or

Characteristic thousands Total 3 months months more or 170care

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s age at lime of birlh:

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s marilal status at lime of birth:

Never married . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried, . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Non-Hispanic while . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s age at IIme of birfh:

tJnder20 years . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s marital status at time of birlh:

Never married . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Non-H6panic black . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s age at time of birth:

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s marital status at hme of birth:

Never married . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11,704

380

527

796

460

1,222

i 10,246

1,016

3,369

5,842

913

9,311

12,020

512

755

752

1,021

995

Percent distribution

100.0 56.1 25.6 16.1

100.0 64.0 ‘20.0 *16.O

100.0 46.2 35.9 *17.9

100.0 63.1 *2 I .9 *15.O

100.0 56.5 *19.6 *21.7

100.0 56.0 28.0 *14.O

100.0 70.4 23.2 6.4

100.0 45.0 40.0 *15.O

100.0 66.1 26.7 *7.3

100.0 77.4 16.2 *4.4

100.0 39.1 43,8 *17.1

100.0 73.6 21.1 5.4

100.0 52.7 36.9 10.4

100.0 37.9 43.8 18.3

100.0 53.7 36.3 ‘6.0

100.0 62,0 30.7 *7.2

100.0 43.2 41.6 15.2

100.0 62.5 32.1 *5.3

1Includes births for which mothets marital status at birth was unknown and other races, not slvxm separately.

12
births there was almost no difference by marital status in

the proportion receiving early prenatal care (59 percent

versus 5S percent, table A).

Showing Hispanic births separately appears to affect

white-black comparisons of the timing of prenatal care. For

example, comparison of data for white and black women in

tables 2 and 3 and in table A shows that excluding Hispanic

births from the comparisons for teenage births cuts the race

difference in half, making it nonsignificant:

Percent receiving care

in first 3 months

Tables

Teenage mothers 2 and 3 Table A

Vie... . . . . . . . . . . . . . 50.9 45.0

Black . . . . . . . . . . . . . . . . 37.0 37.9

Difference . . . . . . . . . . . . . 13.9 7.1

The slightly greater proportion of births to never married non-Hispanic black mothers receiving care in the first

trimester (43 percent) compared with the proportion for

never married non-Hispanic white mothers (39 percent,

table A) is not statistically significant, but it is consistent

with findings from vital statistics and the 19S0 NNS

(Forrest and Singh, 1987; NCHS, 1978a).

These differences suggest that the pattern of the time

of first prenatal care by age and marital status differs by

Hispanic origin, with teenage and never married Hispanic

women resembling non-Hispanic white women, and older

and ever married Hispanic women resembling

non-Hispanic black women. An overall Hispanic versus

non-Hispanic comparison would obscure these two distinct

patterns of prenatal care. Further, differences by Hispanic

origin sometimes affect comparisons of white and black

women as shown above. The sample sizes for Hispanic

pregnancies are too small to investigate these hypotheses in

greater detail in this report, but these findings suggest that

it will be most useful to show Hispanic pregnancies by age

and marital status and contrast them with pregnancies of

non-Hispanic white and non-Hispanic black women separately.

Charatkvistics of the mofher-The timing of first prenatal care for all live births since January 1979 by selected

characteristics of the mother at the date of the NSFG

interview is shown in table 4.

The timing of prenatal care differed sharply with the

socioeconomic characteristics of the mother. Fewer than

half of births to mothers with less than 12 years of schooling

received prenatal care in the first trimester (4S percent),

compared with more than three-fourths of infants born to

mothers wiih some colIcge (77 percent). About 18 pcrccnt

of births to the least educated women rcceivcd care only

after the fifth month of pregnancy or not at all, compared

with only 3 percent of births to college-educated women.

The largest differences in the timing of prenatal care

are in the mother’s most recent occupation. Prenatal care

began in the first trimester for 82 percent of births to

professionals or managers; this proportion declined to less

than 50 percent for births to women working in craft,

operative, or farm occupations, and for women who never

worked. Similarly, the proportion who began care at the

sixth month or later or who never received care ranged

from 3 percent for births to professionals and managers to

21 percent for births to women who had never worked.

Only half of births to low-income women (149 percent

of poverty level or less) began to receive prenatal care in

the first trimester, compared with three of four births to

higher-income women. Similarly, only 46 percent of births

to women receiving Medicaid at the time of the interview

had prenatal care beginning in the tlrst trimester, compared

with 69 percent for those not receiving Medicaid. This does

not necessarily mean that these mothers were Medicaid

recipients at the time they became pregnant; it is possible

that being pregnant, needing care, and having no other

source of care was the reason they became Medicaid

recipients.

The distribution of births by mother’s region, education, occupation, income, and Medicaid status varies by

race; thus the timing of prenatal care for these characteristics is given separately for white and black women in tables

5 and 6. Births to white women living in the Northeast were

more likely to rcccive first-trimester care than births to

women in the South (78 percent versus 65 percent, table 5).

This was also true for black women (63 percent versus 49

percent, table 6). The proportion of births to black women

who received early care differed more sharply by mother’s

educational lCVC1than did births to white women. For white

mothers, the proportions beginning prenatal care in the

first trimester were 52 percent in the lowest education

group and 79 pcrccnt in the highest, a range of 27 percentage points, but for black mothers this proportion ranged

from 35 percent in the lowest education group to 71

percent in the highest, a range of 36 percentage points.

Thus, births to white mothers with less than a high school

education were more likely to receive care in the first

trimester (52 percent) than were births to black mothers

with this amount of schooling (35 percent), but among

births to mothers with at Icast some college, the proportions receiving early care were simik.lr.

There were large race differences in the timing of

prenatal care for sales and clerical and for service workers.

However, the proportions of births receiving first-trimester

care did not differ significantly by race among professionals

and managers or among craft workers, operatives, or farm

workers. In addition, the data also suggest that infants born

to white mothers were more likcly to have rcccived firsttrimcstcr care than infants born to black mothers regardlCSSof whether income at survey date was lCSSthan 150

pcrccnt of the poverty level or more. However, for infants

born to mothers with incomes of 3tltl pcrccnt of the poverty

level or more, the percents receiving early care were similar

by race—79 percent for white and 78 percent for black

women. There also was no significant race difference in the

timing of prenatal care among births to mothers receiving

Medicaid at the interview date.

In summary, there was no significant difference by race

in the proportion receiving first-trimester prenatal care

13
among relatively homogeneous groups: those with incomes

of 300 percent of poverty level or more; craft workers,

operatives, and farm workers; or women receiving Medicaid. Race differences are largest within relatively large and

diverse groups, such as women not receiving Medicaid and

high school graduates. In other words, the very large race

difference in receipt of first trimester prenatal care is not

significant when socioeconomic stahu differences between

white and black women are well conholledfor. This suggests

that socioeconomic status, not race itself, is the most

important determinant of early prenatal care.

Receipt of any prenatal care–About 93 percent of all

women who had pregnancies ending in a live birih or

spontaneous fetal loss in 1979–82 received some prenatal

care (table 7). This percent varied from approximately 90

percent among pregnancies of never married and teenage

mothers to 96 percent of pregnancies of women aged 25 to

29 years. The proportion receiving prenatal care was even

higher for pregnancies ending in a live birth—98 percent–

with very little variation by age, marilal status, or wontedness status at conception. The proportions receiving prenatal care were similar for white and black women and

virtually identical when limited to live births (tables 8

and 9).

The percent of women receiving prenatal care and the

source of care at first visit are shown by race and Hispanic

origin in table B. The data suggest that both overall and at

the older ages, pregnancies to Hispanic women were less

likely to receive any prenatal care (87 percent overall)

compared with pregnancies to non-Hispanic white women

(95 percent overall). However, the data also suggest that

Hispanic teenagers were somewhat more likely than nonHispanic white teenagers to receive any care at all (98

percent versus 87 percent).

Table 10 also shows that pregnancies to women who

had not graduated from high school were less likely to

Table B. Number of pregnancies ending in live births or spontaneous loss in January 1979 or later to women 1544 years of age,

percent receiving prenatal care, and percent distribution of pregnancies receiving care by source of care at first visit, according to race,

origin, and age and marital status at pregnancy outcome: United States, 1982

[Statistics are based on a sample of the housetsold population of the conterminous United States. See appendixes I and II for discussion of the sample design,

sampling variability, and definition of terms]

Source of prenatal care

al fhw vkit

NumDer in Percent receiving Privale Hospital Other

Characteristic thousands prenatal care Total doctor clinic clinic

All pregnancies

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s age at pregnancy outcome:

Under 20 years . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24 years....<,.......<.. . . . . . . . . . . . . .

25-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s marital status at pregnancy outcome:

Never married . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Non-Hlspanlc white . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s age at pregnancy outcome:

Under 20 years . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s marifal status at pregnancy outcome:

Never married . . . . . . . . . . . . . . . .. . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Non-Hispanic black . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s age at pregnancy outcome:

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . .

25-44 years.............,.. . . . . . . . . . . . . .

Mother’s marital status at pregnancy outcome:

Never married . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ever married . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ltve births

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Non-Hispanic whiff ..,...... . . . . . . . . . . . . . . . . .

Non-Hispanic black . . . . . . . . . . . . . . . . . . . . . . . . . .

Percenl distribution

I 1.993 86.6 100.0 61.8 16.0 22.2

406

570

1,018

98.3

80.3

85.4

100.0

100.0

100.0

66,6

45.8

87,9

*15.5

*24.9

●11.6

*17.9

*29.3

‘20.5

522

1,470

88.6

86.6

100.0

100.0

62.5

65.2

‘29.0

●11.4

*18.5

23,4

112.340 94.6 100.0 82.9 6.1 11.1

1,355

3,862

78104

87.1

95.2

95.7

100.0

100.0

100.0

66.0

75.0

90.2

*1 6.5

7.5

*3.4”

*17.5

17.5

6.4

1,230

11,086

12,489

91.4

94.9

100.0

100,0

52.2

86.1

47.6

●18.5

4.7

~7.8

29.3

9.2

90.8 100,0 34.7

631

884

975

90.8

92.0

89.7

100.0

100.0

100.0

31.9

42.6

62.8

18.2

19.4

15.9

49.9

37.9

21.2

1,269

1,213

90.2

91.4

100.0

100.0

37.2

58.6

16.7

16.5

44.0

24.9

1,704

10,246

2,020

93.2

99.2

98,3

100.0

100.0

100.0

61.5

82.6

47.7

16.6

6.1

17.8

21.9

11.3

34.5

1Inctides pregnarwies for which mother’s marital status al cutcome was unknown d other races, not shown separately.

14
receive prenatal care at all (88 percent) than were pregnancies to women with more education (95 percent). This was

true for pregnancies ending in live birth as well, although

the difference was not as large.

First source of prenatal care

Although many studies of prenatal care have been

published, statistics like those in tables 7-12 do not appear

to be available from any other national source. First

sources of prenatal care are categorized in tables 7-12 as

‘{private doctor~’ “hospital clinicfl and “other (nonhospital)

clinic.”

Women interviewed in (hc 1982 NSFG were asked to

specify the type of prenatal care provider they used on their

first visit for each pregnancy ending on or after January 1,

1979. These are listed in tables 7–12 for all pregnancies

except those ending in induced abortion; pregnancies ending in live birth are shown separately. If a woman reported

that her first prenatal care for a particular pregnancy was

by a private doctor, private group practice, co-op, or private

clinic, the care was classified in tables 7–12 as by a private

doctor. Care at a hospital clinic is shown separately in

tables 7–12. Care at a community health center clinic,

public health department clinic, family planning or abortion

clinic, student health service, or military health service

clinic is classified as “other clinics” in tables 7–12 and

sometimes referred to as “nonhospital” clinics in the text.

Chcvactenktics of the pregnmcy-In 75 percent of all

prcgnancics, the first prenatal visit was to a private doctor;

in 9 percent, to a clinic in a hospital; and in 16 percent, to

some other type of clinic. These same percents charactcrfizcd all pregnancies ending in a live birih. There were,

however, large differences in the first source of prenatal

care, depending on the age of the pregnant woman, her

marital status, and lhe wantcdness status of the pregnancy.

The proportion of women receiving care from clinics

dccrcascd as the age of the pregnant woman increased.

Teenagers were four times as likely to use a hospital clinic

or other clinic for the first prenatal visit as women 30-44

years of age (-M pcrccnt, compared with only 11 pcrccnt ).

A majority of pregnancies to never married women (55

pcrccnt) rcccivcd prenatal care scrviccs from hospital clinics or other clinics. This compares with only 18 percent for

pregnancies to ever married women. Furthcrrnorc, planned

pregnancies were associated with privately financed care,

but differences in source of care behvccn mistimccl and

unwanted pregnancies were not significant, All of these

general observations held for live births as WCH.

Data m-e shown separately for pregnancies ofwhitc and

of black women in tables 8 and 9. First sources of care

diffcrccl substantially by race; four of five prcgrmncics of

white women rcceivcd care from a private doctor, compared with fewer than half of pregnancies to black women

(figure 2). Black women were more than twice as likely as

white women to have made their first prcrmtal visit to a

hospital clinic (18 percent versus 7 percent) or other clinic

(34 percent versus 13 percent).

For both races, the proportion rccciving first prenatal

care from a nonhospital clinic declined as age of the woman

increased, but the decline was much steeper for black

women. (The only increase, for white women aged 20-24

years, was not significant.) For about 50 percent of pregnancies to black teenagers receiving care, the first visit was

to a nonhospital clinic. This proportion decreased sharply

as age increased, to 17 percent of pregnancies to black

women 30J14 years of age. Among white women, 17

percent of pregnancies to teenagers first received care from

nonhospita] clinics, declining to 6 percent at age 30-44.

Thus, the proportion of pregnancies receiving care at nonhospital clinics was higher for black than for white women

in each age group, but the difference was greatest at the

youngest ages.

In contrast, the proportion of teenage pregnancies

receiving prenatal services from hospilal clinics was similar

for white and black women (16 percent versus 18 percent).

But among pregnancies to white women, the percent receiving their first prenatal care from a hospital clinic declined sharply with age, from 16 percent to 3 percent, while

among pregnancies to black women, the observed decline

from 18 percent to 14 percent was not large and not

statistically significant.

There was no significant variation in lhe first source of

care by pregnancy order for white women, but first pregnancies of black women were more likely to receive prenatal services from nonhospit al clinics (41 percent versus 14

percent, tables 8 and 9), perhaps because of the higher

proportion of first pregnancies at younger ages for black

women.

For both races, pregnancies of newer married women

were less likely to rcccivc care from private doctors and

more likely to obtain scrviccs from nonhospital clinics than

pregnancies to ever marriul women (figure 2). Prcgnancics

to never married while women were almost four times as

likely to receive their first prenutal care from hospital

clinics (22 pcrccnt) than were pregnancies occurring to ever

married white women (6 pcrccnt ). In contrast, the pcrccnt

of black pregnancies first rccciving prenatal semices from a

hospital clinic did not vary significantly by marital stu[us.

Thus, similar proportions of prcgmmcics to white and black

never marriw! women rcccivecl prcnutal cmc at a hospital

clinic (22 and 19 pcrccnt), but a larger proportion of

pregnancies to never marriccl black women reccivcr,l their

first prenatal care at a nonhospital clinic (44 and 26 percent).

These patterns of variation in source of prenatal care

according to race, age, and marital status apply equally to

the subset of pregnancies cncling in live birih. Thus, it is not

surprising that births rccciving late or noncontinuous prenatol care were more likely [o htivc rcccivecl their first

scrviccs from a clinic—younger, never murricd women and

women whose pregnancy was unwanted at conception were

both more Iikcly to initiate care after (hc first trimester and

to have altcnded a clinic for their first prenatal visit. As

seen in the last line of table 7, 39 pcrccnt of women

rccciving late or discontinuous prenatal care rcccivcd their

15
first services from a clinic, but the proportion varied from

33 percent for white births to 63 percent for black births

(tables 8 and 9).

Among pregnancies receiving care, those to Hispanic

women were less likely than those to non-Hispanic white

women to obtain it from private physicians (62 percent

versus 83 percent, table B). However, this difference was

limited to pregnancies of women aged 20 years or older and

married women. Pregnancies of Hispanic teenagers were

very similar to those of non-Hispanic white [ecnagers in

source of prenatal services, but pregnancies of Hispanic

women 20 and older were more similar to those of nonHispanic black women 20 and older. Vital statistics data

suggest that Hispanic teenage mothers were most often

U.S.-born and older Hispanic women foreign-born;

foreign-born women are probably more likely than U.S.-

born women to use clinics (Ventura and Taffel, 1985).

Characteristics of the woman —The percent of pregnancies receiving any prenatal care and the source of care at

first visit are shown in table 10 and separately for white and

black women in tables 11 and 12 by selected characteristics

of the woman on the date she was interviewed.

Overall, pregnancies to women living in the Midwest

were more likely to have received their first prenatal services from private physicians than were those to women in

the Northeast or South (83 percent versus 71 percent).

Pregnancies to women in the Northeast were more than

twice as likely to have obtained prenatal care at a hospital

clinic than were those in any other region (17 percent

versus 7 to 8 percent). A larger proportion of pregnancies

to women living in the South received care from “other”

clinics (23 percent), compared wiih those in the Northeast

or Midwest (9 to 12 percent).

The proportion of pregnant women receiving care from

private physicians differed sharply with the level of education—from 56 percent for pregnancies to women with less

than 12 years of schooling to 86 percent for women who

had attended college. Pregnancies to women with less than

a high school education were four times as likely to have

received service from a hospital clinic (16 percent versus 4

percent) and over two and a half times as likely to have

received services from ot hcr clinics (28 percent versus 10

percent) as pregnancies to college-educated women.

Differences by education in the proportion of pregnancies receiving care from clinics were larger for white than

for black women. Pregnancies to white women with less

than 12 years of schooling were at least twice as likely to

have first received services at either a hospital clinic or

other clinic than were those to high school graduates (39

percent versus 17 percent). Among pregnancies to black

women, this difference by education was smaller (64 percent versus 56 percent) and not significant. The racial

difference in the proportion of pregnancies to women with

less than a high school education that received care at

hospital clinics was not significant (16 percent versus 19

percent).

Differences according to most recent occupation were

marked. The proportion of pregnancies receiving care from

private sources differed sharply, from 88 percent of professionals and managers to 53 percent of women who had

never worked (table 10). The decline was steeper for black

women, from 78 percent to 30 percent (table 12).

Pregnancies to white women were more likely than

pregnancies to black women to receive their first prenatal

care from private doctors in every occupational group

except professionals and managers, for whom the difference was not significant (tables 11 and 12). Similarly, with

the exception of professionals and managers, the percent

receiving care at nonhospital clinics was two or three times

as large for black as for white women in each occupational

cat egory.

Overall, pregnancies to low-income women were more

than twice as likely to have received care from a hospital

clinic (14 percent versus 6 percent) and almost three times

as Iikcly to have received care at a nonhospi[al clinic (28

percent versus 10 percent) than prcgancies to women with

higher incomes (table 10).

In each income catego~, pregnancies to black women

were less likely than pregnancies to white women to,receive

care from private physicians and substantially more likely to

get it from nonhospital clinics. Indeed, most of these differences were significant at the 0.001 level. The proportion of

black women receiving services at hospital clinics did not

differ significantly by income, but the proportion obtaining

care at nonhospita] clinics was sharply higher for lowincome black women (43 percent) than for high-income

black women (24 percent).

Fewer than half (42 percent) of women receiving Medicaid at the survey date had obtained prenatal care from a

private doctor. About 20 percent received care at a clinic in

a hospital, and 38 percent received care at a communitybasecl clinic. There was no observed difference between

white and black Medicaid recipients in the proportion

receiving hospital clinic services, and the observed differences in the proportions receiving private physician services

and care at “nonhospital” clinics were not large enough to

be significant, given the relatively small number of women

in the sample who were receiving Medicaid.

These generalizations regarding the source of prenatal

care are also true when only pregnancies ending in live

birth are examined.

Cigarette smoking during most

recent pregnancy

Smoking during pregnancy has been shown 10 increase

the risk of adverse pregnancy outcomes, including low birth

weight, prcterm birth, miscarriage, premature rupture of

membranes, infant death, low Apgar scores, and illness

during childhood (Harlap, 1987; Keppel and Taffel, 1987;

Hogue and Sappenfield, 1987; Moss et al., 1987; Sachs,

1987; Stein and Kline, 1983; Anderson et al., 1984; Dougherty and Jones, 1982; Rantakallio, 1983). These effects

worsen when smoking is heavier (Moss et al., 1987: Sachs,

1987; Anderson et al., 1984; Dougherty and Jones, 1982).

Recent studies attribute 21–39 percent of cases of low birth

16
weight, 1l–14 percent of cases of preterm births, and about

4,600 infant deaths in the United States each year to

maternal smoking (Behrman, 19S5; Hogue and Sappenfielcl, 1987; Sachs, 1%S7).

Most well-controllccl studies show that, independently

of other factors, smoking reduces birth weight by 150-300

grams, and doubles the risk of low birth weight (Hogue and

Sappcnficld, 1987; Stein and Kline, 19S3; Anderson et al.,

19s4).

The effects of maternal smoking on postnatal child

health arc more difficult to study, but two recent reports

suggest that maternal smoking during pregnancy has longh.lsting adverse effects. Moss et al. (19S7) found that children under the age of 3 years whose mothers smoked

during pregnancy were more likely to bc in poor health, to

have a chronic condition, to be hospitalized at least once,

and to have more days of bed rest because of illness than

was true for children of mothers who did not smoke during

pregnancy. These relationships were stronger for children

of mothers who smoked more, and they held when controlling for the mother’s age, parity, and education and the

child’s birth weight. Investigators in Finland who followed

children to the age of 14 (Rantakallio, 19S3) found that

children of mothers who smoked during pregnancy had

more respiratory diseases, were shorter, and had lower

average achievement in school than other study children,

after controlling for oiher variables.

Chamctcvistics of the pregnancy-The National Survey

of Family Growth data in tables 13–18 show patterns of

smoking during pregnancy for both married and unmarried

women and include other characteristics not found in any

other national source. Women who had ever been pregnant

were asked, “On the average, during your last pregnancy,

how many cigarettes per day did you usually smoke, if

any?”

The answer categories were:

●

●

●

●

●

●

●

●

About one a clay or less.

Just a fcw (PI).

About half a pack .(5–14).

About a pack (15-24).

About 1% packs (25-34).

About 2 packs (35-44).

More than 2 packs (45+).

Didn’t smoke during last pregnancy.

Women who reported smoking about half a pack (5-14

cigarettes) or less per day are shown in tables 13-15 as

having smoked fewer than 15 pcr day. These women are

sometimes referred to as light smokers in the text. Those

who reported smoking about a pack (15–24) or more per

day are shown in tables 13-15 as having smoked 15 or more

per day and arc called heavy smokers in the text.

Overall, nearly 7 out of 10 women did not smoke at alI

during their most recent pregnancy (69 percent, table 13).

Those who did smoke were divided almost equaIIy between

those smoking fewer than 15 cigarettes per day (16 percent)

and those smoking 15 or more per day (15 percent). The

proportion who did not smoke at all was similar for white

and black women (69 and 71 percent), but black women

were less likely to have smoked 15 or more cigarettes per

day (10 percent versus 16 percent, tables 14 and 15).

For white women, the proportion of nonsmokers increased with age at pregnancy outcome from 58 percent of

teenagers to 73 percent of women aged 25–44 years (table

14). This pattern was not observed for black women (table

15). The highest proportion of bIack women who did not

smoke at all was at ages 20-24 (75 percent) and the lowest

(66 percent) at ages 30-44 years. The proportion of black

women smoking 15 or more cigarettes per day increased

from 6 percent of teenagers to 16 percent of the oldest age

group, but for white women there was a nonsignificant

decIinc with age in the proportion who smoked heavily.

White ever married women were more likely not to

have smoked during their most recent pregnancies than

white never married women (70 percent versus 54 percent,

table 14). However, this difference by marital status was

smalIer and not significant for black women. About 25

percent of never married white women smoked 15 or more

cigarettes pcr day, compared with 15 percent of ever married white women; for black women, the proportions who

smoked heavily were similar by marital status.

Refraining from smoking was more common among

women whose last pregnancy had been wanted at the time

of conception, but for black women, these percents did not

differ significantly.

Of the women whose most recent pregnancy ended in a

live birth, 71 pcrccnt dicl not smoke at all while they were

pregnant, compared with only 59 percent of women whose

most recent prcgnaney ended in a miscarriage or stillbirth.

The difference between the proportions of nonsmokers

according to pregnancy outcome was somewhat larger for

black (17 percentage points) than for white women (12

percentage points). The data suggest, however, that for

both races, the proportion of women smoking 15 or more

cigarettes per day was about 8 percentage points higher for

those whose most rcccnt pregnancy ended in miscarriage or

stillbirth than for those whose pregnancy ended in a live

birth.

For women whose most recent prcgnaney ended in

January 1979 or later, 77 percent who rcceivcd adequate

prenatal care did not smoke at all, compared with only 65

percent of women who did not receive adequate care. The

data suggest that the proportions of women who smoked

were higher for women receiving late or discontinuous care

than for oihers. These findings su~est either that adequate

care discourages some women from smoking during pregnancy or that women with good health habits (such as not

smoking) use prenatal health services more than do women

with worse hcal[h habits.

In general, the Iargest race differences were observed

in the proportion of women smoking 15 or more cigarettes

pcr day during tbcir last pregnancy, with a higher percent of

white than of black women smoking heavily. Race differences in t!le percent smoking heavily were greatest for

17
Table C. Percent of women 1544 years of age whose most recent pregnancy ended in live birth or spontaneous loss not smoking

cigarettes and not consuming any alcoholic beverages during the most recent pregnancy, by race, origin, and selected characteristics:

United States, 1982

[Statistics are basedon a sample of the household population of the contermlnous United States. See appendixes I and II for discussion of the sample design,

sampling varlablllfy, and definition of terms]

Percent not smoking Percent nof drinking

cigarettes at all alcofrol at all

Non-Hispanic Non-Hispanic Non-Hispanic Non-Hispanic

Characfer/sfiC Hispanic whale black Hispanic white black

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82.8 67.2 70.8 69.3 49.8 87.0

Age at pregnancy outcome

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77.7

20-24 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81.7

25-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84.8

54.8

62.0

71.5

72.5

75.0

66.7

77.0

76.3

82.2

66.6

53.6

45.5

77.0

70.4

60.0

Martial status at pregnancy outcome

Nevermarrled . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77.8

Evermarrled . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85.1

45.5

68.4

67.1

72.7

71,5

68,0

47.9

49.9

68.5

65.7

Pregnancy outcome

Llvebkth. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83.1

Spontaneouspregnancyloss... . . . . . . . . . . . . . . . . . 80.4

68.4

55.6

73.2

54.7

70.9

54.5

50.0

47.1

66.8

54.9

1Data for all racesati origins are shown In tables 13 aml 16. Races other than white or black are not shown Separately.

women who had never married orwere in their teens atthe

outcome of their most recent pregnancy. The race differenceinheavy smoking diminished as age increased.

Thepercentsof women nonsmoking during their most

recent pregnancies are given in table C by race and Hispanic origin. The proportion whodid not smoke at all was

83 percent for Hispanic women—higher than for nonHisptmicwhite (67 percent) and black (71 percent) women.

Thepercentwhodid not smoke atall increased significantly

with age for non-Hispanic white women (from 55 to 72

percent), but this increase was smaller and not significant

for Hispanic women (from 78 to 85 percent).

Ever married non-Hispanic white women were one and

a half times as likely to have abstained from smoking during

their most recent pregnancy (68 percent) than were never

married women (46 percent). In contrast, abstention from

smoking did not differ significantly by marital status among

Hispanic or non-Hispanic black women. Thus, the proportion abstaining from smoking was lowest for never married

non-Hispanic white women: Only 46 percent abstained

during their most recent pregnancy, compared with 78

percent of never married Hispanic women and 67 percent

of never married non-Hispanic black women.

To account for differences in time between a woman’s

most recent pregnancy and the date of interview, table D

details smoking behavior by year of outcome. Perhaps

because of increasing awareness of the dangers of smoking

during pregnancy, the proportion smoking heavily (15 or

Table D. Number of women 15-44 years of age whose most recent pregnancy ended in live birth or spontaneous loss and percent

distribution by average number of cigarettes smoked per day during the pregnancy, according to race of woman and year of outcome:

United States, 1982

[Statisticsare basedon a sample of the household population of the coniermlnous United States. See appendixes I and II for discussion of the sample design,

samplmg variability, and definition of terms]

Average number of cigarettes smoked

per day during pregnancy

Number

Race of woman of women Fewer 15 or

and vear of outcome /n thousands Total None than 15 more

Percent distribution

Allwomenl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29,345

9,890

7,974

11,481

100.0 69,4 15.7 14.9

198C-82 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1975-79 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Before 1975 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

100.0 72.2 16.1 11.6

100.0 69.1 15,2 15.6

100.0 67.3 15.7 17.0

White women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24,174 100.0 66.7 15.2 16.1

1960-62 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

197s79, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Before 1975 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8,109

6,299

9,765

100.0 71.8 15.4 12.9

100.0 66.7 14.7 16.6

100.0 66.2 15.4 18.4

4,222

1,412

1,398

1,412

100.0 70.9 19.6 9.5

100.0 70.6 22.6 6.8

100.0 71.6 17.3 10.9

100.0 70.4 18.9 10.7

Black women . . . . . . . . . . . . . . . . . . . . . . . . . . .

1980-82 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1975-79 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Before 1975 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Incbdes white, black, and otkr races.

18
more cigarettes per clay) was smaller for women whose last

pregnancy ended in 1980-82 than for those whose pregnancy ended before 1975 (12 percent versus 17 percent).

For black women, the observed percent decrease betsveen

1975–79 and 1980-82 was smaller than for white women

and not significant. In short, in 1980-82 white women were

still more likely to smoke 15 or more cigarettes per day

during pregnancy than were black women, but the difference was a little less than before 1975.

Characteristics of the woman —Smoking behavior during the most recent pregnancy is shown according to selected characteristics of the woman at the time of the

interview in tables 16-18.

Proportions of women not smoking at all were similar

for all four geographic regions (table 16). White women in

the Midwest and South were more likely to have smoked

“heavily” during their most recent pregnancy than were

black women living in the same regions (tables 17 and 18).

The percent of women who refrained from smoking

during their most recent pregnancy rose substantially with

their years of schooling: 79 percent of women with some

college education did not smoke at all, compared with only

56 percent of women with less than a high school education—a difference of 23 percentage points. Overall, differences by education made a larger difference in the

proportion smoking heavily than in the proportion smoking

lightly women with less than a high school education were

more than twice as likely as college-educated women to

have smoked at least a pack a day during their most recent

pregnancy (24 percent versus 9 percent). It is worth noting,

however, that this difference by education was much larger

for white women (26 percent versus 9 percent) than for

black women (13 percent versus 6 percent, I@re 3).

Given their obscrwcd differences by education, it is not

surprising that a larger percent of women employed as

professionals or managers (78 percent) than of women

working in service occupations (62 percent) or in craft or

farm occupations or as operatives (63 pcrccnt) did not

smoke at all during their most recent pregnancy.

Low-income white women were more likely to have

smoked during their last pregnancy than were higllcrincome white women, but this cfiffcrcncc was smaller for

black women and not significant. Similarly, white women

rccciving Medicaid were much less Iikcly to abstain from

smoking (50 percent, table 17) than were women not

receiving Medicaid (70 percent). Further, for white women,

almost twice as many of those receiving Medicaid as of

those not rccciving Medicaid smoked 15 or more cigarettes

per day (29 percent versus 15 percent). In contrast, there

was no significant cliffcrence by Medicaid status for black

women, either in Ihc proportion who had abstained or in

the proportion who had smoked heavily.

Thus, white women with lCSSthan a high school education, those most rcccntly employed as craft or farm workers

or as opera~ivcs, and those receiving Medicaid at the date

of interview were more li!icly than their black countcrpurts

to have smohxl heavily during their most recent pregnancy

(tables 17 and 1S and figure 3).

Alcohol consumption during most

recent pregnancy

Mothers who drink heavily during pregnancy have

increased risks of spontaneous pregnancy loss, and their

babies have increased risks of low birth weight, pre- and

postnatal growth retardation, mental retardation, learning

disorders, hyperactivity, and perinatal mortality (American

Medical Association, 1993; Kruse, 1984; Mills et al., 1984;

Abel, 1982). Babies of alcoholic mothers are often born

with several of these symptoms, called fetal alcohol syndrome (Abel, 1982; AMA, 1983; Kruse, 1984; Mills et al.,

19s4).

After reviewing a number of epidemiologic studies, the

American Medical Association (1983) concluded that an

alcohol intake of 1 ounce (one drink) per day or more

reduces birth weight, and that the risk of spontaneous

pregnancy loss is increased when the intake is 1 ounce per

week or more. One ounce or more pcr week corresponds to

the “more frequen~” drinking category in tables 19–24. The

effects of the amounts in the “less frequent” category in

tables 19–24 are not known (AMA, 1983; Mills ct al.,

19s4).

In a large recent study, alcohol consumption was associated with reduced birth weight after controlling for smoking and other variables (Mills et al., 1984). The study

showed that increased risks of low birth weight occurred

among newborns of women who consumed onc drink a day

or more (Mills ct al., 1984). However, that is more alcohol

consumption than in the “more frequent” drinking category

in tubles 19-24. Several issues need to be rcsolvcci by

further research, including the health effects of binge drinking and other drinking patterns; the month of pregnancy in

which drinking occurs; and whether the health effects of

beer, wine, and iiquor differ (AMA, 1983; Krusc, 1984;

Stein and Kline, 19S3).

The AMA conclucfcd that the amount of alcohol a

prcgmmt woman can consume without adversely affecting

hcr baby is still unknown, and that, until a safe amount is

dctcrmimxf, prcgm.mt women should no( usc alcohol a[ all

(ANIA, 19S3). Similarly, in July 1981, the Surgeon Gcncml

of the Unitccl Slates advisccl physicians that “ciIch patient

SI1OUICI bc told about the risk of alcohol consumption during

pregnancy and advised not to drink alcoholic bcvcragcs”

(Surgeon General of the Unitccl States, 19S1).

Chcwac[e)istics of [he pregnancy— In the 19S2 Natiorml

Survey of Family Growth, ever pregnant women were

asked, “During your last prcgnanq, how often did you

usually drink alcoholic beverages, that is, beer, wine, or

liquor?”

Women who rcportecl drinking ICSSthan once a week

arc sometimes rcfcrrccl to as “infrequent drinkers” in this

report, and \vomcn w’ho reported drinking at least once a

week arc sometimes refcrrcci to as “rcgular” or “frequent”

drinkers. The frequency with which women drank alcoholic

beverages during their most rcccnt pregnancy ending in live

birth, miscarriage, or sti]lbir[h is given in tahlcs 19-21.

Ovcral], about 55 percent rcportcrl not drinking at all; 34

19
percent, less than once a week; and 12 percent, once a week

or more (table 19). Black women were more likely to have

refrained from drinking altogether than were white women

(67 percent versus 52 percent, tables 21 and 20 respectively), but this difference was due almost entirely to the

differing proportions of women drinking less than once a

week; the percents drinking once a week or more were

similar by race (11–12 percent).

The percent who reported consuming no alcohol at all

during their most recent pregnancy decreased from 71

percent for teenagers to 48 percent for those aged 25–29

years. Women aged 25-44 were at least twice as likely as

teenagers to have consumed alcohol at least once a week

during their most recent pregnancy. Unlike smoking behavior, the same general age-related pattern of alcohol consumption was observed for both white and black women

(tables 20 and 21).

Considering all races combined, never married women

were more likely to have abstained from drinking alcohol

during pregnancy than were ever married women (62 percent versus 54 percent, table 19). However, this difference

was due to the fact that never married women were disproportionately black, and that black women were more likely

to abstain from drinking than white women (tables 20 and

21), because differences in the frequency of alcohol consumption by marital status within the two race groups were

not significant. This similarity by marital status is in sharp

contrast to the pattern for smoking behavior, for which

large differences by marital status were observed, both

overall and for white women in particular (tables 13 and

14). Differences in drinking behavior during pregnancy by

wontedness status at conception were relatively small and

not significant.

Women whose most recent pregnancy ended in miscarriage or stillbirth were almost twice as likely to have been

frequent drinkers (once a week or more) than were those

whose most recent pregnancy resulted in a live birth; 19

percent of women whose pregnancy ended in a pregnancy

loss drank once a week or more, compared with 11 percent

of women whose pregnancy ended in a live birth.

This finding was also observed for white and black

women separately. Black women who last had a live birth

were more likely than black women who last had a pregnancy loss to have abstained from alcohol use (69 percent

versus 55 percent), but the proportions abstaining were

similar by pregnancy oulcome for white women. Unlike

smoking, however, frequency of alcohol consumption did

not differ significantly between women who had received

frequent prenatal care and those who had not.

Overall, differences in frequency of alcohol consumption between black and white women are apparent only in

the percents of those who did not drink at all and of those

who drank less often than once a week. Proportions of

those who drank once a week or more were similar for

black and white women in all categories of the characteristics examined. This is in sharp contrast to smoking behavior, for which the largest race differences were observed in

the proportions of those smoking 15 or more cigarettes per

day.

As seen in table C, 69 percent of Hispanic women did

not drink alcoholic beverages at all during their most recent

pregnancy, compared with 67 percent of non-Hispanic

black women and only 50 percent of non-Hispanic white

women. ln general, for the categories of age, marital status,

and pregnancy outcome given in table C, the proportions

not drinking at all among Hispanic women did not differ

significantly from those for non-Hispanic black women and

were higher than those for non-Hispzmic white women.

The pattern of alcohol consumption during thle most

recent pregnancy by the year in which the pregnancy ended

is outlined in table E. White women whose most recent

pregnancy ended in 1980-82 were less likely to have consumed alcohol once a week or more than women whose last

pregnancy ended before 1975 (9 percent versus :15 percent). For bJack women, there was no significant trend.

Charactoistics of the woman —Alcohol consumption

during the most recent pregnanq is shown by selected

characteristics of the woman at the time of interview in

tables 22–24. Both white and black women living in the

South were more likely to have abstained from alcohol than

were women living in any other region. This regional

differential was particularly large among white wornen (66

percent in the South, versus 44-47 percent in the other

regions).

For white women, alcohol consumption during pregnancy increased with education level (table 23). Only about

33 percent of white women with less than a high school

education drank during pregnancy, compared with 59 percent of college-educated women. Similarly, about 8 percent

of white women with less than a high school education

drank once a week or more, compared with 17 percent of

college-educated women (figure 4). For black women, less

frequent drinking increased with education level, and more

frequent drinking decreased as education increased (figure

4).

Differences in alcohol consumption by occupation were

largely limited to white women. The proportion of white

women not drinking at all during their most recent pregnancy ranged from 37 percent of women employed as

professionals or managers to 74 percent of white women

who had never been employed. White professionals and

managers were more likely to drink once a week or more

than any other occupational group. In contrast, there were

few significant variations in level of drinking by occultation

among black women.

Abstinence from alcohol was more common among

low-income white women than among higher-income white

women (66 percent versus 48 percent) and more common

among white women receiving Medicaid at the date of

interview than among white women not receiving Medicaid

(73 percent versus 51 percent). For black women, on the

other hand, the proportions not drinking at all were similar

by income and Medicaid status. For both races, the proportion not drinking at all was highest for women resicling in

20
Table E. Number of women 15-44 years of age whose most recent pregnancy ended in five birth or spontaneous loss and percent

distribution by average frequency of alcoholic beverage consumption during the pregnancy, according to race of woman and year of

outcome: United Sates, 1982

[Statistics are based on a sample of the household population of the conterminous United States. See appendixes I and II for discussion of the sample design,

sampllng variability, and definition of termsl

Average frequency of afcoholb

beverage consumption during pregnancy

Number Lees fhan Once a

Race of woman of women once a week

and year of oukome in thousands Total Never week or more

Percent dktrlbufiin

Allwomenl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29,345 10CI.O 54.5 33.7 11.8

1980-62 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,890 100.0 55.4 35.6

1975-79 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9.0

7,974 100.0 56.4 32.2

Before 1975 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11.4

11,481 100.0 52.5 33.1 14.4

Whitewomen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24,174 100.0 51.8 36.3 11.9

1980-62 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,108 100.0 53.2 38.2

1975-79 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8.6

6,299 100.0 53.3 35.5

Before1975 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11,2

9,765 100.0 49.6 35.2 15.1

Black Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,222 100.0 67.1 22.1 10.8

1980-62 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,412 100.0 67.4 23.5

197579 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9.1

1,398 100.0 67.6 20.2

Before 1975 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12.2

1,412 100.0 66.3 225 11.2

i lnchdes white, Hack, and otterraces.

nonmetropolitan areas, but this difference was smaller for

blackwomen.

For white women, more frequent drinking (once a

weckormore) duringpregnancy wasmorecommon among

those who were college educated (17 percent), who were

employed as professionals or managers (19 percent), or

whohadincornes at least three times the poverty level (16

percent) than among others. In contrast, more frequent

drinkingwas more prevalent among black women whohad

not finished high school (17 percent) and those receiving

Medicaid at the survey date (16 percent).

Low birth weight

A baby weighing 5fipounds (2,500 grams) or lessat

birth is classified as low birth weight (Institute of Medicine,

1985). In the first 28 days after birth, low-birth-weight

babies have nearly 40 times the mortality of other babies,

and they account for two-thirds of neonatal deaths in the

United States (McCormick, 1985; Brown, 1985; Shapiroct

al., 1980; Institute of Medicine, 1985). Low-birth-weight

babies are also five times more likely to die between 28

days and 1 year after birth and are more likely to develop

neurodevelopmental handicaps, including cerebral palsy

and seizure disorders, congenital anomalies, significant illnesses, learning disorders, and behavioral problems (McCormick, 1985; Brown, 1985; Shapiro et al., 1980; Institute

of Medicine, 1985; NCHS, 1981a; Bchrman, 1985; Siegel,

1985). In addition, neonatal intensive care of low-birthweight babies is expensive-in 1981, $1.5 billion was spent

on neonatal intensive care in the United States, most of it

on low-birth-weight babies (American Public Health Association, 1986; Phibbs, Williams, and Phibbs, 1981),

The biological causes of low birth weight are not well

understood. There is, however, a large lit crat ure on risk

factors–that is, characteristics that make low birth weight

more likely. The list of these characteristics is long; they

include age (under 18 and over 34 years), black race, low

education, having had a previous low-birth-weight baby,

lack of prenatal care, previous muItiple pregnancy losses,

smoking, drinking, short interval since the most recent

pregnancy, low socioeconomic status, and being unmarried

(McCormick, 1985; Brown, 1985; Institute of Medicine,

1985; Behrman, 1985). These characteristics are important

in screening and risk assessment, because they can be

identified before delivery (McCormick, 1985; Brown, 1985;

Institute of Medicine, 1985; Bchrman, 1985). Of these,

smoking may be the most important preventable risk factor,

because 21-39 percent of low-birth-weight infants in the

United States have been attributed to maternal smoking

(Behrman, 1985; Hogue and Sappenfield, 1!-)87; Sachs,

1987). Another very important risk factor for low birth

weight is being of black race after controlling for maternal

age, education, parity, smoking, height, weight, weight gain

during pregnancy, previous low-birth weight deliveries, and

the timing of prenatal care, the percent of black babies who

were low birth weight is still higher than that for white

babies (Brown, 1985).

Chmockristics of the pregnancy-Table 25 shows the

proportion of single live births that were low birth weight by

race of the mother and selected characteristics of the

pregnancy. Variation in the percent low birth weight is

small relative to variations observed in the health-related

behavior during pregnancy reported in the preceding tables.

But because low birth weight often results in long-term

illness or infant death (Institute of Medicine, 1985), even

small variations have important consequences for the populations involved.

Data from Cycle 111of the National Survey of Family

Growth reveal that 6.6 percent of all babies born to women

21
15-44 years of age in 1982 weighed 2,500 grams (5 1/2

pounds) or less at birth. The most striking finding in table

25 is that 5.6 percent of babies born to white mothers (in

this report, white babies) were low in birth weight, compared with 12.2 percent of black babies. This proportion

was higher for black than for white babies in every subgroup in table 25, although not every difference was significant and the size of the differences varies. The percents of

low birth weight for white and blaclc never married women

were not significantly different (12 percent versus 13 percent, figure 5).

Twelve percent of babies of never married white

women were low birth weight, compared with only 5 percent of babies born to ever married white women (figure 5).

However, for black women the proportions of low birth

weight were similar by marital status (13 percent and 12

percent, figure 5). Babies born to teenage mothers were

more likely to be low birth weight than babies born to

mothers aged 25 and older, but some of this difference was

due to a larger share of black births among births to

teenagers.

The largest difference in the percent of low birth

weight was between babies of mothers who did not smoke

during their most recent pregnancy and those who did.

Overall, babies born to women who smoked heavily were

three times as likely to be low birth weight than babies born

to women who did not smoke at all (I3 percent versus 4

percent). The observed difference in the proportion of low

birth weight between babies born to mothers who did not

smoke and those born to mothers who smoked heavily was

more than 9 percentage points for both white women (3

percent versus 13 percent) and black women (9 percent

versus 19 percent, fi~wre 6). The difference was not statistically significant for births to black women, because of the

smaller number of black women in the NSFG sample who

smoked 15 or more cigarettes a day. Effects of alcohol on

birth weight have been found only in women who drank at

least daily. The NSFG was too small to have enough such

women in the sample to draw reliable conclusions about the

relationship between alcohol consumption and birth weight.

The difference between white and black babies in the

percent having low birth weight was significant for women

who did not smoke and for women who did not drink

alcohol during their most recent pregnancy. The differences

between black women and while women who smoked were

not significant because of small sample sizes for black

babies. But despite this, the observed difference in the

percents of low birth weight between babies born to black

women and those born to white women who drank once a

week or more during pregnancy was large enough (18

percent versus 5 percent) to attain statistical significance at

the 5-percent Ievel.

Of babies born to Hispanic women, 5.5 percent

weighed 2,500 grams or ICSSat birth (table F). Differences

in the percents low birth weight by marital status of the

mother for Hispanic births (14 percent versus 4 percent)

were at least as large as for non-Hispanic births (11 pcrccnt

versus 5 percent).

Table F. Percent of single live births that were low birth weight,

by race, origin, and marital status of mother at time of birth:

United States, 1982

[Statistics are based on a sample of the household population of the

conlerminous United States. See appendixes I and II for discussion of the

sample design, sampling variability, and defkution of terms]

Mother% maritti status at time of bkth

All nrarilal Never Ever

Race and orlgln stafuses married Married

Total . . . . . . . . . . . . . . . . . . . . 6.6 12.2 5.8

Hispanic . . . . . . . . . . . . . . . . . . . 5.5 *13.9 *3.5

Non-Hispanic white. . . . . . . . . . . . 5.7 11.4 5.3

Non-Hiapanlc black. . . . . . . . . . . . 12.3 12.8 12.1

i Mudes races other than white or black, m! shown separately.

Charactenktics of the mother-Table 26 shows the percent low birth weight according to selected characteristics

of the mother at the date of interview.

Overall, nearly 9 percent of babies born to mothers

with less than a high school education were 1(OWbirth

weight, compared with 5 percent of those born to mothers

with some college education. These differences by level of

education arc simikm to those for babies born to women

employed as professional, managerial, sales, or clerical

workers (5.6 percent) compared with those born to service,

craft, and farm workers and operatives (8.2 percent).

Across the income categories in table 26, the proportions of low-birth-weight infants were similar, but 10 percent of infants born to mothers receiving Medicaid at the

survey date weighed 2,500 grams or less at birth, compared

with only 6 percent of those born to mothers not receiving

Medicaid. However, for black women there was no significant difference in this proportion by Medicaid status.

Source of payment for delivery

A report based on the NCHS 1984 Health Interview

Survey showed that white persons 18-44 years of age were

more likely to have private medical insurance than black

persons; black persons 18-44 years of age were much more

likely to have no coverage than white persons were (NCHS,

1987b). The report also showed that the percent of persons

18-44 years of age covered by private insurance increased

as education and income increased. Conversely, the proportion who had no health care coverage decreased as education and family income increased (NCHS, 1987b).

Chmxk/istics of the bit~h–The number of live births

since 1979 and the pcrccnt paid for from spccificd sources

are shown in table 27 and for white and black women

separately in tables 28 and 29. Note that the percents add to

more than 100 because many women reported more than

one source of payment for delivery. The most common

combination was private medical insurance plus “sc]f, family, or friends.”

Overall, 63 percent of deliveries were paid for, entirely

or in part, by private medical insurance; 41 percent, by the

woman, her family, or friends; 10 percent, by Medicaid; 9

22
percent, by State anrllor local government; and 6 percent, in

other ways. The difference in source of payment by race

was very Iargcx 68 percent of white births were covered by

private medical insurance (table 28), compared with only

38 percent of black births (table 29 and figure 7). Because

private medical insurance often covers most but not all of

medical expenses, and because white women were more

likely to use insurance than black women, white women

would be expected to use their own income more often than

black women—and this was the case: 44 percent of deliveries to white women were at least partly paid for using

out-of-pocket funds, compared with 24 percent for births to

black women (figure 7).

Even more strikingly, although only 7 percent of all

white women used Medicaid as a source of payment for live

birth, 30 percent of black women did so. About 8 percent of

deliveries to white women were paid for by other government sources, compared with 15 percent of deliveries to

black women. The figure for all other sources was small

and similar for both races (figure 7).

The percent of deliveries paid for through private

mcclical insurance increased dramatically with age of the

mother, from 27 percent for teenage mothers to 80 percent

for women 30-44 years old. This increase with age was

similar for both black and white women—an increase of

approximateely 50 percentage points over the entire age

range, with the largest difference for adjacent age groups

seen between teenage women and women aged 20-24.

Thus, a larger percent of white births than of black births

were paid for from private medical insurance in every age

group.

On the other hand, nearly half–47 percent—of births

to black teenagers were paid for by Medicaid, compared

with only 20 percent of births to white teenagers. For

women aged 30-44 at delivery, the proportion pair-l for by

Medicaid was 2 percent for white and 18 percent for black

women.

Overall, a higher proportion of births to teenagers were

paid for through non-Federal governmental sources (24

percent) than was true for other age groups (4-9 pcrccnt).

The proportions of births paid for through these sources

were similar for white and black tccnagcrs and for white

and black women aged 3044, but a higher proportion of

black than of white births were paid for by State and/or

local government sources for women 20-29 years of age.

Method of payment differed dramatically by marital

status of the mother at birth. For all races combined, 72

percent of births to ever married mothers were paid for

with private medical insurance, compared with only 18

pcrccnt of births to never married rnothcrs. The proportion

paid for out of pocket (“self, family, or friends”) was almost

twice as great for deliveries to ever married women (45

percent) as for those to never married women (23 pcrccnt).

Ordy 4 percent of births to ever married women were paid

for by Medicaid, compared with 40 percent of births to

never married women.

Differences by race in the source of payment for births

to never married women were not significant. Significant

race differences were found, however, for births to ever

married women (and, therefore, for all births).

For both black and white births, those that were

wanted at the time of conception were much more likely to

be paid for from private medical insurance than were births

that were either mistimed or unwanted, and less likely to be

paid for from Medicaid.

Sources of payment for birth differed substantially

between women receiving early and continuous prenatal

care and those receiving later or discontinuous care. Births

with early and continuous care were more likely to be paid

for with private medical insurance (73 percent versus 45

percent) and less likely to be paid for by Medicaid (6

percent versus 18 percent) and non-Federal government

sources (5 percent versus 16 percent) than were births

receiving late or discontinuous care (table 27). About 12

percent of white deliveries and 41 percent of black deliveries following late or discontinuous prenatal care were paid

for through Medicaid.

In assessing these figures, it should be noted that poor

women may not have been receiving Medicaid when they

became pregnant or sought prenatal care. Some may have

been determined eligible for Medicaid ordy ajler they became pregnant. Births to white mothers receiving early and

continuous prenatal care were less likely to be paid for

from non-Federal government sources than were those

receiving late or discontinuous care, but for black women

the proportions paid for from these sources did not differ

significantly by timing and continuity of prenatal care.

Differences in the proportions paid for out of pocket and

from all other sources were not significant, either overall or

for eilhcr race group (tables 27-29).

As expected, sources of payment for delivery differed

sharply by whether prenatal care was reccivecl at a clinic or

from a private doctor. Births to those rccciving care at a

clinic were much lCSSlikely than births rccciving care at a

private doctor to be paid for out of pocket (28 percent

versus 45 pcrccnt ) or by private medical insurance (27

pcrccnt versus 76 pcrccnt ). Births rccciving prenatal care

from clinics were also much more Iikcly than those cared

for by private doctors to be paid for by Medicaid (27

pcrccnt versus 5 percent ), by State and/or local government

(18 percent versus 6 pcrccnt), and by other sources (15

pcrccnt versus 3 pcrccnt ). About 1 in 7 births to women

rccciving care from clinics was paid for from “all other”

sources. The largest part of the “all other” category is the

mili[ary. It is Iik+ that many of these births rcccived

prcnatzd care at chmcs in military hospitals.

The pattern of source of payment for delivery according to prenatal ctirc provider for white births closely rcscmblcd the paitern for all races, but for black birlhs [he

pcrccnts of dc]ivcric!s paid for out of pocket and from other

government sources did not cliffcr significantly by type of

prenatal care provider.

Sources of payment for delivery by origin and race are

seen in table G. About 40 pcrccnt of births to Hispanic

women were paid for (entirely or in part) out of pocket

(“self, family, or friends”); 42 pcrccnt were paid with private

23
Table G. Number of live births in January 1979 or later to women 15-44 years of age and percent paid for from specified sources, by

race, origin, and selected characteristics: United States, 1982

[Statistics are heed on a sample of Ihe household population of the Conterminous Untied States. See appendixes I and II for discussion of the sample design,

sampling variability, and defuwtion of termsJ

Source of payment

Number Sel( Private

of births h family, or medics/ Other All

CharacterWc thousands friends insurance Medicaid government other

Percentl

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21,704 40,1 41.9 19.6 14.5 ●4.5

Mother’s age at time of birth:

Under 20 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . .

25-44 yeafs . . . . . . . . . . . . . . . . . . . . . . . . .

380

527

796

*35.3

39.2

43.0

*23.6

*28.7

59.4

%28.0

*26.8

*10.6

*25.3

*13.1

*10.3

*0.5

*8.2

*4. 1

Mother’s marital status at time of birth:

Nevermarried . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . .

460

1,222

*28. O

44.9

44.4

*17.3

51.5

44.6

*9.7

5.0

*15.3

*14.2

6.8

*2.7

*5.3

Non-Hispanicwhife . . . . . . . . . . . . . . . . . . . . . . . . . . 6,0

Mother’sageattime ofbirth:

Under20years . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

210,248 71.6

1,016

3,389

5.842

37.6

39.7

48.4

34.7

65.0

82.1

*1 7.9

+7.0

*1.5

23.9

*7.2

*3,5

*5.O

8.6

*4.7

Mother’s marital status at time of birth:

Nevermarrled . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . .

913

9,311

25.5

46.2

+18.6

76.7

32.2

*2.4

30.5

30.5

4.5

15.2

*3.9

6.2

Non-Hispanic black . . . . . . . . . . . . . . . . . . . . . . . . . . 6.6

Mother’s age at time of birth:

Under20yeare . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2W4years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,020 24.0 37.3

512

755

752

21.4

25.0

24.6

*13.5

34.1

56.8

46.0

30.6

20.0

20.6

15.7

11.0

●6.7

*7.7

*5.4

Molher’s marital status atfimeofbklh:

Nevermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1.021 17.6

30.5

16.4

58.6

46.5

14.3

22.9

*7.2

*4.3

’995 8.9

~Tl?esumofthe percents exceeds 100.Obecausesome women reported morethanonesource ofpayment.

‘Includes births fcf which moths% marital status at time of birth wes unknown.

medical insurance; 20 percent, with Medicaid; 14 percent

from other government sources; and 5 percent, from other

sources. Thus, births to Hispanic women were much less

like]ythan birthsto non-Hispanic white women to bepaid

for by private medical insurance (42 percent versus 72

percent), andmore likely to bepaidfor by Medicaid (20

perccnt versus 5 percent) and other government sources

(15percent versus 7 percent). Comparing bir[hsto Hispanic women with births to non-Hispanic black women

(table G), births to Hispanic women were more likely to be

paid forout ofpocket (40 percent versus 24percent) and

less likely to be paid for by Medicaid (20 percent versus 31

percent) than births to non-Hispanic black women. As

observed for both white and black non-Hispanic births,

deliveries to never marriccl Hispanic women were much

more likely to be paid for through Medicaid (45 percent

versus 10 percent) and less likely to be paid for through

insurance (17 percent versus 52pcrccni) than was true for

deliveries to ever married Hispanic women.

Charackvistics of the mother-Tables 30, 31, and 32

show the percents of births paid for from various sources

according to characteristics of the mother at the date of

interview (not necessarily at the date of the birth).

For both white and black births, the proportion paid for

by private insurance increased with the rising education of

24

the mother-from 40 to 84 percent for births to white

women and from 16 to 58 percent for births to black

women. The proportions paid by Medicaid declined sharply

as the mother’s education increased, for both white and

black births, and the race difference in the use of Medicaid

was very large for all three categories of education. For

example, at the lowest educational level, 49 percent of black

births and only 20 percent of white births were paid for

using Medicaid.

Source of payment for delivery differed considerably

according to the most recent occupation of the mother. For

all races combined, 84 percent of births to women employed asprofessionals or managers used private medical

insurance and54pcrcent used income from self, family, or

friends, but only 2 percent used funds from Medicaid or

other government sources. In contrast, only27 percent of

births to women who had never worked used private medical insurance to pay for delivery, 38 percent used out-ofpockct resources, but 32 percent used Medicaid and 14

percent used State or local government sources .Theproportion of births toprofessionals andmana.gerswl]o used

their own income as a source of payment was higher for

white than for black women (56 percent versus 23 percent).

However, theother four sources ofpayrnent for birthsto

professional and managerial women were similar by race.
On the other hand, there were large race differences in

payment for births to women in the other occupational

groups. More than half of births to never employed black

women were paid for using Medicaid, compared wit$ 26

percent for never employed white women.

Births to low-income women were more likely to have

been paid for using Medicaid (24 percent versus 2 percent)

or by other government sources (19 percent versus 2-4

percent) than were births to higher-income women, but

there were significant differences by race within this income

catego~. Birlhs to low-income black women were more

likely to have been paid for by Medicaid than were births to

low-income white women (41 percent versus 18 pcrccnt).

Fewer than half (47 percent) of current Medicaid

recipients reported Medicaid as a source of payment for

clclivcry. In addition, 30 percent of births to current Medicaid recipients were paid for through other government

sources. Taken together, these findings suggest that in

many cases either the woman was eligible for Medicaid

during her pregnancy but unable to complete the application process before delivery; or, after delivery (or as a result

of the birth), she lost support from her parents or the

baby’s father, or her income decreased, and she thus became eligible for Medicaid.

Trends in source of payment for

delivery: 1973-82

The percent distributions of source of payment for

delivery for the most recent birth to women interviewed in

1973 and for the most recent birth since January 1979 to

women interviewed in 1982 are given in table 33 and figure

8. Over this 9-year period, the percent of women who paid

for their most recent delivery entirely from their own or

their family’s own income declined from 22 percent to 10

percent (figure 8). The decline was apparent at all ages, at

all levels of education and income examined, in every

region, and for both white and black women. However, the

decline was largest among births to teenagers (from 38

percent to 9 percent). The declines were generally similar

across cat egories of all variables except age.

The percent of women who paid for their most recent

birth entirely through private medical insurance increased

by approximately 10 percentage points, from 28 percent in

1973 to 38 percent in 1982 (figure 8). In contrast to the

trend in self-payment, however, this increase was smaller

and not significant among teenagers, black and Hispanic

women, women with a high school education or less, lowincome women, and those living in the Midwest. The

proportion of women who used a combination of private

medical insurance and their own income to pay for their

most recent delivery declined from 32 to 25 percent (figure

8).

These data suggest that there has been a slight increase

in the proportion of women paying for delive~ from Medicaid between the two survey dates, but the rise from 7 to 10

percent was not large enough to be significant at the 5

percent level. Overall, a similar lhree-point increase was

suggested in the proportion of most recent deliveries paid

for from other government sources (from 6 to 9 percent),

but larger, significant increases were found among births to

teenagers, black women, women with Icss than 12 years of

education, and low-income women. The data also suggest

that a Iargcr proportion of Hispanic women interviewed in

1982 than of those interviewed in 1973 used other government sources to pay for their most rcccnt deliveries.

25
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27
List of detailed tables

1. Number of pregnancies ending in a live birth in January

1979 or later to women 15-44 years of age and percent

distribution by months pregnant when prenatal care

began, according to selected characteristics of the birth:

United States, 1982...,, ... ....... ....... ............ ...........

2. Number of pregnancies ending in a live birth in January

1979 or later to white women 15-44 years of age and

percent distribution by months pregnant when prenatal

care began, according to selected characteristics of the

birth: United States, 1982 .......................... .... .......

3. Number of pregnancies ending in a live birth in January

1979 or later to black women 15-44 years of age and

percent distribution by months pregnant when prenatal

care began, according to selected characteristics of the

birth: United States, 1982 ....... ....... .... ...................

4. Number of pregnancies ending in a live birth in January

1979 or later to women 15-44 years of age and percent

distribution by months pregnant when prenatal care

began, according to selected characterisitcs of the

mother United States, 1982 .... .............. ..... ....... ....

5. Number of pregnancies ending in a live birth in January

1979 or later to white women 1544 years of age and

percent distribution by months pregnant when prenatal

care began, according to selected characteristics of the

mother United States, 1982 ............. ..... ................

6. Number of pregnrmcies ending in a live birth in Janua~

1979 or later to black women 15-44 years of age and

percent distribution by months pregnant when prenatal

care began, according to selected characteristics of the

mother: United States, 1982 ...... .. ..........................

7. Number of pregnancies ending in a live birth or spontaneous loss in January 1979 or later to women 15-44

years of age, percent receiving prenatal care, and percent distribution of pregnancies receiving care by

source of care at first visit, according to selected characteristics of the pregnancy United States, 1982 ........

8. Number of pregnancies ending in a live birth or spontaneous loss in January 1979 or later to white women

15-44 years of age, percent receiving prenatal care, and

percent distribution of pregnancies receiving care by

source of care at first visit, according to selected characteristics of the pregnancy United States 1982 ....... ..

9. Number of pregnancies ending in a live birth or spontaneous loss in January 1979 or later to black women

15-44 years of age, percent receiving prenatal care, and

percent distribution of pregnancies receiving care by

source of care at first visit, according to selected characteristics of the pregnancy: United States, 1982 ........

10. Number of pregnancies ending in a live birth or spontaneous loss in January 1979 or later to women 15-44

years of age, percent receiving prenatal care, and percent distribution of pregnancies receiving care by

30 source of care at first visit, according to selected characteristics of the woman: United States, 1982 ..... .......

11. Number of pregnancies ending in a live birth or spontaneous loss in January 1979 or later to white women

15-44 years of age, percent receiving prenatal care, and

30 percent distribution of pregnancies receiving care by

source of care at first visit, according to selected characteristics of the woman: United States, 1982 . ...........

12. Number of pregnancies ending in a live birth or spontaneous loss in January 1979 or later to black women

31 15-44 years of age, percent receiving prenatal care, and

percent distribution of pregnancies receiving care by

source of care at first visit, according to selected characteristics of the woman: United States, 1982 ............

13. Number of women 15-44 years of age whose most

31 recent pregnancy ended in a live birth or spontaneous

loss and percent distribution by average number of

cigarettes smoked per day during the pregnancy, according to selected characteristics of the pregnancy

United States. 1982 ... ............ .... ....... ..... ....... .......

32 14. Number of white women 15-44 years of age whose

most recent pregnancy ended in a live birth or spontaneous loss and percent distribution by average number

of cigarettes smoked per day during the pregnancy,

according to selected characteristics of the pregnancy:

33 United States, 1982 .......... ............ .............. .........

15. Number of black women 15-44 years of age whose

most recent pregnancy ended in a live birth or spontaneous loss and percent distribution by average numbe,r

of cigarettes smoked per day during the pregnancy,

according to selected characteristics of the pregnancy

34 United States, 1982 .......... ....... ................. ...........

16. Number of women 15-44 years of age whose most

recent pregnancy ended in a live birth or spontaneous

loss and percent distribution by average number of

cigarettes smoked per day during the pre=mancy, according to selected characteristics of the woman:

35 United States. 1982 .......... ........................ .... .......

17. Number of white women 15-44 years of age whose

most recent pregnancy ended in a live birth or spontaneous loss and percent distribution by average number

of cigarettes smoked per day during the pregnancy,

according to selected characteristics of the woman:

36 United States, 1982 .......................... ..... ....... .......

37

38

39

40

41

42

43

44

28
18. Number of black women 15-44 years of age whose

most recent pregnancy ended in a live birth or spontaneous loss and percent distribution by average number

of cigarettes smoked per day during the pregnancy,

according to selected characteristics of the woman:

United States, 1982 ................... ..... ..... ....... .........

19. Number of women 15-44 years of age whose most

recent pregnancy ended in a live birth or spontaneous

loss and percent distribution by average frequency of

alcoholic beverage consumption during the pregnancy,

according to selected characteristics of the pregnancy:

United States, 19S2 ... ..... .... ..... ....... .......... ....... ....

20. Number of white women 1544 yearn of age whose

most recent pregnancy ended in a Iive birth or spontaneous loss and percent distribution by average frequency of alcoholic beverage consumption during the

pregnancy, according to selected characteristics of the

pregnancy: United States, 1982 ......... .......... ....... ....

2.1. Number of black women 15+44 years of age whose

most recent pregnancy ended in a live birth or spontaneous loss and percent distribution by average frequency of alcoholic beverage consumption during the

pregnancy, according to selected characteristics of the

pregnancy: United States, 1982 .... ............ ..... ..... ....

zz Number of women 15–44 years of age whose most

recent pregnancy ended in a live birth or spontaneous

loss and percent distribution by average frequency of

alcoholic beverage consumption during the pregnancy,

according to selected characteristics of the woman:

United States, 1989. ..... .......... ....... .... ..... ............ ..

23. Number of white women 15-44 years of age whose

most recent pregnancy ended in a live birth or spontaneous loss and percent distribution by average frequency of alcoholic beverage consumption during the

pregnancy, according to selected characteristics of the

woman: United States, 1982 ........ ..... ................... ..

24. Number of black women 15-44 years of age whose

most recent pregnancy ended in a live birth or spontaneous loss and percent distribution by average frequency of alcoholic beverage consumption during the

pregnancy, according to selected characteristics of the

woman: United States, 1982 .... .... ..... ....... ..... .........

25. Number of single live births to women 15-44 years of

age and percent low birth weight, by race and selected

45 characteristics of the birth: United States, 1982 ... .......

26. Number of single live births to women 15-44 years of

age and percent low birth weight, by race and selected

characteristics of the mothe~ United States, 1982... ....

27. Number of live births in January 1979 or later to

46 women 15-44 years of age and percent paid for from

specified sources, by selected characteristics of the

birth: United States, 198? .. .. ....... ....... ..... ..... .........

28. Number of live births in January 1979 or later to white

women 15-44 years of age and percent paid for from

specified sources, by selected characteristics of the

47 birth: United States, 1982 ......... ..... ............ ...........

~g. Number of live births in January 1979 or later to black

women 1544 years of age and percent paid for from

specified sources, by selected characteristics of the

birth: United States, 1982 .. ......... ..... ....... ..... ....... ..

30. Number of live births in January 1979 or later to

48 women 15-44 years of age and percent paid for from

specified sources, by selected characteristics of the

mothe~ United States, 1982 . .......... ............ .... .......

31. Number of live births in January 1979 or later to white

women 1544 years of age and percent paid for from

specified sources, by selected characteristics of the

49 mothen United States, 1982 .... .............. .............. ..

32. Number of live births in January 1979 or later to black

women 15+1 years of age and percent paid for from

specified sources, by selected characteristics of the

mothen United States, 1982 ........... .... ..... ..............

33. Number of women 15-44 years of age who have ever

50 had a live birth and percent distribution by source of

payment of the hospital bill for the most recent birth,

according to selected characteristics: United States,

1973 and 1982....... ............ ..... ........................ ....

51

52

53

54

55

56

57

58

59

60

29
Table 1. Number of pregnancies ending in a live birth in January 1979 or later to women 15-44 years of age and percent distribution by

months pregnant when prenatal care began, according to selected characteristics of the birth: United States, 1982

[Statistics are based on a sample of the household population of the Conterminous Unlfed States. See appendixes i and II for discussion of the sample design,

sampling variability, and definition of terms]

Months pregnant when prenatal care began

Number in Less than 3or4

Characteristic

5 months or

thousands Tots/ 3 months months more or no care

Percent dlstr~bufion

All pregnancies ending in a We btrth . . . . . ., 114,372 100.0 65.9 25.6 8.5

Mother’s age at time of birth:

Under 20 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,972 100.0 45.7 37.5 16.8

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,764 100.0 61.4 30.1 B.5

25-29 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,863 100.0 75.1 19.5 *5.4

30-44 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,773 100.0 72.1 19.9 *8.O

Birth orde~

First . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,001 100.0 63,4 28.1

Second . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

&4

4,900 100.0 72.9 20.7 6.3

Third orhigher . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,471 100.0 60.2 28.2 1“1.7

Mother’s marital status al time of birllr

Never married . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,471 100.0 43.8 39.1 17.2

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,872 100.0 70.6 22.7 fL7

Wontedness status at conception:

Wanledthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9,127 100.0 72.6 20.9 6.6

3,823 100.0 56.0 33.5 10.5

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,422 100.0 49.6 34.9 *15.5

1Includes births fw which mother’s marital status at birth or wontedness status at mnceptlon was unknown.

Table 2. Number of pregnancies ending in alive birth ln January 19790rlater towhite women 15-44 years ofage and percent

distribution by months pregnant when prenatal care began, according to selected characteristics of the birth: United States, 1982

[Statistics are based on a sample of the household population of the contermlnous United States. See appendixes I and II for discussion of the sample design,

sampling variability, and definition of terms]

Monlhs pregnant when prenatal care began

Number In Less than 3or4 5monthsor

C/raracteristlc thousands Total 3 months months more or no care

PercenI distribution

Allpregnancies ending in alive birth . . . . . . . . . 111,836 100.0 68.7 23.6 7,7

Mother’s age at time of birth:

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . 1,364 100.0 50.9 34.7 *14,3

20-24years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,890 100.0 63.3 28.0 8,7

25-29years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,200 100.0 77.0 18.8 *4.2

30-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,381 100.0 73.3 18.2 *8. 5

Birth order

First, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,902 100.0 66.0 26.3 7.7

Second . . . . . . . . . . . . . . . . . . .:.......,.,.. 4,142 100.0 76.2 18.7 *5. 1

Third orhigher. . .,, ...,... . . . . . . . . . . . . . . . . 2,792 100.0 62.3 26.1 11.7

Mother’s marital status attimeofblrth:

Nevermarried . . . . . . . . . . . . . . . . . . . . . . . . . . 1,350 100.0 46.6 35.7 17.7

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,460 100.0 71.6 21.9 6.4

Wontedness status at conception:

Wanted lien . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,912 100.0 74.1 19.3 6.5

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,980 100.0 58.5 33.0 *6.5

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 944 100.0 55.1 29.6 *15.1

1Includes bhths for which mother’s marital status at birth or wontedness status at mnception was unknown.

30
Table 3. Number of pregnancies ending in a live birth in January 1979 or later to black women 15=%4 years of age and percent

distribution by months pregnant when prenatal care began, according to selected characteristics of the birth: United States, 1982

[Statistics are based on a sample of the household population of the ccntermlnous United States. See appendixes I and II for discussion of the sample design,

sampling variability, and definition of terms]

Months pregnant when prenatal care began

Number in Less than 3or4 5 months or

CharacferMb thousands Total 3 months months more or no care

Percent distribution

Ali pregnancies ending in a live birth . . . . . . . . . . . . . . . 12,095 100.0 53.0 36.6 10.4

Mother’s age at time of birth:

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . . 528 100.0 37.0 44.3

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16.7

774 100.0 53.9 37.9

25-29 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*8.2

505 1Oil.o 64.3 26.1

30-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*9.7

286 i 00.0 50.9 37.2 *2.O

Birth ordec

First . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 657 100.0 49.2 38.4

Second . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12.4

603 100.0 61.1 31.5 *7.5

Third orhigher . . . . . . . . . . . . . . . . . . . . . . . . . . . . 635 100.0 50.4 39.2 *10.5

Mother’s marital status at time of birth:

Never married . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,049 100.0 42.7 41.7

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15.7

1,042 100.0 63.4 31.5 *5. 1

Wontedness status at conception:

Wantedihen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 935 100.0

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

63.4 32.0 ●4.5

709 100.0 50.2 35.6

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14.3

450 100.0 35.9 47.9 16.2

1Includesbirihsfor which mother’s marital status at birth or wantedm?ss status at mnception wss unknown.

Table 4. Number of pregnancies ending inalive birthin January 19790r Iatertowomenl 544years ofage and percent distribution by

months pregnant when prenatal care began, according toseIected characteristics of the mother: United States, 1982

[Statisticsare based on a sample of the household population of the conterm[nous United Stales, See appendixes I and II for discussion of the sample design,

sampling variability, and definition of terms]

Months pregnant when prenatal care began

Number in Less fhan 3or4 5monfhsor

Ctraracteristk thousands Total 3 months months more or no care

Percent distnbuhon

Allpregnancles endmginalivebkth . . . . . . . . . . . . . . 114,372 100,0 65,9 25.6 8,5

Region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,653 100.0 75.0 19.3

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*5.8

3,839 100.0 65,7 29.0

South, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

‘5.3

4,719 100.0 60.6 28,8

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,161

10.5

100.0 66,4 22.1 11.5

Education:

Lessthan 12years ..,...... . . . . . . . . . . . . . . . . 3,516 100.0 46.2 33.4

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16,4

5,669 100.0 66.7 25.9

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . .

7.4

5,187 100.0 ?7. 1 20,0 ●2.9

Most recent occupation:

Professionalormanageriel . . . . . . . . . . . . . . . . . . . . 2,222 1Cx3,0 81.9 15.5

Salesorcierical . . . . . . . . . . . . . . . . . . . . . . . . . . .

*2.6

5,502 100.0 72.8 220

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5.2

2,575 100.0 65,7 25.4

Craftorfarm workeroroperalive . . . . . . . . . . . . .

*8,9

1,851 100.0 46.6 42,9

Neverworked . . . . . . . . . . . . . . . . . . . . . . . . . . . .

●10.3

2,142 100.0 48,3 309 20.7

Poverty level income:

149percentorless . . . . . . . . . . . . . . . . . . . . . . . . . 5,113 100.0 501 341

150percentormore . . . . . . . . . . . . . . . . . . . . . . . . 9,260

15.8

100.0 74.7 20.9

300percentormore . . . . . . . . . . . . . . . . . . . . . . .

4,4

4,663 100.0 78.7 18.4 ●3.o

Medlcaldslatus:

RecewesMedicald . . . . . . . . . . . . . . . . . . . . . . . . . 2,059 100.0 45.9 37.5

DoesnotreceiveMedicaid . . . . . . . . . . . . . . . . . . . .

16.6

12,269 100.0 69.2 23.6 7.1

f Irdudes births for which last occupation or Medicaid status was unkmwn.

31
Table 5. Number of pregnancies ending in a live birth in January 1979 or later to white women 1S-44 years of age and percent

distribution by months pregnant when prenatal care began, according to selected characteristics of the mother: United States, 1982

[Statistics are based on a sample of the household population of the contermlnous United Slates. See appendkes I and II for discussion of the sample design,

sampling variability, and definition of terms]

Months pregnant when prenatal cara began

Number in Less Vran 3or4 5 months or

Characteristic thousands Total 3 months months more or no care

Percent distribution

All pregnancies ending in a We birlh . . . . . 111,836 100.0 68.7 23.6 7.7

Region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,183 100.0 77.6 16.7

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,449 100.0 67.4 28.2

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,458 100.0 64.8 25.8

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,746 100.0 68.1 20.5

*5.7

*4. 4

9.4

11.4

Education:

Lessthan 12yeare . . . . . . . . . . . . . . . . . . . . . . . . . 2,794 100.0 51.8 30.7 17.5

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,693 100.0 69.1 23.9 7.0

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . . 4,438 100.0 79.2 18.7 *2. 1

Most recent occupation:

Professional ormanagerial . . . . . . . . . . . . . . . . . . . . 1,998 100.0 81.9 16.1

Salesorclerlcal . . . . . . . . . . . . . . . . . . . . . . . . . . .

*2.1

4,619 100.0 75.7 19.7

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*4.6

2,116 100.0 68.0 23.0

Craftorfarm workeroroperative . . . . . . . . . . .

+’9.0

1,532 100.0 47.7 41.7 *1O.6

Neverworked . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,542 100.0 52.0 28.1 19.9

Poveriylevel income:

149percentorless . . . . . . . . . . . . . . . . . . . . . . . . . 3,774 100.0 53.3 31.2 15.5

150percentormore . . . . . . . . . . . . . . . . . . . . . . . . 8,062 100.0 76.0 20.0 4.0

300percentormore. ,....., . . . . . . . . . . . . . . . 4,095 100.0 78.9 18.6 *2.5

Medicaid status:

RecewesMedlcaid . . . . . . . . . . . . . . . . . . . . . . . . . 1,222 100.0 47.4 35.3 *17.3

DcxasnotrecelveMedicaid . . . . . . . . . . . . . . . . . . . . 10,599 100.0 71.2 22.2 6.6

1lnc~de~ Mfih5 for which Imt occupation or Medicaid Stsh Wss unk~wn.

32
Table 6. Number of pregnancies ending in a live birth in January 1979 or later to black women 15-44 years of age and percent

distribution by months pregnant when prenatal care began, according to selected characteristics of the mother: United States, 1982

[Statisfka are baaed on a sample of the household population of the contermlnous United States. See appandkes 1and II for discussion of the sample design,

sampling variability, and definition of terms]

Months pregnant when prenatal care began

Number in Less than 3or4 5 months or

Characferktlc thousands Total 3 months months more or no care

Percent distribution

All pregnancies ending in a live birth . . . . . . . . . . . . . . . 12,095 100.0 53.0 36.6 10.4

Region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389 100.0 62.7 33.0 *4.3

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 320 100.0 53.4 39.1 ●7.6

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,141 100.0 48.9 38,8 12.3

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244 100.0 56.4 28.9 *1 4.7

Education:

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . 652 100.0 35.2 46.5 18.3

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 867 100.0 54.7 36.2 9.2

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . . 576 100.0 70.7 26.1 *3.2

Most recent occupation:

Professional ormanagerial . . . . . . . . . . . . . . . . . . . . 151 100.0 90.8 *7.6

Salesorclerical . . . . . . . . . . . . . . . . . . . . . . . . . . .

*1.7

682

servic e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

100.0 58.5 36.2 *5.3

433 100.0 52.3 38.6

Craflorfarmworkeroroperafiie . . . . . . . . . . . . . . . .

●9. 1

274 100.0 47.3 45.9 *6.8

Neverworked . . . . . . . . . . . . . . . . . . . . . . . . . . . . 532 100.0 38.9 40.3 20.6

Poverty level income

149percentorless . . . . . . . . . . . . . . . . . . . . . . . . . 1,185 100.0 42.6 42.4 i 4.9

150 percentormore . . . . . . . . . . . . . . . . . . . . . . . . 910 100.0 66.6 2?3.0 *4.4

300percentormore . . . . . . . . . . . . . . . . . . . . . . . 369 100.0 78.3 19.3 *2.3

Medicaid slatus:

Receives Medicaid . . . . . . . . . . . . . . . . . . . . . . . . . 786 100.0 44.3 41.8

DoesnotreceiveMedicaid . . . . . . . . . . . . . . . . . . . .

13.9

1,290 100.0 58.2 33.5 8.3

i Includes births for which last occupation or Medicaid stalus was unkmwn.

33
Table 7. Number of pregnancies ending in a live birth or spontaneous loss in January 1979 or later to women 15-44 years of age,

percent receiving prenatal care, and percent distribution of pregnancies receiving care by source of care at first visit, according to

selected characteristics of the pregnancy: United States, 1982

[Statistics are based on a sample of the household population of the conterminous Umted States. See appendixes I and II for discussion of the sample design,

samplmg variability, and definition of terms]

Source of prenatal care at first visit

Number In Percent receiving Private Hospital Other

Characteristic thousands prenatal care Total doctor clinic clink

Percent distribution

Allpregnanciesl . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s age at pregnancy oulcome:

Under 20years . . . . . . . . . . . . . . . . . . . . . . . .

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-29 years............,.. . . . . . . . . . . . . . .

30-44yeara . . . . . . . . . . . . . . . . . . . . . . . . . . .

Pregnancy ordec

Firstpregnancy . . . . . . . . . . . . . . . . . . . . . . . . . .

Secondpregnancy, . . . . . . . . . . . . . . . . . . . . . . . .

Third pregnancyorhlgher . . . . . . . . . . . . . . . . . . . .

Mother’s marital status at pregnancy outcome:

Nevermarrled . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wontedness status at conception:

Wantedtben . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Lwebirths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s age at birth:

Under20years . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-29yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

30-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s mariial status at pregnancy outcome:

Nevermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wontedness status at conception:

Wantedthen . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Prenatal care:

Earlyand continuous . . . . . . . . . . . . . . . . . . . . . . .

Lateordiscontinuous ..,.... . . . . . . . . . . . . . .

%7,397 93.1 100.0 75.3 8.8 15.8

2,474

5,450

5,637

3,636

89.6

93.0

96.0

91.0

100,0

100.0

100.0

100.0

55.6

67.0

82.7

69.3

16.2

11.1

6.7

*3.8

26.1

21.9

10.6

*6.9

5,526

5,604

6,267

94.0

93.0

92.4

100.0

100.0

100.0

71.4

78.1

76.5

9.6

8.0

8.6

18.7

13.9

14.9

3,093

14,272

89.8

93.8

100.0

100.0

45.3

81.6

19.9

6.5

34.8

11.9

10,697

4,710

1,991

95.4

90.9

86.0

100.0

100.0

100.0

80.0

69.1

62.6

7.6

9.5

*14.5

12.4

21.3

22,9

‘14.372 98.4 100.0 74.9 9.0 16.1

1,972

4,764

4,663

2,773

98.1

97.4

99.7

98.0

100.0

100.0

100.0

100.0

55.1

66.8

82.9

88.7

16.3

11.4

6.6

‘4.2

28.7

21.8

10.5

*7. 1

2,471

11,872

97.1

9&7

100.0

100.0

43.4

81.3

20.8

6.6

35.8

12.0

79.6

68.8

60.4

7.5

9.9

*16.6

9,127

3,623

1,422

98.6

97.7

99.3

100.0

100.0

100.0

12.8

21.3

23.0

9,124

5,052

100.0

95.5

100.0

100.0

62.2

60.9

7.0

12.9

10.8

26.2

l..Allpre9nancies,, referSto liWbjflk, misardages, andstillMdhS. Itiuced abortimsareexcluded.

21c.Ades pregnancies for which data were missing on mother% marital status at outcome or on prens.tal care.

34
Table 8. Number of pregnancies ending in a live birth or spontaneous loss in January 1979 or later to white women 15-44 years of age,

percent receiving prenatal care, and percent distribution of pregnancies receiving care by source of care at first visit according to

selected characteristics of the pregnancy United States, 1982

[Statktks are based on a sample of the household population of the conterminous United States. See append~es I and II for discussion of the sample design,

sampling variability, and definition of terms]

Source of prenatal care at first visif

Number in Percent receiving Private

Characteristic

Hosptfal Other

thousands prenatal mre Total doctor clink clinic

Percent distribution

Atlpregnanclesl . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214,148 93.6 100.0 60.2 7.3 12.5

Mother’s age at pregnancy outcome:

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-29 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

30-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Pregnancy ordec

First pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . .

%condpregnancy . . . . . . . . . . . . . . . . . . . . . . . . .

Third pregnancy orhigher . . . . . . . . . . . . . . . . . . . .

Mother’s mardal status at pregnancy outcome

Never married . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wontedness status at conception:

Wantadthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,728

4,425

4,995

3,000

89.5

93.2

96.9

91.3

94.5

92.9

93.5

eo.5

94.1

95.4

91.5

87.0

100.0

Icno

100.0

100.0

66.6

71.9

85.6

91.2

16.3

9.5

*5,2

*2.8

17.1

16.6

9.2

●6.O

4,498

4,643

5,007

100.0

ICKI.O

100.0

77.6

81.8

81.1

8.0

7.3

8.8

14.4

10.8

12.2

1,695

12,427

100.0

100.0

52.2

83.8

21.7

5.5

26.0

10.7

9,163

3,695

1.269

100.0 83.7

74.0

71.3

6.3

‘7,5

*14.8

10.0

18.5

●13.8

100.0

100.0

100.0

100.0

100.0

IQ3.O

100.0

Liveblrths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211,636

Mother’s age at birth:

Under20years . . . . . . . . . . . . . . . . . . . . . . . . . . .

2C-24years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-29years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

30-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Molher’s mariialstatus atbirth:

Nevermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wontedness stalus at cone.eplion:

Wantedthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Prenatal care:

Earlyandconlinuous . . . . . . . . . . . . . . . . . . . . . . . .

Lateordiscontinuous . . . . . . . . . . . . . . . . . . . . . . .

98.3 79.9 7.5 12.7

1,364

3,690

4,200

2,361

98.4

97.2

99.8

97.7

96.5

96.6

96.4

97.6

100.0

100.0

94.9

65.4

71.7

86.1

90.6

*16.3

9.8

●4.9

●3.2

18.3

18.6

9.0

*6.2

1,350

10,460

100.0 48.6

63.8

23.6

5.5

27.8

100.0 10.7

7,912

2,980

e44

100.0

100.0

100.0

83,5

73,5

69.1

6.2

●7. 9

*17.3

10.3

18.8

●13.7

7,656

3,636

100.0

100.0

85.6

67.3

5.6

11.1

8.6

21.5

1-AII prWnancie~,, ,erem to live births, miscarriages, and sldlblrlhs. Inducedabort’kmsare exdwd.

‘Inchdes pregnamies for which data were rrissirg on mdher’s marital status at wtmrne or on prenatal care.

35
Table 9. Number of pregnancies ending In a live birth or spontaneous loss in January 1979 or later to black women 15-44 years of age,

percent receiving prenatal care, and percent distribution of pregnancies receiving care by source of care at first visit, according to

selected characteristicsof the pregnancy United States, 1982

[Statistlsearebasedon a sample of the household population of me contefmlnous Untted states.Seeappendixes I and II for dtssusslon of the sample design,

sampling verte.bllity, and detinltton of terms]

Source of prenatal care at fkit visil

Number In Percent receiving Private HosPllal Other

Charactwlstb thousands prenatal care Total dmfor clink clinic

Percent dlstributkm

Allpregnanciesl . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 48.3 17.5 34.2

Mother’s age at pregnancy outcome:

Under 20yeare . . . . . . . . . . . . . . . . . . . . . . . . . . .

2@24yeafs . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26-29 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SO-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Pregnancy ordec

Fifefpregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . .

Second pregnancy . . . . . . . . . . . . . . . . . . . . . . . . .

Thlrdpregnancy orhlgher . . . . . . . . . . . . . . . . . . . .

Molher’s marital status at pregnancy outcome

Never mafrlad . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermafrled . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wontedness status at conception:

Wantedthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Livebirlhs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s age at Wfh:

Under20yeare . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24yaars . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-29yaars . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

30-14years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s marilal status at blrlt?:

Nevermarrled . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarrled . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wontedness status at conception:

Wanledthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Prenatalcsre:

Esriyendcontinuous . . . . . . . . . . . . . . . . . . . . . . .

Lateordtscontinuous . . . . . . . . . . . . . . . . . . . . . . .

22,574 91.0

646

902

616

4(N

91.0

92.2

89.6

90.3

100.0 31.5 18.3 50.2

100.0 43.1 19.1 37.8

100.0 60.3 16.9 22.6

100.0 69.4 *13.9 ●16,7

806

685

1,062

93.2

92.5

66.4

100.0 42.3 16.9 40.8

100.0 48.6 15.9 35.5

100.0 52.8 19.2 28.0

1,267

1,271

90.4

91.6

10Q.O 37.1 18.7 44.2

100.0 59.8 16.2 24.0

1,116

850

95,6

89.4

64.8

100.0 52.6 16.6 30.9

100.0 47.5 20.0 32.5

100.0 40.5 15.9 43.6

22,065 9&4 100.0 48.3 17.6 34.1

526

774

505

266

97.0

98.6

98.7

100.0

100.0

100,0

33.2

42.5

61.0

69.7

18.6

19.1

16.6

*13.1

48.2

38,3

22.4

*17.2

100.0

100.0

1,049

1,042

97.6

99.2

100,0 37.6

59.1

18.7

16.4

43.7

100.0 24.5

935

709

460

99.5

97.4

97.7

100.0

100+0

100,0

52.2

48.8

39.4

16.3

20.0

16.4

31.5

31.2

44.2

1,040

1,001

100.0

96.7

100.0

100.0

57.9

37.3

14.4

21.2

27.7

41.5

f4cAllpreg~les,} referstollwblflh, mlscardages,arxt stillbirths.lmluced abortbnssreexckled.

zl~~d~p~~ies forwhi~dtiawm rdsslngonmcthets msritelsts.tusatcutcome oronprenatslcare.

36
Table 10. Number of pregnancies ending in a live birth or spontaneous loss in January 1979 or iater to women 15-44 years of age,

percent receiving prenatsi care, and percent distribution of pregnancies receiving care by source of care at first visi$ according to

seiected characteristics of the woman: United States, 1982

IStatiitiis are based on a sample of the household population of the conterminous United States. See appendxes I and II for discussion of the sample design,

sampling varlabilii, and definition of terms]

source of prenatal ewe at tirst visil

Number in Percent recatving Private Hosplfal Other

Ctraracterbtk thousands prenatal care Total doctor Clwc cllnk

Percent diitributbn

Allpregnancissl . . . . . . . . . . . . . . . . . . . . . . . . . . . . %7,397 93.1 100.0 75.3 8.8 15.8

11.9

9.4

22.8

16.5

27.7

14.2

10.4

●8.6

11.6

16.1

20.6

31.9

28.2

9.6

7.5

37.7

12.4

16.1

12.2

9.8

22.6

17.3

26.0

14.7

9.9

*9.2

11.6

15.5

21.1

32.0

28.3

9.5

7.4

37.8

~24

Reg”bm:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Education:

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . .

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . .

Most recent occupation:

Profasslonalormanagerial . . . . . . . . . . . . . . . . . . . .

Salesorclericai . . . . . . . . . . . . . . . . . . . . . . . . . . .

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Craftorfarmwori(eroroperathre . . . . . . . . . . . . . . . .

Neverworkad . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Poverty level Incomw

149 percentorless . . . . . . . . . . . . . . . . . . . . . . . . .

150percentormore . . . . . . . . . . . . . . . . . . . . . . . .

300parcentormore. ,, . . . . . . . . . . . . . . . . . . . .

Madicaidstatus

RecetvesMedfcaid . . . . . . . . . . . . . . . . . . . . . . . . .

DoesnolreceiveMedlcaid ..,. . . . . . . . . . . . . . . . .

3,244

4,501

5,672

3,980

94.3

93.7

93.3

91.2

87.6

94.8

94.7

93.2

94.5

93.4

94.9

87.9

100.0 71.3

83.1

70.5

76.8

68.2

76.5

85.6

87.9

82.0

71.4

69.6

52.9

16.8

7.5

6.7

*6.7

16.1

9.3

*4.O

100.0

IOQ.O

100.0

100.0

100.0

100.0

100.0

100.0

10Q.O

100.0

100.0

lW.O

100.0

100.0

100.0

100.0

1CQ.o

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100,0

Iwo

100.0

IWI.O

103.0

100.0

100.0

100.0

4,156

6,746

6,495

2,738

6,749

3,263

2,074

2,458

●3.5

6.4

12.5

*9.9

15.2

5,910

11,487

6,025

91.7

93.8

94.2

57.6

84.4

87.1

14.3

6.1

5.3

19.9

7.1

2,S67

14,963

91.4

93.4

42.3

80.5

LMebirths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ‘14,372 96.4 74.9 9.0

RagIon:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sough . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Education:

Lessthan 12yeare . . . . . . . . . . . . . . . . . . . . . . . . .

12yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . .

Most recent occupation:

Professbnalormanagerial . . . . . . . . . . . . . . . . . . . .

Salesorclerical . . . . . . . . . . . . . . . . . . . . . . . . . . .

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Craftorfarmworl(eroroparalNe . . . . . . . . . . . . . . . .

Neverworked . . . . . .. ~..... . . . . . . . . . . . . . . .

Poverfylevellncome:

149percentorlass . . . . . . . . . . . . . . . . . . . . . . . . .

150percantormore . . . . . . . . . . . . . . . . . . . . . . . .

300percentormore . . . . . . . . . . . . . . . . . . . . . . .

Medicaldslalus

ReceivesMadlcaid . . . . . . . . . . . . . . . . . . . . . . . . .

DoesnotreceNe Medicaid . . . . . . . . . . . . . . . . . . . .

2,653

3,639

4,719

3,161

99.5

96.9

97.8

97.9

69.5

83.6

70.6

75.2

18.3

*6.6

6.7

●7.6

3,516

5,689

5,187

95.5

99.2

99,5

55.2

76.6

85.7

87.5

82.0

71.7

68.9

52.2

16.9

8.6

*4.4

2,222

5,502

2,575

1,851

2,142

5,113

9,260

4,663

00.9

99.3

96.7

97.9

94.7

97.0

99.2

100.0

*3.3

6.5

12.6

*9.9

15.9

57.0

64.5

66.8

14.7

6.0

*5.8

2,059

12,269

97.7

06.5

42.2

80.4

200

7.2

1-AII pregtiies,) refers to live blr(hs, miscarriages, and stlllbklhs. khad tirtbm am exckfed.

‘Inchdes pregnawies for which rnotkr’s last occupation or nmlhet’s Medicaid stalus was unkno,vn.

37
Table ll. Number ofpregnancies ending Inalive bitihor spontaneous loss in January 19790r Iaterto white women 15-44 years of age,

percent receiving prenatal care, and percent distribution of pregnancies receiving care by source of care at first visitj according to

selected characteristics of the woman: United States, 1982

[Statisticsare basedon a sampleof the householdpopulationof the conlermlnousUnited States. See appendixes I and II for discussion of the sample design,

sempllrrg variability, and definifiin of terms]

Source of prenatal care at fimt visit

Number In Percent receiving Private Hospital Other

CharacterLstk thousands prenatal care Total doctor clirrlo cllnic

Percent distribution

100.0

100.0

100.0

100.0

100.0

100.0

100,0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

103.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

60.2

76.1

86.0

78.4

78.8

60.9

7.3

14.1

*6,3

*5.2

*5.8

15.7

7.5

*2.5

*3. 1

*4.7

10.9

*10.6

*12,6

13.5

4.7

*4.4

20.0

6.0

7.5

15,6

*5.3

*5.2

*6.6

16.7

6.8

*2.6

*3.O

*4.6

●11.0

*I 0.7

*13.4

14.2

4.4

*4.7

19.5

6.1

12.5

*9.8

7.7

16.4

15.4

23.5

9.5

9.3

*8.9

9.0

12.6

16.6

25.3

23.6

7.6

6.6

33.9

10.3

12.7

●9.6

8.1

16.6

15.8

23.9

10.1

8.4

*9.4

8.9

*11.6

17.5

26.0

23.7

7.6

6.6

34.0

10.2

Allpregnanclesl . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214,148 93.6

Region:

NcrttIeset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Education:

Lessthan 12years, . . . . . . . . . . . . . . . . . . . . . . . .

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . .

Most recent occupation:

Professionalormanageriel . . . . . . . . . . . . . . . . . . . .

Salesorclerltal . . . . . . . . . . . . . . . . . . . . . . . . . . .

Serve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Craftorfarm workeroroperative . . . . . . . . . . . . . . . .

Neverworked . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Poverty level income:

149percenlorless . . . . . . . . . . . . . . . . . . . . . . . . .

150percentormore . . . . . . . . . . . . . . . . . . . . . . . .

WOpercentcrmore . . . . . . . . . . . . . . . . . . . . . . .

Medicaid status:

RecetvesMadicald . . . . . . . . . . . . . . . . . . . . . . . . .

DoesnctreceNeMedicaid . . . . . . . . . . . . . . . . . . .

2,622

3,989

4,197

3,340

95.3

94.6

93.1

91.6

3,251

5,521

5,375

88.4

95.3

95.1

93.2

95.6

93.3

95.9

67.1

63.0

88.2

88.0

86.3

76.5

72,7

62.1

62.9

87.7

2,430

5,565

2,638

1,670

1,759

4,264

9,663

5,182

92.6

94.1

94.7 69.0

1,354

12,757

92.2

93.8

46.1

63.7

79.9

74.6

86.6

78.2

77.6

59.4

63.1

88.9

67.6

86.5

77.4

71.8

60.6

62.1

68.0

66.7

46.5

83.6

Livebiflhs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

211,636 98.3

Region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

south . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Education:

Lessthan 12yeare, . . . . . . . . . . . . . . . . . . . . . . . .

12years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . .

Most recent occupafiin:

Professtonalormanagerkd . . . . . . . . . . . . . . . . . . . .

SaIesorclerical . . . . . . . . . . . . . . . . . . . . . . . . . . .

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cr6ftorfarmworkeroroperatNe . . . . . . . . . . . . . . . .

Never Worked . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Poverty level Income:

149percentorlees. .,...... . . . . . . . . . . . . . . . .

WOpercentormore. . . . . . . . . . . . . . . . . . . . . . . .

300percenlormcre . . . . . . . . . . . . . . . . . . . . . . .

Medkakistatus

Receives Medicaid......,.. . . . . . . . . . . . . . . . .

DoesnotreceiveMedicatd ...,. . . . . . . . . . . . . . . .

2,183

3,449

3,456

2,746

99.5

98,9

97.6

97.7

2,794

4,693

4,346

94.9

99.3

99.5

1,998

4,619

2,116

1,502

1,542

100.0

99.3

98.6

97.7

93.5

3,774

8$62

4,095

96.6

99.1

100.0 100.0

1,222

1o,5e9

97.5

98.4

100.0

100.0

1,.AII pregMWIeS,, refem to IIW births, mlxe,rriages, ad stillbirths. Irduced abortiins we excluded.

2j~~d@ ~regmIeS fo, whlti mothets k+t occupation or mothefs Medkeid $tams w= unk~n.

38
Table 12. Number of pregnancies ending in a live birth or spontaneous loss in January 1979 or later to black women 15-%4 years of age,

percent receiving prenatal care, and percent distribution of pregnancies receiving care by source of care at first visit, according to

selected characteristics of the woman: United States, 1982

[Statistics are based on a sample of the household pOpUkitlOn of the contermlnous United States. See appendixes I and II fOr discussion of the sample design,

sampllng varfabilify, and definition of terms]

Source of prenatal care at fkst vlsfl

Number in Percent raceivlng Private Hospital Other

Characteristic thousands prenatal mre Total doctor Clkrk clink

Percent distribution

All pregnancies . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i,22,574 91.0 100.0 48.3 17.5 34.2

23.2

26.4

41.9

26.6

44.5

35.7

20.4

*1O.5

25.6

35.8

35.9

50.1

42.7

23.9

18.3

45.3

27.6

34.1

25.7

25.9

41.0

25.8

44.0

35.5

21.0

*11.2

26.1

36.0

34.9

46.5

42.4

23.5

*18.O

44.8

27.5

Region:

Notiheast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Education:

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . .

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . .

Most recent occupation:

Professional ormanagerlal . . . . . . . . . . . . . . . . . . . .

Salesorclerical . . . . . . . . . . . . . . . . . . . . . . . . . . .

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CraflorfarmworKeroroperath4e . . . . . . . . . . . . . . . .

Neverworked . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Poverty level income

149percentorless . . . . . . . . . . . . . . . . . . . . . . . . .

150percentormore . . . . . . . . . . . . . . . . . . . . . . . .

300 percentormore . . . . . . . . . . . . . . . . . . . . . . .

Medicaid status:

Receives Medicaid . . . . . . . . . . . . . . . . . . . . . . . . .

DoesnotreceiveMedtcald . . . . . . . . . . . . . . . . . . . .

483

394

1,340

356

824

1,051

700

178

876

543

328

617

1,417

1,157

513

940

1,612

92.6

86.7

93.4

64.6

100.0

100.0

100.0

lcslo

100.0

100.0

100.0

100.0

100.0

100.0

100.0

Im.o

100.0

100.0

100.0

100.0

1M.o

100.0

44.9

50.9

45.8

W.o

36.3

44.2

67.7

76.2

56.8

41.6

55.5

30.1

36.7

59.6

69.7

33.3

57.0

46.3

31.9

226

12.2

*13.4

19:2

20.1

11.9

●11.3

17.6

226

●6.6

19.7

16.6

16.3

*12.1

21.4

15.3

17.6

85.6

94.3

92.5

96.1

89.8

93.7

69.5

eo.3

90.0

92.3

90.3

89.7

91.6

Ltvebirths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22,095 96.4

Region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Education:

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . .

12yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . .

Most recent occupation:

Professlonalormanagerlal . . . . . . . . . . . . . . . . . . . .

Salesorclerical . . . . . . . . . . . . . . . . . . . . . . . . . . .

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Craftorfarmworkeroroperative . . . . . . . . . . . . . . . .

Neverworked . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Poverty level income:

149percentorless . . . . . . . . . . . . . . . . . . . . . . . . .

150percenIormore . . . . . . . . . . . . . . . . . . . . . . . .

300percentormore . . . . . . . . . . . . . . . . . . . . . . .

Medica!d status:

Receives Medicaid . . . . . . . . . . . . . . . . . . . . . . . . .

DoesnotrecefveMedicaid . . . . . . . . . . . . . . . . . . . .

369 99.5

98.4

98.1

98.1

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100,0

100,0

too.o

41.7

51.7

47.0

60.6

36.6

44.7

67.0

60.2

55.6

42.0

56.4

31.3

39.4

59.8

69.8

33,4

57.5

32.7

22.4

12.1

*13.6

19.4

19.6

*12.1

●6.7

16.3

22.0

●8.6

20.2

16.2

16.6

*12.3

21.8

14.9

320

1,141

244

652

667

576

97.5

98.5

99.2

99.2

9%3

w. 1

98.6

97.3

151

682

433

274

532

1,185

910

369

97.3

99.8

lfx).o

786

1,290

97.8

96.9

1,,AII pregmxies$) ~efem to IIW bkths, miscarriages, and stillbirths. Induced s.bortkkm are EXCk%d.

%chtdes pregnsnsies for which mother% last occupation or mothats Madicaid status was unkwn.

39
Table 13. Number of women 15-44 years of age whose most recent pregnancy ended in a five birth or spontaneous loss and percent

distribution by average number of cigarettes smoked per day during the pregnancy, according to selected characteristics of the

pregnancy: United States, 1982

[Statistics are based on a sample of the household population of the contermlnous United Stake. See appendixes I end II for discussion of the sample design,

sampling variability, and definition of terms]

Average number of cigarettes smoked

Number of

w day during pregnancy

women In Fewer 15 or

CheracterLstJ$ thousands Total None fhan 15 more

Percent dislribufiin

All Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i 29,357 100.0 69.4 15.7 14.9

Age at pregnancy outcome:

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,933 100.0 61.6 22,3

20-24yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16.1

9,511 100.0 88.4 17.2

25-29yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16.4

10,784 100.0 72.4 13.9

30-44yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13.7

6,149 100.0 72.5 13.3 14.2

Pregnancy order:

Firstpregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,436 100.0 68.2 19.8

Secondpregnency . . . . . . . . . . . . . . . . . . . . . . . . .

12.0

9,562 100.0 72.4 14.2

Thirdpregnancyorhigher . . . . . . . . . . . . . . . . . . . .

13.4

13,339 100.0 67.9 14.8 17.4

Marital status at pregnancy outcome:

Nevermarriad . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,252 100.0 59.9 22.6

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17.5

25,899 100.0 70.7 14.7 14.5

Wontedness status at conception:

Wanledthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18,130 100.0 72.4 13.8

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13.8

7,024 100.0 65.5 18.2

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16.3

4,202 100.0 63.2 19.5 17.3

Pregnancy outcome

Ltveblrfh, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26,224 100.0 70.7 15.2

Spontaneouspregnancyloss. . . . . . . . . . . , . . . . . .

14.1

3,133 100.0 59.0 19.7 21.4

Prenatalcsra2

Eartyandcontlnuous . . . . . . . . . . . . . . . . . . . . . . . . 7,308 100.0 76.9 12.7

Lateordlecontinuous . . . . . . . . . . . . . . . . . . . . . . .

10.4

4,548 100.0 64.8 19.2 16.0

ll~hdeswomn forwbmdtdstatus aicutcomeatitimlng andcmtidtyofprenetal carewereunkrwm fOrtbMdrOCent Pre9m~Y.

2PragnarClesendingon or afterJaruary 1, 1979.

6

40
Table 14. Number of white women 15-44 years of age whose most recent pregnancy ended in a live birth or spontaneous ioss and

percent distribution by average number of cigarettes smoked per day during the pregnancy, according to selected characteristics of the

pregnancy United States, 1982

[Statistics are based on a sample of the household population of the conterminous Untted States. See eppendLxes I and IIfor dlscueeion of the sample design,

sampling variability, and definttlon of terms]

Average number of c@areftes smoked

Number of

pef day durtng pregnancy

wom~ in Fewer 15 or

Characfe&tic thousands Total None then 15 more

Percent distribution

All women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124,174 100.0 68.7 15.2 16.1

Age at pregnancy outcome

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,034 100.0 57.9 22.0 20.1

20-24 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,776 100.0 64.3 17.3

26-29 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18.4

9,320 100.0 72.5 13.3

3044yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14.2

5,043 100.0 73.0 12.8 14.3

Pregnancy ordec

First pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,173 100.0 66.9 19.7

Second pregnancy . . . . . . . . . . . . . . . . . . . . . . . . .

13.4

8,118 100.0 71.5 14.1

Third pregnancy orhigher . . . . . . . . . . . . . . . . . . . .

14.4

10,663 lW.O 67.5 13.9 18.6

Marifet status at pregnancy outcome

Never married . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,608 100.0 54.1 21.1

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

24.8

22,509 100.0 69.9 14.7 15.4

Wontedness status at conception:

Wanted then . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15,686 100.0

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

71.9 13.4 14.6

5,568 100.0 64.0 17.6

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18.4

2,920 100.0 60.4 2a3 19.3

Pregnancy outcome

Livebirth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21,602 1rxt.o 69.9 14.8

Spontaneous pregnancy loss.. . . . . . . . . . . . . . . . . .

15.3

2,372 100.0 57.7 19.0 23.3

Prenatal care:z

Earlyandcontinuous . . . . . . . . . . . . . . . . . . . . . . . . 6,209 1Cw.o 76.6 12.2

Lateordiscontinuous . . . . . . . . . . . . . . . . . . . . . . .

11.3

3,433 1Cn3.o 64.3 ?8.4 17.3

1Imbdes Wmn forwhom mantelstatusat wtcome, andtiminge.rdcontinuityor prenaralcarewere unknownforthe K@@r-m Pq~W.

‘Pregnancieserding on or afterJanua~ 1, 1979.

41
Table 15. Number of black women 15-44 years of age whose most recent pregnancy ended in a live birth or spontaneous loss and

percent distribution by average number of cigarettes smoked per day during the pregnancy, according to selected characteristics of the

pregnancy United states, 1982

[Statistics are based on a sample of the household population of the contermlnous UnifedSlates. See appendxes I and II for discussion of the sample design,

sampling variability, and defimtlon of terms]

Average number of cigarettes smolred

Number of

per day during pregnancy

womam In Fewer 15 or

Characteristk thousands Total None than 15 more

Percent distribution

Allwomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14,234 100.0 71.0 19.5 9.5

Age al pregnancy outcome:

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . . 822 100.0 72.6 21.7

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*5.8

1,479 100,0 75.3 18.1

25-29years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6.5

1,146 100.0 66.0 20.5

30-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11.5

786 100.0 65.5 18.6 15.8

Pregnancy orde~

Fkstpregnsncy . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,092 100.0 74.9 1S.9

.%condpregnancy. ..,..... . . . . . . . . . . . . . . . .

6.1

1,099 100,0 73.2 17.7

Thirdpregnancyorhlgher . . . . . . . . . . . . . . . . . .

9.1

2,043 100.0 67.7 20.9 11.5

Mafifal statusatpreg nancyoulcome

Nevermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,646 100.0 67.3 23.3

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9.4

2,537 100.0 73.0 17.4 9.6

Wontedness status at conception:

Wanledthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,872 100.0 73.0 18.4

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8.5

1,232 100.0 71.5 22.0

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6.5

1,129 100.0 67.0 18.8 14.3

Pregnancy outcome

Ltvebirth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,668 100.0 73.3 78.4

Spontaneouspregnancyloss. . . . . . . . . . . . . . . . . .

8.3

566 100.0 56.2 26.9 16.8

Prenataf care?

EartyandconWruous.., . . . . . . . . . . . . . . . . . . . . . 674 100.0 76.6 17.7

Lateordiscontinuous . . . . . . . . . . . . . . . . . . . . . . .

*5.7

S71 100.0 64.3 24.6 11.0

1lmbdes women for whom marttal status at oufcorr-e, ard timing and continuity of prenatal care were unknown for the most recent pregnancy.

ZPregWcIeS e“di”g on or after Jarwary 1, 1979.

42
Table 16. Number of women 15-44 years of age whose most recent pregnancy ended in a five birth or spontaneous loss and percent

distribution by average number of cigarettes smoked per day during the pregnancy, according to selected characteristics of the woman:

United States, 1982

[Stalietlcs are based on a sample of the household population of the conterminous United States. See appendixes I and Hfor dscussion of the sample design,

sampling variability, and defintlion of terms]

Average number of clgaretfes smoked

Number of

per day durtng pregnancy

womei-rin Fewer 15 or

Cheracteristb thousands Total A42ne than 75 more

Percent dlstrlbutlon

Allwomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i29,357 100.0 69.4 15.7 14.9

Region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,764 100.0 69.3 19.4

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11.3

7,736 100.0 66.2 17.1

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16.7

10,139 100.0 70.9 13.7

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15.4

5,699 100.0 71.4 13.5 15.2

Education:

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . 6,360 Iwo 55.7 20.7 23.6

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,652 100.0 68.3 16.1 15.6

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . . 10,345 100.0 79.2 12.1 6.7

Most recent occupation:

Professionalormmagerlai . . . . . . . . . . . . . . . . . . . . 4,362 100.0 77.5 11.4

Salesorclerical . . . . . . . . . . . . . . . . . . . . . . . . . . .

11.2

12,630 100.0 72.3 14.1

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13.6

5,662 100.0 61.9 20.5

Craftorfarmworkeroroparatiie.. . . . . . . . . . . . . . .

17.6

4,075 100.0 63.1 16.6

Neverworked . . . . . . . . . . . . . . . . . . . . . . . . . . . .

20.3

2,442 100.0 69.2 17.6 13.0

Povertylevel income:

149percentorlees . . . . . . . . . . . . . . . . . . . . . . . . . 7,553 100.0 63.3 19.8

150parcentormore . . . . . . . . . . . . . . . . . . . . . . . .

16.9

21,604 100.0 71.6 14.2

300percentormore . . . . . . . . . . . . . . . . . . . . . . .

14.2

12,316 100.0 72.2 13.9 13.9

Medicaid status

ReceivesMadicaki . . . . . . . . . . . . . . . . . . . . . . . . . 2,620 100.0 57.5 21.2

Does notreceNeMediceid . . . . . . . . . . . . . . . . . . . .

21.3

26,556 100.0 70.7 15.1 14.2

Residence

Metropolitan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22,637 1Oa.o 69.0 18.0

Nonmetropoliten . . . . . . . . . . . . . . . . . . . . . . . . . . .

15.0

6,720 1CO.o 71.0 14.5 14.5

i Inck.ides women whose lest occupation or Medicaid status wes unkmwm.

43
Table 17. Number of white women 16-44 yeara of age whose most recent pregnancy ended in a live birth or spontaneous loss and

percent distribution by average number of cigarettes smoked per day during the pregnancy, according to selected characteristic of the

woman: United States, 1982

[Statistlca are based on a sample of the household population of the contenrrinous United States. See appendixes I and II for discussion of the sample desfgn,

sampllng variability, and definition of terms]

Average number of clgareties smoked

Number of

per day during pregnancy

womea In Fewer 15 or

CtraracterMc thousands Total None than 15 more

Percent distribution

All women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124,174 100.0 64?.7 15.2 16.1

Region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4,880 100.0 66.3 19.9 11.8

6,730 100.0 65.7 16.7 17.6

South, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,672 100.0 70.2 12.5

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17.3

4,682 100.0 70.8 12.8 16.4

Education:

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . 4,804 100.0 53.2 20.4

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26,4

10,S67 100.0 67.6 15.6

13yeatsormore . . . . . . . . . . . . . . . . . . . . . . . . . .

16.8

8,703 100.0 78.8 11.8 9.4

Most recent occupation:

Professionalormanagerlal . . . . . . . . . . . . . . . . . . . . 3,827 100.0 77.0 11.1

SaIesorclerkal . . . . . . . . . . . . . . . . . . . . . . . . . . .

11.9

10,741 100,0 71.6 13.8

&N& . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14.6

4,466 100.0 60.9 20.1

Craftorfarrnworkeroroperative . . . . . . . . . . . . . . . .

19.0

3,226 100.0 61.2 15.9

Neverworked . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22.9

1,789 100.0 68.5 17.0 14.6

Poveriy level income:

149percentorless . . . . . . . . . . . . . . . . . . . . . . . . . 5,263 100.0 60.9 19.5

150percentormore . . . . . . . . . . . . . . . . . . . . . . . .

19.6

18,912 100.0 70.9 14.0

300percenlormore . . . . . . . . . . . . . . . . . . . . . . .

15.1

10,825 100.0 71.3 14.0 14.7

Medicaldslatus:

Receives Medicaid . . . . . . . . . . . . . . . . . . . . . . . . . 1,480 100.0 50.4 20.2

DoesnotreceiveMedlcaid . . . . . . . . . . . . . . . . . . . .

29.4

22,569 100.0 70.1 14.9 15.1

Residence:

Metropolita n . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16,3541 100.0 6s.3 15.4

Nonmetropolftan . . . . . . . . . . . . . . . . . . . . . . . . . . .

16.3

5,824 100.0 70.0 14.5 15.5

!Imhdeswomn vimaalastoccupatlon orh%dicaidstatw wmunkmwn.

44
Table 18. Number of black women 15-44 years of age whose most recent pregnancy ended in a live birth or spontaneous loss and

percent distribution by average number of cigarettes smoked per day during the pregnancy, according to selected characteristics of the

woman: United States, 1982

[Slatlstks are based on a sample of the household population of the contermlnous United Sta!as. See appendixes I and II for discussion of the sample design,

sampling variability, and defintlkm of termsl

Number of

par day during pregnancy

women h Fewer 15 or

Characteristk thousands Total None than 15 more

Percent diitributlon

Allwomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14,234 1CN3.o 71.0 19.5 9.5

Region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 700 100.0 71.3 19.6

Midw@X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

+9.0

847 100.0 67.5

south. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

23.0 9.4

2,202 100.0 73.2 17.4

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9.4

485 100.0 66.8 22.8 ●1O.4

Eduoalbn:

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . 1,269 100.0 63.3 24.0

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,736

12.7

100.0 71.8

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . .

18.6 9.6

1,229 100.0 77.7 16.3 6.0

Most recent occupation:

Professkmalormanagerial . . . . . . . . . . . . . . . . . . . . 354 100.0 S0.8

Salesorclerical . . . . . . . . . . . . . . . . . . . . . . . . . . .

*13.9 *5.3

1,464 100.0 73.6

.%wloe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17.7

1,105

8.7

100.0 64.0

Craftorfarmworkeroroperative . . . . . . . . . . . . . . . .

23.8

718

12.2

100,0 73.1

Naverworlred . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17.7

543

9.2

100.0 69.5 22.2 *8.4

PoverlyleveIlncome

149percentorless . . . . . . . . . . . . . . . . . . . . . . . . . 2,063 1CH3.O 68.6 22.2

l~percentormore . . . . . . . . . . . . . . . . . . . . . . . .

9.3

2,151 100.0 73.3

300percentormore . . . . . . . . . . . . . . . . . . . . . . .

17.0

954

9.7

100.0 71.4 17.5 11,1

Medioaidstatus

ReceWsMedk8id . . . . . . . . . . . . . . . . . . . . . . . . . 1,078 10Q.O *.4 22.7

DoesnotreceiveMedkaid . . . . . . . . . . . . . . . . . . . . 3,112

10.9

100.0 725 18.4 9.1

Residence:

Metropolllan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,454 10C%O 69.8

Nonmetropollten. . . . . . . . . . . . . . . . . . . . . . . . . . .

20.3

760

9.9

100.0 76.3 16.2 *7. 5

tlmhd~~~n Wk=l~~@on orkfedlcddstatus wasunhown.

45
Table 19. Number of women 15-44 years of age whose most recent pregnancy ended in a iive birth or spontaneous ioss and percent

distribution by average frequency of aicoholic beverage consumption during the pregnancy, according to seiected characteristics of the

pregnancy United States, 1982

[Statistics are based on a sample of the household population of the contermlnous United States. See append~es I and II for discussion of the sample design,

sampling variability, and definition of terms]

Average frequency of alcoholic beverage

consumptkm durrhg pregnancy

Number of

women In Less than Once a

Characte&tic thousands To:& Never once a wedr week or more

Percent distribution

Allwomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129,357 100.0 54.5 33.7 11.8

Age at pregnancy outcome

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,933 100.0 70.9 22.7

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*8.4

9,511 100.0 59.2 31.8

25-29 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9.0

10,764 100.0 48.0 38.5 13.5

30-44ye8fs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,149 100.0 51.0 33.4 15.5

Pregnancy orden

Firstpregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,436 100.0 80.6 30.8

Second pregnancy . . . . . . . . . . . . . . . . . . . . . . . . .

8.6

9,582 100.0 51.3 37.0

Third pregnancyorh!gher ..., . . . . . . . . . . . . . . . .

11.7

13,339 100.0 54.0 32.7 13.3

Marital statusatpregnancy outcome:

Nevermarriad . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,252 100.0 62.0 25.5 12.5

Evermarriad . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25,899 100.0 53.5 34.9 11.6

Wontedness status at conception:

Wantedthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18,130 100.0 53.7 34.7 11.6 ‘

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,024 100.0 53.3 35.1

Unwalled . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11.7

4,202 100.0 60.4 27.0 12.6

Pregnancy outcome

Uvebkth. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26,224 100.0 55.0 34.1

Spontaneouspregnancyloes . . . . . . . . . . . . . . . . . . .

10.9

3,133 100.0 50.4 20.3 19.3

Prenatal carixz

Earlyandcontinuous . . . . . . . . . . . . . . . . . . . . . . . . 7,306 100.0 54.8 37.4

Lateordkcontinuous . . . . . . . . . . . . . . . . . . . . . . .

7.8

4,548 100.0 57.7 30.9 11.4

I Inchdes women for whom marital status at outcome and timing and mntlr-dtyof prenetal care were unknown for the rrwst recent pregmrwy.

Zpmgmmim ending on or after Jaw.Jary 1, 1979.

46
Table 20. Number of white women 15-44 years of age whose most recent pregnancy ended in a live birth or spontaneous loss and

percent distribution by average frequency of alcoholic beverage consumption during the pregnancy, according to selected

characteristics of the pregnancy: United States, 1982

[Statistics are based on a sample of the household population of the contermlnous UnttedStates.Sw appendixesI and Ii for discussion of the sample design,

sampling variability, and definition of terms]

Average frequency of alcofrok beverage

Number of

corsumptkwr during pregnancy

women In Less man Once a

Chamcferktic thousands Totst Never orrce a WS9K week or more

Allwomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ‘24,174 100.0 51.8 36.3 11.9

Age at pregnancy outcome

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,034 100.0 66.0 25.7 *6.3

20-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,778 100.0 56.3 34.4

25-29 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9.2

9,320 100.0 46.1 40.5 13.3

30-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,043 100.0 46.7 35.6 15.6

Pregnancy order

Firstpregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,173 100.0 56.6

Secondpregnancy . . . . . . . . . . . . . . . . . . . . . . . . . 8,118 Iwo 48.3

Third pregnancyorhlgher . . . . . . . . . . . . . . . . . . . . 10,663 lW.O 52.1

34.4

39.4

34.9

8.8

12.3

13.0

Marftal statusatpregnan cyoutcome

Nevermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,506 100.0 55.0 32.5 *12.4

Evermarriad . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22,509 100.0 51.5 36.7 11.8

Wontedness status at conception:

Wantedthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15,666

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

100.0 51.8 36.5 11.6

5,566 1W1.o 49.0 36.5 12.5

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,920 1M.o %.9 30.8 12.3

Pregnancy outcome:

Ltiebirth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21,602 100.0 52.2 36.6 11.0

Spxrtaneous pragnancyloss. . . . . . . . . . . . . . . . . . . 2,372 100,0 4a. 1 32.0 20.0

Prenatal car.xz

Earlyandcontinuous . . . . . . . . . . . . . . . . . . . . . . . . 6,209 i 00.0 53.4 39.3

Lateordiscontlnuous . . . . . . . . . . . . . . . . . . . . . . .

7.3

3,433 100.0 54.5 34.3 11.3

1lnckjes womemforwhomrnerftalstatusat cutcorneandlimingand continuityof venntd careware unk- ~r i~ * r~~ P%I~.

‘Pregnanciesendingon or aftwJanuary 1, 1979.

47
Table 21. Number of black women 15-44 years of age whose most recent pregnancy ended in a live birth or spontaneous loss and

percent distribution by average frequency of alcoholic beverage consumption during the pregnancy, according to selected

characteristics of the pregnancy United States, 1982

[Statistics are based on a sample of the household population of the contermlnous United States. See appendixes I and II for discussion of the sample design,

sampling variability, and definitkx of terms]

Average frequency otaicoholic beveni’ge

Number of

corrsumptkm during pregnancy

women In Less than Once a

Characteristic thousends Total Never once a w&?k week or more

Percent dlstributiin

Allwomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14,234 Irxr.o 67.1 22.0 10.9

Age at pregnancy outcome:

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . . 822 100.0 77.0 15.9

20-24 yesrs . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

●7.2

1,479 100.0 70.4 20.3

25-29 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9.3

1,146 100.0 61.1 26.6

3C44yeers . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12.4

786 100.0 59.6 24.9 15.5

Pregnancy order

Firstpregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,092 100.0 75.9 17.3

.%condpregnancy . . . . . . . . . . . . . . . . . . . . . . . . .

6.8

1,099 100.0 67.1 25.0

Thlrdpregnancyorhigher . . . . . . . . . . . . . . . . . . . .

7.9

2,043 100.0 62.5 22.9 14.6

Mariial status at pregnancy outcome:

Nevermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,648 100.0 68.6 19.8

Evermarriad . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11.6

2,537 100.0 65.9 23.6 10.5

Wontedness status at conception:

Wantedthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,872 i 00.0 65.1 24.7

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10.2

1,232 100.0 71.7 20.4

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7.9

l,12a 100.0 65.5 19.3 15.3

Pregnancy outcome:

Liveblrth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,666 100.0 69.0 21.3

Spontaneouspregnancyloss. . . . . . . . . . . . . . . . . . .

9.7

100.0 55.1 26.3 18.6

Prenatal carwz

Earlyandcontlnuous, . . . . . . . . . . . . . . . . . . . . . . . 874 100.0 66.8 26.4

Lateordiacontlnuous . . . . . . . . . . . . . . . . . . . . . . .

*6.8

871 100.0 67.9 19.9 12.2

1l~~,j~$ ~omn for ~~m mafital status at WtCOM and timing and mntinully of prenatalcarewere unk- fort~ M* rece~ P~9~ncy.

‘Pregnanoles ending on or aflar January 1, 1979.

48
Table 22. Number of women 1s44 years of age whose moat recent pregnancy ended in a live birth or spontaneous loss and percent

distribution by average frequency of alcoholic beverage consumption during the pregnancy, according to selected characteristicsof the

woman: United States, 1982

I.Statistics are based on a sample of the household population of the conterrnlnous Unled States. See appendkes I and II for dkcusskm of the sample design,

sampling variabilhy, and definition of terrnsi

Awarage frequency ofalcdrolh? beverage

Number of

consurnptbr during pregnancy

women In Less than Once a

Characterktk thousands Total Never once a weefr week or mom

Percent distribution

Allwomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . %,357 100.0 54.5 33.7 11.8

Region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,764 100.0 46.4 37.3

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,736 Im.o 49.1 39.2

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,139 100.0 67.9 23.8

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,6S9 100.0 46.6 40.1

Educat!on:

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . 6,36JJ 100.0 67.1

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,652 100.0 55.8

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . . 10,345 100.0 45,4

23.4

35.0

36.4

16.3

11.0

8.3

13.3

9.5

9.3

16.2

Most recent occupation:

Professionalormanagerlal . . . . . . . . . . . . . . . . . . . . 4,362 100.0 39.5 42.2 16.3

Salesorclerlcal . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,630 100.0 52.6 35.6 11.8

SONkO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,662 100.0 55.8 35.6 8.5

Craftorfarmworkeroroperative . . . . . . . . . . . . . . . . 4,075 100.0 63.3 25.9 10.7

Neverworlred . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,442 100.0 73.2 17.7 9.1

Poverty level Income

149percentorless . . . . . . . . . . . . . . . . . . . . . . . . . 7,553 100.0 66.4 25.3 8.4

150percenIormore . . . . . . . . . . . . . . . . . . . . . . . . 21,LW4 100.0 50.4 36.6 12.9

300percentormore . . . . . . . . . . . . . . . . . . . . . . . 12,316 100.0 46.8 37.3 16.0

Medlcakfstalus:

RecetvasMedicaid . . . . . . . . . . . . . . . . . . . . . . . . . 2,620 100.0 70.1

DoesnotraceiveMadkaid . . . . . . . . . . . . . . . . . . . . 26,556 100.0 53.0

Residence

Metropol~an . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22,637 100.0 50.5

Nonmetropolllan . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,72U 100.0 66.3

19.3

35.1

36.0

25.9

10.6

11.9

13.5

5.9

llnchdeswomen forwhomlsstexupstlon orMedicaidstatus wasunlamvm

49
Table 23. Number of white women 15-44 years of age whose most recent pregnancy ended in a five birth or spontaneous loss and

percent distribution by average frequency of alcohoiic beverage consumption during the pregnancy, according to selected

characteristics of the woman: United States, 1982

[Statistics are based on a sample of the household populatkm of the contermlnous United States. Sss appendixes I end II for discussion of the sample design,

sampling variebilii, and definition of terms]

Average frequency of alcoholic beverage

Number of

consumption during pregnancy

women In Less then Once a

Charecferistk thousands Total Never once a weak week or more

Percent distribution

Allwomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ‘24,174 100.0 51.8 36.3 11.9

Region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,880 100.0 43.5 39.0

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,730 100.0 47.0 41.5

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,672 100.0 66.3 25.6

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,692 100.0 44.0 43.3

17.5

11.5

8.1

12.8

Education:

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . 4,904 100.0 67.3 24.8

12yeers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7.9

10,567 100,0 53.1 37.6

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . .

9.3

6,703 100.0 41.5 41.2 17.3

Mostrecentoocupatio n:

Professionatormanagerial . . . . . . . . . . . . . . . . . . . . 3,827 100.0 38.8 43.9

Salesorclerical . . . . . . . . . . . . . . . . . . . . . . . . . . .

19.3

10,741 100.0 50.5 37.6

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11.9

4,466 100.0 52.5 40.4

Craftorfarmworkeroroperative . . . . . . . . . . . . . . . . 3,226 100.0 60.4 28.6 in

Neverworked . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,789 100.0 73.5 17.0 *9.5

Poverfylevel income:

149percentorless . . . . . . . . . . . . . . . . . . . . . . . . . 5,263 100.0 65.6 27.4

150percentormore . . . . . . . . . . . . . . . . . . . . . . . .

7.1

18,912 100.0 48.0 38.8

300percentormore . . . . . . . . . . . . . . . . . . . . . . .

13.2

10,825 100.0 44.4 39.2 16.4

Med!eaktstatus

ReoeivesMedicaid . . . . . . . . . . . . . . . . . . . . . . . . . 1,490 100.0 72.6 20.4 *7.O

DoesnotreceNeMedicsld . . . . . . . . . . . . . . . . . . . . 22,569 100.0 50.5 37.3 12.2

Resldervxx

Metropolitan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16,350 100.0 47.0 39.2

Nonmetropol~an, . . . . . . . . . . . . . . . . . . . . . . . . . .

13.9

5,824 100.0 67.1 27.2 5.7

fImhdes womenforwtmmlestocwpatlon .x Medicaidstatuswes unknown.

50
Table 24. Number of black women 15-44 years of age whose most recent pregnancy ended in a live birth or spontaneous loss and

percent distribution by average frequency of alcoholic beverage consumption during the pregnancy, according to selected

characteristics of the woman: United States, 1982

[Statistics are based on a sample of the household population of the conterminous United Slates. See appendixes I end II for d-sskx of the sample design,

sampling varlabllity, and definltkm of terms]

Aberage rk?quency of alcotrok beverage

Number of

consumption durkrg fnwgrrancy

wcvnen h Less then Once a

Charscieristls thousands Total Never onceaweelr weak or more

Percent disfribufion

Allwomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . %4,234 100.0 67.1 22.0 10.9

Region

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mtiwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

70+3 100.0 61.6 27.1 11.3

647 100.0 63.1 25.2

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11.7

2,202 lm.o 724 18.4

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9.3

485 lW.O 56.5 25.4 16.1

Education:

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . 1,269 100.0 64.7

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,736 100.0 70.2

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . . 1,228 1W.o 65.3

18.2

21.4

26.6

17.0

8.4

7.9

Most recent occupation:

Professionalormanagerial . . . . . . . . . . . . . . . . . . . . 354 100.0 60.0 33.7

Salesorclerical . . . . . . . . . . . . . . . . . . . . . . . . . . .

*6.3

1,464 100.0 66.0 23.9

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10.0

1,105 100.0 66.4 19.8

Crafforfarmworkeroroperative . . . . . . . . . . . . . . . .

13.7

718 100.0 71.2 17.7

Neverworked, . . . . . . . . . . . . . . . . . . . . . . . . . . .

11.1

543 100.0 71.2 WI ●9. 6

Povertylevel income:

149percentorlessc . . . . . . . . . . . . . . . . . . . . . . . . 2,(X33 100.0 67.7 19.9

150percentormore . . . . . . . . . . . . . . . . . . . . . . . .

12.4

2,151 100.0 66.6 24.0

3@) percen!ormore . . . . . . . . . . . . . . . . . . . . . . .

9.3

954 100.0 62.7 26.9 10.4

Medicaid status:

RecetvesMedicald . . . . . . . . . . . . . . . . . . . . . . . . . 1,078 I&J.o 65.4 18.6

DoesnolreceiveMedk.aid . . . . . . . . . . . . . . . . . . . .

16.0

3,112 100.0 67.7 23.1 9.2

Res!dencs

Metropoltlan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,454 100.0 65.1 23.3

Nonmelropditan. . . . . . . . . . . . . . . . . . . . . . . . . . .

11.6

760 100.0 76.2 16.1 *7.7

flndudeswmrwn forwhomlastoccupation cfMediw”dstetus was unknown.

51
Table 25. Number of single live births to women 15-44 years of age and percent low birth weight by race and selected characteristicsof

the birth: United States, 1982

[Statistics are based on a sample of Ihe household population of Ihe conlermlnous United States. See appendixes I and II for discussion of the sample design,

sampling variabifii, and definition cf terms]

All races White Black

Number of Percent Number of Percent Number of Percent

births In low births in low births in low

Characteristic thousands birth weight thousands bhih we/ght fhousands birlh weight

Allllve bkths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s age at birth:

Under 20yeara . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Bklh ordec

Flret birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Second birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Third birth orhigher . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s marital status at birth:

Nevermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wontedness status al conceptkm:

Wsntedthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mistlmedorunwanted . . . . . . . . . . . . . . . . . . . . . . .

Amount smoked during pregnancy (most recent bhm):

Didnotsmoke . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Fewerthan 15perday . . . . . . . . . . . . . . . . . . . . . . .

150rmoreperday . . . . . . . . . . . . . . . . . . . . . . . . .

Frequency of alcohol consumption during pregnancy (most

recent birth):

Didnotdrink . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Lessthanonceaweek . . . . . . . . . . . . . . . . . . . . . .

Onceaweekormore . . . . . . . . . . . . . . . . . . . . . . .

lm,511 6.6 156,602 5.6 110,907 12.2

14,803

29,013

25,634

&7

6.7

5.3

10,601

23,668

22,060

7.3

5.6

4.7

3,811

4,364

2,704

13.2

12.4

10.5

30,662

21,666

16,940

7.2

6.4

5.8

25.417 6.2

z

4,503

3,012

3,392

13.2

10.9

13;139 12.0

8,304

60,603

12.3

5.6

3,821

52,339

12.0

5.1

4,340

6,405

12.7

12.0

41,970

27,540

5.8

7.9

36,112

20,490

5.3

6.2

4,58f

6,328

10.2

13.6

18,265

3,666

3,637

4.2

10.0

12.9

15,072

3,161

3,282

3.3

9.1

12.6

2,639

657

295

9.0

15.4

*18.6

14,222

8,794

2,361

6.2

6.5

●6.2

11,244

7,665

2,401

5.2

6.4

*4.7

2,469

773

2-52

10.9

*8,0

+47.7

llnchdes birthsforwhichn-nlhar’sage at blrt~ dherk maritalstatusat birth,wantadnessstatusat conception,emountsnmkadduringPre9rMIwY, or frequencyof aicohd consWIPtion dwha

pregnancywasunkrown.

52
Table 26. Number of single live births to women 15-44 years of age and percent low birth weigh$ by race and selected characteristicsof

the mother: United States, 1982

[Stal(stim are based on a sample of the household population of the conterminous United Statas. See appendixes I and II for d-sslon of the sample design,

sampling variabilii, and definition of terms]

All races White Black

Number of Percent Number of Percent Number of Percent

births in low births h tow births kr tow

Charecteristlc thousands birth we~ht thousands birth we&ht thousands birth we@ht

Alllive births. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

159,511 6.6 158,802 5.6 i 10,907 12.2

Region:

Notiheast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13,475

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6.5 11,133 5.9 1,899 10.6

18,750 7.5 16,275 6.3 2,225

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14.9

23,669 7.2 17,457 5.7 5,581

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12.1

13,617 4.5 11,738 4.1 1,202 10.2

Education:

Lessthan 12yeare . . . . . . . . . . . . . . . . . . . . . . . . . 18,247 8.9 13,!3)5 7.5 4,198

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13.9

29,285 6.2 24,628 5.3 3,970

130rmoreyear3 . . . . . . . . . . . . . . . . . . . . . . . . . . 21,978

11.2

5.3 18,488 4.6 2,741 11.0

Most recent occupation:

Professional, managerlel, eales, and clerical workers. . . . 37,724 5.6 32,275 5.0 4,220

Service, craft, and farm worl(er eandoparetb’es . . . . . . .

11.3

24,920 8.2 19,207 7.0 5,247

Neverworked . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13.3

6,418 6.6 4,765 *5.O 1,379 10.5

Poverty level income

149percentorless . . . . . . . . . . . . . . . . . . . . . . . . . 20,286 7.7 13,893 5.6 5,932

150percentormore . . . . . . . . . . . . . . . . . . . . . . . .

129

49,225 42,709 5.6 4,975

300percentormore . . . . . . . . . . . . . . . . . . . . . . .

11.4

26,223 % 23,239 5.6 1,395 11.0

Medicalds!attx

RacelvesMadicaid . . . . . . . . . . . . . . . . . . . . . . . . . 7,278 10,2 4,088 8.7 3,096

DoesnotreceiveMedicaid . . . . . . . . . . . . . . . . . . . .

12.0

61,770 6.2 52,178 5.4 7.724 12.3

Reskfancw

Metropolita n . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53,331 7.1 42,708 6.1 8,976

Nonmetropdtan. . . . . . . . . . . . . . . . . . . . . . . . . . .

12.1

16,184) 5.1 13,895 4.2 1,932 12.4

1l~~d~~ b]fl~ fm ~hl~h ~t~ts l~t ocm@i~” or ~~<~ M~~d ~t~~ ~~ ““k-~,

53
Table 27. Number of live births in January 1979 or later to women 15-44 years of age and percent paid for from specified sources, by

selected characteristics of the birth: United States, 1982

[Skdlsiics are based on a sample of the household population of the conterminous United Skdes. See appendixes I and II for discussion of the sample design,

sampling variability, and definition of terms]

Source of payment

Number of Seit Private

births In fami~, or medical Other All

Character&t/c thousands kiends insurance Medicaid government other

Percenti

214,372

1,972

4,764

4,663

2,773

6,001

4,900

3,471

2,471

11,672

9,127

3,823

1,422

9,124

5,052

10,466

3,514

602

13,451

1,062

13,046

Alllive birlhs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mothar’s age at time of birth:

Under 20yeafs . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24 yesra . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25-29 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

30-44yaars . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

BirthordeK

First. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Second . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Thlrdorhigher . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mothef’s martIalslalus attlmeofblrth:

Nevermarriad . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wantednasa status at concepllon:

40.7 63.1 10,4 9.1 5.9

32.2

37.3

46.5

42.6

27.3

55.9

75.0

60.3

26,9

13.4

*4. 7

*3.6

23.7

9.1

*4. 1

*7.4

*4.7

8.2

*5.2

*3.9

40.8

38.3

44.2

68.2

68.6

63.6

11.7

8.5

11.1

10.2

7.3

9.6

6.2

6.5

●4.5

22.5

44.5

18.3

72.3

39.9

4.4

24.6

5.9

*3.6

6.3

6.2

16.5

21.5

Wanted then. . . . .

Mistime d........

Unwanted. . . . . .

Prenatal care:

Early and continuous.

Late or discontinuous

Prenatal care providec

. . . . . . . . . . . . . . . . . . . . . . . 40,8

41.7

37.6

72.6

48.6

41.2

6.8

11.3

17.6

5.3

7.1

*6.3

. . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . .

42.1

38.6

73.1

44.7

6.4

17.9

5.4

15.8

5.7

6.5

. . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . .

44.8

27.9

75.9

27.0

4.8

27.1

6.2

17.9

2.7

14.9

Privatedodor . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hosphalorothercllnk . . . . . . . . . . . . . . . . . . . . . . .

Birth weight:

51Apoundsorless ..,...... . . . . . . . . . . . . . . . .

Morethan51Apounds . . . . . . . . . . . . . . . . . . . . . . .

Whather Infanl came home from hospital wilh mother:

Dldnotcomehome . . . . . . . . . . . . . . . . . . . . . . .

Camehome . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

40.7

40.8

54.1

63.6

‘18.0

10.0

●6.3

8.9

●8.5

5.7

36.3

40.7

55.5

64.2

*1 6.3

10.0

*13.4

8.8

*4.9

5.7

17hewmofthepments exceeds 100.0beceuse somewomenreportedn-orethanorwsource cfpayment.

‘Inchdes Mths for wkkh mother’smaritalstatusat birih,timingandcontlruityof prenatalcare, prenatalcare provider,birth we~hi, or whether the infant cams homefrom hospital with tha mother

wesurkrrawnor notappficsble.

54
Table 28. Number of live births in January 1979 or later to white women 15-44 years of age and percent paid for from specified sources,

by selected characteristics of the birth: United States, 1982

[Statistics are based on a sample of the household population of the contermlnous United States. See appendkes I and II for discussion of the sample destgn,

sampling variability, and definition of terms]

Source of payment

Number of Seit Private

birihs in fami~, or medical Other

Characteristic

All

thousands f?iends Insurance Medhxid government other

Percentl

Allliie bifths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s age at time of birth:

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . .

20-24 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26-29 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

30-44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Birth orde~

First

Seco;tillII:IIInII:nJI:II: :::::::::::::

Third orhlgher . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s martial status al time of birth:

Nevermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wontedness status at conception:

Wantedthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unwanted. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Prenatal care:

Earlyandcontinuous . . . . . . . . . . . . . . . . . . . . . . . .

Lateordlscontlnuous . . . . . . . . . . . . . . . . . . . . . . .

Prenatal care provldec

PrNatedcetor . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hospltalorothercllnic . . . . . . . . . . . . . . . . . . . . . . .

Birth weight:

5,Apoundsor[ess . . . . . . . . . . . . . . . . . . . . . . . . .

Morethan 5!4pounds . . . . . . . . . . . . . . . . . . . . . . .

Whether infant came home from hospital with mothen

Didnotcomehome . . . . . . . . . . . . . . . . . . . . . . . . .

Camehome . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

%1,636

1,364

3,890

4,200

2,381

4,902

4,142

2,792

1,350

10,46JJ

7,912

2,980

944

7,656

3,838

9,191

2,319

58a

11,138

7e8

10,808

43.8 67.5 7.0 7.8 5.8

37.1

39.6

49.1

45.4

32.0

80.2

78.1

81.5

20.2

9.6

*3.1

*2O

23.7

8.0

●2.6

*7.4

●3.9

8.6

*5.1

*3.8

43.5

40.9

46.9

82.5

725

88.9

8.4

*5.6

●6.7

8.8

*6.5

‘8.0

6.0

*6.4

●4.7

26.8

46.0

18.7

73.7

36.4

3.3

24.3

5.7

*3.6

6.2

43.2

45.0

45.6

75.1

53.8

47.2

4.4

12.4

●11.7

6.0

9.7

●16.6

5.0

●7.1

‘8.9

44.5

42.5

76.3

49.2

4.6

12.1

4.2

12.1

5.3

*7. 1

46.6

31.6

78.0

28.4

3.3

21.7

5.3

17.9

●2.6

17.7

45.9

43.8

81.3

Oa.o

●1O.8

6.9

*5.9

7.6

*9.5

5.7

40.6

43.8

62.5

88.5

*8.3

7.0

*14.6

7.4

*4.7

5.6

‘The.sumorthepercents exceeds100.0because sonwwamenreported morethanonescur~ ofpaymmt.

‘Irc!udestirths forwtichnwttwfs msritalstatusat bklh,timingand contiruityofprenatal Csre,prer?atalcare provider, bhthweigtt, cfwkiherltmltiti camehomefrom Imspltdwilhtka rrw+twr

was udamwn or rnt applicable.

55
Table 29. Number of live births in January 1979 or later to black women 15-44 years of age and percent paid for from specified sources,

by selected characteristics of the birth: United States, 1982

[Statistics are based on a sample of the household population of the contermlnous United States. See appendixes I and II for discussion of the sample design,

sampling variability, and definition of terms]

Source of payment

Number of S%ft Private

births in faml~, or medical Other All

Characterk’tk thousands friends insurance Medicakl government other

Alllive birIhs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s age at time of birth:

Under 20years . . . . . . . . . . . . . . . . . . . . . . . . . . .

2C-24years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26-29 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

30-14 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Birth ordar:

First . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Second . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ttrirdorh[gher . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mother’s marital status attimeofblrm:

Navermarried . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Evarmarried . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wontedness status at conception:

Wantedthen . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mistimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unwanted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Prenatal care

Earlyandcontlnuous . . . . . . . . . . . . . . . . . . . . . . . .

Lsteordlacontinuous . . . . . . . . . . . . . . . . . . . . . . .

Prenafsl care provkfer:

Prlvatedoctor . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hospifalorotherclinic . . . . . . . . . . . . . . . . . . . . . . .

Bltth weight:

5!Apoundsorless . . . . . . . . . . . . . . . . . . . . . . . . .

Morethan5!Apounds . . . . . . . . . . . . . . . . . . . . . . .

Whether infant came home from hospital with mother

Didnotcomehome . . . . . . . . . . . . . . . . . . . . . . . . .

Camehome . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22,095

528

774

505

266

857

603

635

1,049

1,042

935

709

45a

1,040

1,002

981

1,048

203

1,876

239

1,824

24.1 37.7 30.3 15.1 6.4

21.6

25.3

26.7

*2I .3

*13.1

33.9

53.6

64.8

47.0

30.5

19.7

*17.6

20.6

15.9

*11.3

*9.7

*6.5

*7.6

*5.5

*4.4

26.1

22.4

20.5

31.1

45.4

39.2

33.1

25.6

31.0

16.1

*11.4

17.3

*6.9

*7.8

*4.2

17.6

30.6

16,0

59.3

46.9

13.7

23.3

*6.9

*4.2

8.5

25.1

26.0

19.3

49.3

30.5

24.9

21.8

33.9

43.2

12.8

14.4

20.8

8,0

*7,4

*1,3

25.6

23.1

47.9

26.0

20.4

41.1

14.1

16,1

7.6

*5.3

26.5

22.1

56.0

19.3

17.0

421

12.6

i 7.4

*3.8

9.1

*24.3

24.1

32.9

38.1

41.3

29.2

*1 0.2

15.7

*7.3

6.3

*24.4

24.1

26.7

39.3

45.1

28.2

*11.2

15.8

*5.9

6.5

%eeumofthepmerrts exceedslCO.Obeceuse sorrwwmrenreporled morethanonescurce ofpayrment.

‘lnchdes b!rk for wtich mother’s marital status at birth, timing ard continuity of prenatal care, prenatal sere provider, birth weight, or whether the lnfent came hem frcin Imspltal with the mother

was unknown or not applicable.

56
Table 30. Number of live births in January 1979 or later to women 1S-44 years of age and percent paid for from specified sources, by

selected characteristics of the mothe~ United States, 1982

[Statistics are based on a sample of the household population of the contemninous Unfled States. Sea appendixes I and II for discussion of the sample design,

sampling varlablltty, and definition of terms]

Number of sax Private

births h? fami~, or madhxt Other All

Characteristic thousands fiierrds insurance Madkakt aovarnmerrt other

AlllNebiflhs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214,372 40.7 83.1 10.4 9.1 5.9

Region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,653 32.8 71.1 16.0 *4.7

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

%?.6

3,839 37.7 75.7 ‘6.8 7.3

Sough . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*3.O

4,719 44.7 53.7 10.7 10.6

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6.9

3,161 45.2 55.1 9.9 12.7 *7.6

Education:

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . 3,516 33.4 35.3 25.0 17.0 *6.5

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,869 42.2 64.0 7.8 9.2

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . .

6.5

5,187 .44.0 80.8 *3. 6 *3.6 ●4.8

Mosl recent occupation:

Professkmalormanagerial . . . . . . . . . . . . . . . . . . . . 53.9 63.9 ●0.9 *1.2

Salesorclerlcal . . . . . . . . . . . . . . . . . . . . . . . . . . .

*6.2

%% 39.8 71.9 5.5 6.2 6.1

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,575 34.9 68.7 11.0 15.5

Crafforfarmworkeroroperetiie . . . . . . . . . . . . . . . .

*5.6

1,851 39.7 621 ●10.9 *12.7

NeverWorked . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*3.2

2,142 37.5 26.7 31.9 14.0 ●7.6

Povertylevei income:

149percentorless . . . . . . . . . . . . . . . . . . . . . . . . . 5,113 32.8 35.6 23.6 19.1

150percentormore . . . . . . . . . . . . . . . . . . . . . . . .

8.5

9,260 45.1 78.3 3.2

300percentormore . . . . . . . . . . . . . . . . . . . . . . .

4.4

4,863 43.9 83.0 *25 ?2 *4.2

Medicaid status:

ReceivesMedicald . . . . . . . . . . . . . . . . . . . . . . . . . 2,059 14.2 14.0 47.3 30.4

Doasnot receiveMedlcaid . . . . . . . . . . . . . . . . . . . .

●3.2

12,269 45.2 71.3 4.3 5.6 6.3

‘Timsumofths pmcents exceeds lm.obecause Somewomsnrepxted morelhanonesource dpsyrnwi

‘Icchdes births fm which rrmlhefs last occupation or mdker’s MedirAd SISAJS was unknown.

.

57
Table 31. Number of live births in January 1979 or later to white women 16-44 yeara of age and percent paid for from specified sources,

by selected characteristicsof the mother: United States, 1982

[Sfallstics are based on a sample of the household population of the conterminous United States. See append~es I and II for discussion of the sample design,

sampllng varlabiliry, and definition of terms]

Source of payment

Number of Sex Private

births In faml~, or medical Other All

Characteristic thousands Mends insurance Medicaid government other

Percentf

Allllve Mrths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211,836 43.8 67.5 7.0 7.8 5.8

Region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,183 35.7 77.0 13.2 *2.3 *2.3

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,449 39.0 79.5 *3.9 *6.4

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*3. 1

3,458 50.1 58.7 *4.4 9.6

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9.9

2,746 48.4 55.9 9e.3 11.6 *7.O

Education:

Lessthan 12yeare . . . . . . . . . . . . . . . . . . . . . . . . . 2,794 37.8 39.7 19.6 14.9 *7.6

12yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,693 45.0 66,9 *4.2 8.2

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . .

6.0

4,348 46.5 83,8 *1.9 *2.8 *4.5

Most recent occupation:

Professional ormanagerial . . . . . . . . . . . . . . . . . . . . 1,998 56.4 85.3 *0.6

Salesorclerlcal . . . . . . . . . . . . . . . . . . . . . . . . . . .

*6. 1

4,619 41.8 74.8 *3. 1 *5.8 *5.9

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,118 36.3 61.1 *7.7 14.1 *5. 1

Craft orfarmworkeroroperatlve . . . . . . . . . . . . . . . . 1,502 40.2 65.0 *8.6 *1 1.9 *3.7

NeverWorked . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,542 44.6 32.4 25.8 *10.7 *8.8

Poverty level Income:

149percentorless . . . . . . . . . . ) . . . . . . . . . . . . . . 3,774 36.7 39.7 18.3 18.4 9.5

150percentormore . . . . . . . . . . . . . . . . . . . . . . . . 8,062 47.2 60.5 *1.7 *2.8 4.2

300percentormore . . . . . . . . . . . . . . . . . . . . . . . 4,095 45.2 64.3 ‘1.8 *2.4 *3.8

Medicaid status:

RecelvesMedlcaid . . . . . . . . . . . . . . . . . . . . . . . . . 1,222 *16.1 +37.4 41.8 33,0

DoesnotreceiveMedicaid . . . . . . . . . . . . . . . . . . . .

*3.9

10,599 47.0 73.2 3.0 4.9 6.1

lT~sufrrofthe percetis exceads l@J.Obecause somewmnenreported rrsxethsnonescurce Ciwmefi.

‘Inchdea births for which rrottwr% last occupation or mother’s Medicaid slatus was unknown.

58
Table 32. Number of live births in January 1979 or later to black women 15-44 years of age and percent paid for from specified sources,

by selected characteristics of the mother: United States, 1982

[StatMics are based on a sample of me household population of the conterminous UnitedStates. See appendixes I and II for discussion of the sample design,

sampling variability, and defmltlon of terms]

Source of payment

Number of Self Private

births m fami/y, or medtcal Ofher All

Characterislk thousands friends insurance Medicaid government other

Percenll

Allhve births. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22,095 24.1 37.7 30.3 15.1 6.4

Region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389 19.9 40.1 34.2 *11.4

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*5.O

320 *13.5 38.9 39.7 *15.O

south. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*2.6

1,141 28.5 36.7 29.2 13.6

West, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*6.3

244 *24.2 36.6 *16.7 27.9 *13.7

Education:

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . .

12years. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13yearsormore . . . . . . . . . . . . . . . . . . . . . . . . . .

652

667

576

15.6

29.5

25.7

16.0

40.3

57.9

46.6

25.1

17.4

24.1

13.6

*7.3

*2.2

*7.9

*6.6

Most recent occupation:

Professional ormanagerial . . . . . . . . . . . . . . . . . . . . 151 *22.5 63,8 *4.3 *1.5

Salesorclencal . . . . . . . . . . . . . . . . . . . . . . . . . . .

*9.6

662 27.7 48.9 21.2 *10.3

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

●8.9

433 20.0 35.3 27.5 20.6

Crafforfarm workeroroperalive . . . . . . . . . . . . . . . .

*6.7

274 33.1 47.3 26.7 *10.O

Neverworlred . . . . . . . . . . . . . . . . . . . . . . . . . . . .

*1.O

532 19.2 *7.8 52.3 23.2 *2.6

Poverty level income:

149percentorless . . . . . . . . . . . . . . . . . . . . . . . . . 1,165 21.2 22.4 40.5 19.8

150percentormore . . . . . . . . . . . . . . . . . . . . . . . .

*6.2

910 28.0 57.6 16.9 9.0

300percentormore. . . . . . . . . . . . . . . . . . . . . .

*6.6

369 29.1 64.0 *12.2 *1.3 *10.I

Medicaid status:

ReceMes Medlcald . . . . . . . . . . . . . . . . . . . . . . . . . 786

DoesnotreceiveMedicaid . . . . . . . . . . . . . . . . . . . . 1,290

10.8 ●7.8

32.5 55.8

57.6

13.4

25.3 *1.9

8.9 9.2

lTksumofthe percenkexceeds lW.Obecausesome vmmenreport.% moreihanocesource @payment.

‘Ir’chdes births ior which molfwr’s last occupation or mdher’s Medicaid status was unkrmwn.

59
0)

O Table 33. Number of women 1s-44 years of age who have ever had a live biti and Peroent distribution by source of payment of the hospital bill for the most recent birth, according to

selected characteristics United States, 1973 and 1982

[Statlst!cs are bawd on a sample of the household population of the CCMteMIinfJUSUnited states. sea aPPandtxas I and II for dtxusskm of the sample deelgn, sampling variability, end deflnitbn of terms]

Source of payment

Uwn income

Own hrcome Insurance and Ottrer

Women

All

on~ only Insurance Medica+d government other

Charactertstlc 19s2~ 1973 Totat 199.2 1973 198.2 1973 1962 1973 1962 1973 1982 1973 1982 1973

Numtw In thousands Percent distribution

Allwomen . . . . . . . . . . . . . 212,060 Z25,~3 100.0 10.0 22.2 37.5 27.9 25.1 32.2 10.1 7,1 9.1 6.0 6.3 4.6

Age at time of birth:

Under 20years . . . . . . . . 1,473 2,788 IWO *9. 1 36.1 16.4 ●10.5 ●6. 1 *14.5

20-24 years . . . . . . . . . . 3,647 8,619

25.1 17.3 28.3 ●6.7

100.0 11.8

14.9 *1 2.9

26.2 36.8 26.6 18.1 27.5 13.8

25-44 yeare . . . . . . . . . .

7.9

6,760

9.0 7.6

13,915 100.0 9.1

10.5 ●4.3

16.8 42.5 32.0 33.3 38.5 4.6 4.6 4.9 4.9 5.5 ‘3.2

Race:

White . . . . . . . . . . . . . . 9,946 22,182 100.0 10.6 22.3 39.1 28.8 28.0

Black . . . . . . . . . . . . . .

35.2 6.6

1,752

4.6

3,359 IrM.o 6.8 21.6 28.3

7.9 5.9

21.9

7.8

8.6

3.2

13.2 30.0 23.9 15.0 5.4 11.3 14.1

Educat!on:

Lees.than 12yeam. . . . . . 2,669 8,319 ILX3.O 12.5 28.2 23.9 22.7 11.9 21.6 23.9

12yeare . . . . . . . . . . . . . 4,771

14.6 17.4 *4.3

12,161 100.0 11.1 19.6 36.1

10.4

31.7 24.6

6.7

34.8 8.1

13years ormore . . . . . . . 4,419 5,323 100.0 7.1 19.0

4.2 9.2 7.0 8.9 *2.7

45.7 27.2 34.2 42.7 *3.3 ●2. 1 ●3.6 ●6.3 6.2 *2.7

Poverty level income

149 percent or lees. . . . . . 3,869 5,818 100.0 12.3 25.2 19.4 17.2 12.5 18.9 24.6

150 percent or more. . . . . 8,110 19,9s5

21.7 19.8 ●6.7

100.0 8.8 2?.4 46.4 31.0 31.3

11.4 10.3

36.0 3.0

3(XI percent or more. . . . 4,0e7

2.9

10,212 100.0 6.4 20,5 49.0

3.8 5.8 6.7

31.7 33.2

3.0

3e.7 *2.2 *0.9 ●2.5 5.0 6.7 ●2.2

Ftagton:

Notlheast . . . . . . . . . . . . 2,201 5,406 100.0 *5,0 14.0 48.3 35.0 21.5 33.4 14.6

Midwest . . . . . . . . . . . . . 3,228

10.7 ●5.4

6,757

*3.O

100.0

*5.3

*6.6 16.3

*3.6

47,2 4f.8 26.4 29.7

Saute . . . . . . . . . . . . . .

7.0 *5.7

4,0e3 8,Li30

8.1 *3.2

100.0

*4.5

13.1

*3.3

26.8 28.4 19.3 24.6 33.2 10.5

West . . . . . . . . . . . . . . .

*5.2

2,562 5,138 100.0 13.3 31.2 28.9

10.1

16.2

6.4 12.2

27.4

7.0

32.3 9.4 *8.4 11.8 *8.7 9.2 *3,2

lWOmn ~~ mostrecentrm birthoccurredon or aftcxJarwary 1, 1979.

‘Inchdes white,black,end othsrrasesandwomenforwiwm age at Eat birthwasunkrmvn.
Appendixes

I.

II.

HI.

Technical notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Background. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Statistical design. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Measurement pro$ess . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Data reduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Reliability ofestimates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . #. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Estimation ofstandard errors... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Testing differences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Nonsampling error . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Interview nonresponse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Item nonresponse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Definitions ofterms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dependent variables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Characteristics ofpregnancies.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Demographic terms . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Items onthe 1982 National Surveyof Family Growth questionnaire related to health aspects ofpregnancy and

childbirth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

List of appendix tables

I. Estimates ofparameters A and Bforrelative standmd error cuwes, byage, m~itals tatus,andr ace . . . . . . . . . .

II. Approximate relative standmd errors mdstmdard errors forestimated number ofpre@ancies ofwomen of all

races 1982 National Survey of Family Growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

III. Approximate standard errors for estimated percents expressed in percentage pints, for pregnancies to women of

all races: 1982 National Survey of Family Growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

62

62

62

63

63

63

63

64

65

65

66

67

67

68

69

71

64

64

65

61
Appendix I

Technical notes

Background Statistical design

This report is one of a series based on the National

Survey of Family Growth (NSFG), conducted by the National Center for Health Statistics (NCHS). The NSFG was

designed to provide data on fertility, family planning, and

aspects of maternal and child health that are closely related

to childbearing.

The NSFG is a periodic survey based on personal

interviews with a nationwide sample of women. The NSFG

has been conducted three times–in 1973, 1976, and 1982.

The present report is based on Qcle III of the NSFG. A

detailed report on Cycle III is contained in “National

Survey of Family Growth, Cycle III: Sample Design,

Weighting, and Variance Estimation,” Series 2, No. 98,

Vital and Health Statistics (NCHS, 1985a). A detailed

description of the methods and procedures used in Cycle I

can be found in “National Survey of Family Growth, Cycle

I: Sample Design, Estimation Procedures, and Variance

Estimation,” Series 2, No. 76, of VW and Health Statistics

(NCHS, 1978b), and for Cycle II, in “National Survey of

Faniily Growth, Cycle II: Sample Design, Estimation Procedures, and Variance Estimation,” Series 2, No. 87, of

Vital and Health Statistics (NCHS, 1981b). This appendix

presents a summary of the more important technical aspects of the 1982 NSFG.

Fieldwork for Cycle III was carried out under a contract with NCHS by Westat, Inc., between August of 1982

and February of 1983. For the first time, the sample

represented all women 15-44 years of age, regardless of

marital status, in the civilian noninstitutionalized population of the conterminous United States. Women living in

group quarters, such as college dormitories, were included

in Cycle III. Interviews were conducted with 7,969 women;

3,201 were black, 4,577 were white, and 191 were of other

races.

Interviews were conducted by trained female interviewers in respondents’ homes and lasted an average of 1 hour.

The interview focused on pregnancy history, use of contraceptives in each pregnanq interval, physical ability to bear

children, expectations of bearing children in the future, use

of family planning and infertility services, marital history,

labor force participation, and a wide range of social, economic, and demographic characteristics.

NOTE A list of references follows the text.

The NSFG is based on a multistage area probability

sample. Black households and households with resident

teenage women were sampled at higher rates than were

other households so that reliable estimates of statistics

could be presented separately for black and teenage

women. In addition, the sample was designed to provide

tabulations for each of the four major geographic regions of

the United States.

The first stage of the sample design consisted of drawing a sample of primary sampling units (PSU’S). A PSU

consisted of a county, a small group of contiguous counties,

or a standard metropolitan statistical area, as defined by the

U.S. Bureau of the Census in 1970. The second and third

stages of sampling were used to select several segments

(clusters of 15 to about 60 dwelling units) within each PSU.

A systematic sample of dwelling units was then selected

from each segment. Each sample dwelling unit was visited

by an interviewer, who listed all household members. The

interviewer then consulted a computer-generated sampling

table to determine which woman, if any, should be interviewed.

The statistics in this report are estimates for the national population and were computed by multiplying each

sample case by the number of women she represented in

the population. The multipliers, or final weights, ranged

from less than 500 to more than 50,000 and average~dabout

7,000. They were derived by using three basic steps:

. Infldion by the reciprocal Of the probability of selection-The probability of selection is the product of the

probabilities of selection of the PSU, segment, household, and sample person within the household.

● Nonresponseadjustment-The weighted estimates were

ratio adjusted for nonresponse by a multiplication of

two factors. The first factor adjusted for nonresponse

to the screening questionnaire by imputing the (characteristics of women in responding households to women

in nonresponding households in the same PSU and

stratum. The second factor adjusted for nonresponse to

the interview by imputing the characteristics of responding women to nonresponding women in the same

age, race, and marital status category and PSU. Response to the screener was 95.1 percent and response

to the interview was 83.5 percent, yielding a combined

response rate of 79.4 percent.

62
● Postsiratijication by man”tid status, age, and race—The

estimates were ratio adjusted within each of 24 age,

race, and marital status categories to independent estimates of the population of women aged 1544. The

independent estimates were derived from the Current

Population Surveys of the U.S. Bureau of the Census.

The effect of the ratio estimating process was to make

the sample more closely representative of the noninstitutionalized population of women 1544 years of age in the eonterminous United States. The final poststratification reduced the sample variances of the estimates for most

statistics.

All figures were individually rounded; aggregate figures (numbers) were rounded to the nearest thousand.

Aggregate numbers and percents may not add to the total

because of this rounding.

Measurement process

Field operations for Cycle III were carried out by

Westat, Inc., under contract with NCHS; these operations

included pretesting the interview schedule, selecting the

sample, interviewing respondents, and performing specified

quality control cheeks. Interviewers, all of whom were

female, were trained for 1 week prior to field work. The

first five interview schedules done by each interviewer were

reviewed; after a high level of quality was achieved by an

interviewer, this review was reduced to a sample of questionnaires, unless an unacceptable level of error was found.

A 10-percent sample of respondents were recontacted by

telephone to verify that the interview had taken place and

that certain key items had been accurately recorded.

A portion of the interview schedule applicable to this

report is reproduced in appendix 111. Two forms of the

questionnaire were used, one for women 15-24 years of age

and one for women 2544 years of age. The questionnaire

for women aged 15–24 included a few additional items that

referred to early experiences that women over 25 could not

be expected to remember accurately.

Data reduction

The responses of each woman to the interview questions were translated into predetermined numerical codes,

and these code numbers were recorded on computer tapes.

The first few questionnaires eodcd by each coder were

checked completely, after an acceptable level of quality was

reached, verification of coding was performed on a systematic sample of each coder’s questionnaires. The data were

edited by computer to identify inconsistencies between

responses as well as code numbers not allowed in the

coding scheme; these errors were corrected.

Missing data on all variables used in this report were

imputed to provide consistent national estimates. (To speed

release of the public use computer tape, however, not all

variables on the computer tape were imputed.) If the level

of missing data is relatively high (more than 5 percent), this

fact is noted in appendix II. Only two items are so affected:

poverty level income and age (or date) at first intercourse.

Reliability of estimates

Beeause the statistics presented in this report are based

on a sample, they may differ somewhat from the figures

that would have been obtained had a complete census been

taken using the same questionnaires, instructions, interviewing personnel, and field procedures. This chance difference between sample results and a complete count is

referred to as sampling error.

Sampling error is measured by a statistic called the

standard error of estimate. The chances are about 68 in 100

that an estimate from the sample will differ from a complete count by less than the standard error. The chances are

about 95 in 100 that the difference between the sample

estimate and a complete count will be less than twice the

standard error. The relative standard error of an estimate is

obtained by dividing the standard error of the estimate by

the estimate itself and is expressed as a percent of the

estimate. Numbers and percents that have a relative standard error of more than 30 percent are considered unreliable. These figures are marked with an asterisk to caution

the user, but they may be combined to make other types of

comparisons of greater reliability.

Estimation of standard errors

Because of the complex multistage design of the NSFG

sample, conventional formulas for calculating sampling errors are inapplicable. Standard errors were, therefore, estimated empirically by using a technique known as balanced

half-sample replication. This technique produces highly

reliable, unbiased estimates of sampling errors. Its application to the NSFG has been described elsewhere (NCHS,

1978b, 1981b, 1985a).

Because it would be prohibitively expensive to estimate

and cumbersome to publish a standard error for each

percent or other statistic by this technique, standard errors

were computed for selected statistics and population subgroups that were chosen to represent a wide variety of

demographic characteristics and a wide variation in the size

of the estimates themselves. Curves were then fitted to the

relative standard error estimates (ratio of the standard

error to the estimate itself) for numbers of women according to the model

RSE (N’)=(A +B/N’)%

where N’ is the number of women and A and B are the

parameters whose estimates determine the shape of the

curve. Separate curves were fitted for women of all races

combined and white women, and for black women,

because a different sampling rate was used for black

women.

NOTE A list of references fdo~s the text.

63
Table L Estimates of parameter A and B for relative standard

error curves, by age, marital status, and race

Age, mariai status, WIY race Parameter A Parameter B

Pregnancies of women 1544 years

of age bv marital status and race

All pre~nancles:l

Allraces andwhte . . . . . . . . . . .

Black . . . . . . . . . . . . . . . .

Pregnancies of ever married Women:i

Allraces and white . . . . . . . . . . .

Black . . . . . . . . . . . . . . . . . . .

Pregnancies of never married women

andofleenagers 15-19 years ofagei

All races

Nevermarried . . . . . . . . . . . . .

Teenagers . . . . . . . . . . . . . . . .

White:

Nevermarrled . . . . . . . . . . . . . .

Teenagers . . . . . . . . . . . . . . . .

Black:

Never married and teenagers . . .

-0.000001353283

0.0001091980

0.003120391

-0.0001123101

0.01388728

0.005951224

0.07096595

0.01024644

25567.442370

7143,225243

43592.725400

15676.710304

6660.961987

7802.208396

13265.323113

9664.917046

0.004546507 3430.760245

1 Parameters for pregnancies we also used when computing standard errors for numbers and

percents of births ard living children.

Separate curves were fitted for teenagers, for the same

reason. The estimates of A and B are shown in table I.

To calculate the estimated standard error or relative

standard error of an aggregate or percent, the appropriate

estimates of A and B are used in the equations:

RSE. ,= (A +B/N’)”

SEN,= (A +B/iV’)w (N’)

RSEP, = (B/P’”(100– P’)/X’)”

SEP,= (BP@O- P’)/X’)x

Table IL Approximate relative standard errors and standard

errors for estimated number of pregnancies of women of all

races: 1982 National Survey of Family Growth

Relative standard

Size of est/mate standard error error

100,000 . . . . . . . . . . . . . . . . . . .

500,000 . . . . . . . . . . . . . . . . . . .

1,000,000 . . . . . . . . . . . . . . . . . .

5,000,000 . . . . . . . . . . . . . . . . . .

10,000,000 . . . . . . . . . . . . . . . . .

15,000,000 . . . . . . . . . . . .. . . . .

30,000,000 . . . . . . . . . . . . . . . . .

50,000,000 . . . . . . . . . . . . . . . . .

50.6

22.6

16.0

7.1

5.1

4.1

2.9

2.3

50,600

113,000

180,000

360,0CKI

510,000

619,000

875,000

1,129,000

where

N’= number of pregnancies,

P’= percent,

X’= number of pregnancies in the denominator

of the percent,

SE= standard error, and

RSE= relative standard error.

Tables II and 111show some illustrative standard errors

of aggregates and percents of pregnancies of women of all

races from Cycle 111of the NSFG.

Testing differences

The standard error of a difference between two comparative statistics, such as the proportion of babies born to

white mothers that were low birth weight compared with

that of babies born to black mothers, is approximately the

square root of the sum of the squares of the standard errors

of the statistics considered separately, or calculated by this

formula: If

d=P’l –P’2

then

Sd= (P’ J2(RSEPJ2+ (P’2)2(RSEPJ2

where P’l is the estimated percent for one group and P’2

is the estimated percent for the other group, and RSEP,I

and RSEP,2 are the relative standard errors of P’, and P’2.

This formula will represent the actual standard error

quite accurately for the difference befsveen separate and

uncorrelated characteristics, although it is only a rough

approximation in most other cases.

A difference among comparable proportions or other

statistics from two or more subgroups is considered to be

statistically significant when a difference of that size or

larger would be expected by chance in fewer than 5 percent

of repeated samples of the same size and type, if no true

difference existed in the populations sampled. Such a difference would be statistically significant at the 0.05 level. By

this criterion, if the observed difference or a larger one

could be expected by chance in more than 5 percent of

Table Ill. Approximate standard errors for estimated percents expressed in percentage points, for pregnancies to women of all races:

1982 National Survey of Family Growth

Estimated percent

2 or 5 or 10 or .20 or 30 or 40 or

Base of percent 98 95 90 80 70 80 50

100,000 . . . . . . . . . . . . . . . . . . . . . . . 7.1 11.0 15.2 20.2 23.2 24.8 25.3

500,000 . . . . . . . . . . . . . . . . . . . . . . . 3.2 4.9 6.8 9.0 10.4 11.1 11.3

1,000,000 . . . . . . . . . . . . . . . . . . . . . 2.2 3.5 4.6 6.4 7.3 7.8 6.0

5,000,000 . . . . . . . . . . . . . . . . . . . . . 1.0 1.6 2.1 2.9 3,3 3.5 3.6

10,000,000 . . . . . . . . . . . . . . . . . . . . . . 0.7 1.1 1.5 2.0 2.3 2.5 2.5

20,000,000 . . . . . . . . . . . . . . . . . . . . . . 0.5 0.8 1.1 1.4 1.6 1.8 1.8

30,000,000 . . . . . . . . . . . . . . . . . . . . . 0.4 0.6 0.9 1.2 1.3 1.4 1.5

50,000,000 . . . . . . . . . . . . . . . . . . . . . . 0.3 0.5 0.7 0.9 1.0 1.1 1.1

&le of use of table Ill: If 30 percent of pregnancies In a specific catagoy received their firet prenatal care In the third or fourth month of pregnancy and the base of that percent was 10,OOO,OCO,

thtin the 30-percent column ard the 10,000,000 row indicate that one standard error is 2.3 percentage points end two standard errors are twice that, cr 4.8 percentage points Therefore, the chance

is 95 [n 100 th~ the tme peme”t i“ the pop”latio” Wm ktween 25.4 and S4.e (30.0 percent plus or minus 4.S percent). This is celled a 95-p8rcent confidence interval. h addition, the retstk

standard error of that 30-percent estimate IS 2.3 perceni dhdded by 30 @rcent, or 7.7 percent.

64
repeated samples, then one cannot be sufficiently confident

to conclude that a real difference exists betsveen the populations. When an observed difference is large enough to be

statistically significant, the true difference in the population

is estimated to lie between the observed difference plus or

minus two standard errors of that difference in 95 of 100

samples.

Although the 5-percent criterion is conventionally applied, it is in a sense arbitrary; depending on the purpose of

the particular comparison, a different level of significance

may be more useful. For greater confidence, one would test

for significance at the 0.01 (l-percent) level, but if one can

accept a 10-percent chance of concluding a difference exists

when there actually is none in the population, a test of

significance at the 10-percent level would be appropriate.

The term “similar” means that any observed difference

between hvo estimates being compared is not statistically

significant, but terms such as “greater,” “less,” “larger,”

and “smaller” indicate that the observed differences are

statistically significant at the 0.05 level using a txvo-tailed

t-test with 39 degrees of freedom. Statements about differences that are qualified in some way (as by the phrases “the

data suggest” and “some evidence”) indicate that the difference is significant at the 0.10 level but not at the 0.05

level.

When a substantial observed difference is found not to

be statistically significant, one should not conclude that no

difference exists but simply that such a difference cannot be

established with 95-percent confidence from this sample.

This is especially important in Cycle III, because the number of ever married women in the sample is 4,651, compared with 7,970 in Cycle II—a reduction of 42 percent.

This means that the standard errors in Cycle III are larger

than those in Cycle H, so it is harder to establish significant

differences in Cycle III than in Cycle II. Lack of comment

in the text about any two statistics does not mean that the

difference was tested and found not to be significant.

The number of replicates in the balanced half-sample

replication design minus one (39 in Cycle 111) can reasonably be used as an estimate of the number of degrees of

freedom, although the exact value of the degrees of freedom is unknown. Therefore, in this report, differences

betsveen sample statistics are compared using a two-tailed

t-test with 39 degrees of freedom.

For example, in the years up to and including 1982,

12,2 percent of the 10,907,000 births to black women and

5.6 percent of the 56,602,000 births to white women were

low birth weight. To test this racial difference at the 0.05

level of significance, compute

12.2–5.6

t =

V(12.2)2RSE2[1U) +(5.6)2RSE’(5,,

Relative standard errors are computed using the

appropriate values for B from table 1:

‘SE(l’2AA!ZZE

=0.0686

and

RSEc~dl=

W

(25567.442370)(100-5.6)

(5.6)(56,602,000)

=0.0873

thus

12.2–5.6

t=

=6.81

The two-tailed 0.95 critical value (1-a) for a t statistic with

39 degrees of freedom is 2.02. Therefore, the difference is

significant at the 5-percent level.

Nonsampling error

Although sampling error affects the reliability of survey

estimates, nonsampling error may introduce bias. The results of any survey are subject to at least four types of

nonsampling error, including interview nonresponse; nonresponse to individual questions or items within the interview; inconsistency of responses to questions; and errors of

recording, coding, and keying by survey personnel.

To minimize nonsampling error, stringent quality control procedures were introduced at every stage of the

survey, including a check on completeness of the household

listing extensive training and practice of interviewers; field

editing of questionnaires; short verification interviews with

a subsample of respondents; verification of coding and

editing, independent recode of a sample of questionnaires

by NCHS; keypunch verification; and an extensive computer “cleaning” to check for inconsistent responses, missing data, and invalid codes. A detailed description of some

of these procedures follows; others were discussed above.

Interview nonresponse

Interview nonresponse means that no part of an interview was obtained. It resulted from failure at any of three

principal steps: (1) failure to list all households in sample

segments, (2) failure to screen all listed households, and (3)

failure to interview an eligible woman in each screened

household. A discussion of these steps follows.

The completeness of a list cannot be tested directly,

because this requires an independent, accurate enumeration of the households that should have been listed. In the

NSFG, the completeness and accuracy of lists were tested

by the missed dwelling unit (DU) procedure at the time of

65
screening: Where the first structure in a segment was

included in the sample, the whole segment was checked to

see whether any structures had been missed in the listing

process; where the first structure was a multiple-DU structure and the first-listed unit in the building was included in

the sample, the entire structure was checked for missed

DU’S.

Of the original sample of 34,641 DU’S screened, 3,614

were found to be vacant or not to be DU’S. Of the 31,027

occupied DU’S, 4.9 percent were not screened successfully.

Screening was completed in 29,511 households; 9,964 of

these contained eligible respondents who were selected for

interview. Interviews were not completed in 16.5 percent of

these cases, because of refusals by respondents (8.3 percent) and by the parents of respondents under 18 years of

age (1.5 percent), no contact after repeated calls (2.8

percent), or other problems (4.0 percent).

The adjustment for interview nonresponse described

above imputes to nonresponding women the characteristics

of responding women of the same age group, race, marital

status, and geographic area.

Item nonresponse

answer to a question, when the question was erroneouslynot asked or the answer was not recorded by the interviewer, or when the answer could not be coded. The rate of

nonresponse to individual questions was very low in Cycle

111, as it was in Cycle II. Some examples of item nonresponse from among a total of 7,969 respondents are as

follows: religion of respondent, 11 cases and respondent’s

occupation, 37 cases. The item with the most nonresponse

was family income (from which poverty-level income was

derived), with 1,767 cases. All missing data were imputed in

this report. For those few items for which the proportion of

cases imputed was high, this fact is noted in the appropriate

section of the definitions.

As with all survey data, responses to the NSFG were

subject to deliberate misreporting by the respondent. Such

misreporting cannot be detected directly, but it can be

detected indirectly by the extensive computer “cleaning”

and editing procedures used in the NSFG.

Item nonresponse may have occurred when a respondent refused to answer a question or did not know the

66
Appendix II

Definitions of terms

Dependent variables

Months pregnant when prenatal care begam—For pregnancies ending in January 1979 or later, women in the 1982

survey were asked, “During this pregnancy, did you ever

visit a doctor or clinic for prenatal care?” Women who

answered “yes” were then asked, “How many months

pregnant were you when you first visited a doctor or clinic

for prenatal care?” Women who answered that they were

less than a month, 1 month, or 2 months pregnant were

classified as beginning prenatal care in the first trimester,

or at “less than 3 months.” Those who said they were 3 or 4

months pregnant were classified as “3 or 4 months pregnant” in the tables. Women who said they had been pregnant at least 5 months when they began prenatal care and

those who received no prenatal care at all are combined, in

the category”5 months or more or no care,” in tables 1–6.

Research on the proportion of births receiving first

trimester prenatal care has used 3 national data sources

birth certificates (Forrest and Sin@, 1987; Ingram, Makuc,

and Kleinman, 1986; NCHS, 1978a), the 1980 National

Natality Survey (NNS) (Prager et al., 1984), and the National Survey of Family Growth (NSFG) (Forrest and

Singh, 1987). Because the questions are worded and administered differently in these 3 sources, the proportions reporting first-trimester care differ (Forrest and .Singh, 1987).

However, in one recent study the largest differences are

seen in the first 1 or 2 months of pregnancy, which su~ests

that (1) the timing of the beginning of pregnancy differs

among sources of data; (2) some women may be counting

pregnancy tests as first prenatal visits; and (3) mothers

report, but physicians may sometimes be unaware of, early

visits to other providers of prenatal care (Forrest and Singh,

1987). One additional difference is that some data sources

use “current month” of pregnancy, while others use “completed month.” For example, a woman who was 7 weeks

pregnant at her first visit may report that she is currently in

her second month of pregnancy, or that she had completed

one month of pregnancy at her first visit. Such a woman

would be classified in this report as getting care after 1

completed month of pregnancy. In Cycle IV of the NSFG,

additional questions on the timing of the first visit will be

asked to address these issues, which should help to determine which source is providing the most accurate estimate

of the extent of first-trimester care.

NOTE A list of references follows the text.

First source of prenatal care-Women who reported

that they visited a doctor or clinic for prenatal care (for

pregnancies ending in January 1979 or later) were asked,

“To which of the places on the card did you go for your first

visit?” They were then shown a card listing the following

types of medical facilities

A.

B.

c.

D.

E.

F.

G.

H.

J.

K

Community health center clinic. . . . . . .

Public health department clinic. . . . . . .

Family planning clinic. . . . . . . . . . . . . . .

Abortion clinic . . . . . . . . . . . . . . . . . . . . .

Student health service clinic. . . . . . . . . .

Military health service clinic . . . . . . . . .

Hospital clinic . . . . . . . . . . . . . . . . . . . . .

Private doctor . . . . . . . . . . . . . . . . . . . . .

Private group practice, co-op, or private

clinic . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other (specify) . . . . . . . . . . . . . . . . . . . . .

01

02

03

04

05

06

07

08

09

10

In this report, women who answered H or J were

classified as receiving care from a “private doctor or clinic”;

women who answered G, as using a “hospital clinic”; and

those who answered A–F or K, as using “other clinic.” In

previous NSFG reports on use of family planning services

(NCHS, 1986b; Mosher and Horn, 1986), the categories

“other clinic” and “hospital clinic” were combined into an

overall “clinic” category. With respect to prenatal care,

sample sizes are not large enough to allow separate analyses of use of the seven different types of clinics.

Smoking during pregnancy– Women in the NSFG who

had ever been pregnant were asked, “On the average

during your (last) pregnancy, how many cigarettes per day

did you smoke, if any?”

The responses were coded in the following categories

About one a day or less . . . . . . . . . . . . . . . . . 01

Just afew(2+) . . . . . . . . . . . . . . . . . . . . . . . . . 02

About halfapack (5-14) . . . . . . . . . . . . . . . . . 03

About apack (15-24) . . . . . . . . . . . . . . . . . . . 04

About lYzpacks (25-34) . . . . . . . . . . . . . . . . . 05

About 2packs (35-44) . . . . . . . . . . . . . . . . . . . 06

More than 2packs (45+) . . . . . . . . . . . . . . . . 07

Didn’t smoke during (last) pregnancy . . . . . . 96

In this report, women in categories 01,02, and 03 were

classified as having smoked fewer than 15 cigarettes per

day. Those in categories 04,05,06, and 07 were classified as

having smoked 15 or more per day. Women in category 96

were labeled as “did not smoke at all.”

67
Women who were currently pregnant were excluded

from the statistics on smoking and drinking during the most

recent pregnancy. In contrast, in a previous report (NCHS,

1987a), currently pregnant women were included in the

tables showing smoking and drinking during pregnancy, but

excluded from the statistics by age at pregnancy outcome

(NCHS, 1987a). In this report, they were excluded entirely

so that the totals would be more consistent throughout the

tables and so that the data would refer only to completed

pregnancies.

Alcohol consumption dunngpregnancy-Women in the

NSFG who had ever been pregnant were also asked,

“During your (last) pregnancy, how often (did) you usually

drink alcoholic beverages, that is, beer, wine, or liquor?

Was it

Every day . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Afewdays a week . . . . . . . . . . . . . . . . . . . . . . 2

Once a week . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Once a month . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Less than once a month . . . . . . . . . . . . . . . . . . 5

Or never?” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

In this report, women in category 6 “did not drink at

all”; women in categories 4 and 5 drank “less than once a

week”; and those in categories 1, 2, and 3 drank “once a

week or more.”

Low birth weight—A “low-birth-weight” baby is one

who weighs 5 pounds 8 ounces or less at birth. Statistics on

birth weight in this report are shown only for single live

births, because multiple births often have lower birth

weights. For all births in the NSFG, women were asked,

“How much did (child’s name) weigh at birth?” Women

who could not remember were then asked, “Did (child’s

name) weigh more than 5]%pounds, or less?”

As noted in the text, births in this report occurred

during a period of several years up to and including 1982

and are based on a sample, but births in the vital statistics

system occurred during a specified calendar year and are

based on birth certificates. (In most states, statistics on

birth weight were based on all birth certificates; in selected

states, data on birth weight were based on a 50 percent

sample of birth certificates.)

Source of pqvnent for delivey–Women who had had

one or more live births were asked the following question

for each live birth in January 1979 or later: “This card lists

some of the ways in which medical bills can be paid. When

(child) was born, in which of these ways was the bill paid?”

The woman was then handed a card containing the

following categories

A. Your (or your husband’s) own income. 01

B. Partner, boyfriend, or his family . . . . . . 02

C. Insurance (which you carry or is carried

for you) . . . . . . . . . . . . . . . . . . . . . . . . . . . 03

D. No charge—paid by Medicaid . . . . . . . . 04

NOTE A lk.t of references follows the text.

68

E. Government assistance other than

Medicaid (State or local) . . . . . . . . . . . . 05

F. Military . . . . . . . . . . . . . . . . . . . . . . . . . . . 06

G. Parents or other relatives. . . . . . . . . . . . 07

H. Some other Way (ripeci&). . . . . . . . . . . . 08

Up to three answers were coded for each birth, so the

percents in these tables add to more than 100. Responses to

categories A, B, and G were combined to form the category

“self, family, or friends”; category C is labeled “private

medical insurance” in the tables; catego~ D is labeled

“Medicaid”; and category E is labeled “other government.”

Responses in categories F and H were combined to form

the “all other” category in the tables.

Characteristics of pregnancies

Prenatal care—In this report, prenatal care was classified as “early and continuous” if it began in the first

trimester and if the woman made at least one prenatal visit

per month. Prenatal care was classified as “late or discontinuous” if care did not begin in the first trimester or if the

visits were made less often than once a month. It should be

stressed that this variable reflects only the timing and

frequency of prenatal visits; it does not measure the length

of the visits, what the doctor and patient talked about, the

qualifications and experience of the doctor or other provider, or the woman’s level of satisfaction with the care.

Age at birth or pregnancy outcome —13ach woman was

asked the month, day, and year each pregnancy ended. Her

date of birth was subtracted from the date the pregnancy

ended to compute her age in completed years when the

child was born or the pregnancy otherwise ended.

Birth order or pregnancy order–Births are classified by

birth order. Where the birth order is “first;’ the birth was

the woman’s first birth; where it is “second;’ the birth was

the woman’s second birth. Similarly, where the pregnancy

order is “first,” it was the woman’s first pregnancy where it

is “second,” it was the woman’s second pregnancy, and so

on.

Mm”taI status at birth and atpregnancy outcome—These

are classified as “never married” or “ever married.” If the

date of the baby’s birth was before the date of the woman’s

first formal marriage, the woman was classified as “never

married at birth”; if the date of the baby’s birth was after

the date of her first formal marriage, she was classified as

“ever married at birth.” The same procedure was used for

other pregnancy outcomes.

Wontedness status at conception –Pregnancies were

classifed as “wanted thenj’ “mistimed,” “unwanted;’ or

“undetermined’ according to the mother’s report of her

attitude toward the pregnancy at the time she became

pregnant. There were very few “undetermined” pregnancies, so they are included in the totals but not shown

separately in this report. The wontedness of each pregnancy

was determined from a series of questions that asked

whether the woman had wanted to become pregnant at the

time of conception. It is important to emphasize that an
“unwanted pregnancy” does not necessarily mean “unwanted child”; many children who were not wanted at

conception nonetheless become cherished members of

their families.

Wanted then–A pregnancy was classified as “wanted

then” if the woman had stopped usin~ or was not using,

contraception at about the time she became pregnant,

because she wanted to become pregnant, or if she said that

she became pregnant later than she had wanted to or at the

right time.

Mistimed-Women whose pregnancies were classified

as wanted were asked, “Did you become pregnant sooner

than you wanted, later than you wanted, or at about the

right time?” If the mother said that the pregnancy occurred

sooner than she wanted, the pregnancy was classified as

“mistimed.”

Unwanted–A pregnancy was classified as unwanted if

the woman, at the time the pregnancy occurred, did not

want to have a(nother) baby, ever.

For further details on how pregnancies are classified by

wontedness status, see ‘Wanted and Unwanted Childbearing: United States, 1973–82; Advance Data No. 108, May

9, 1985 (NCHS, 1985c).

Demographic terms

Characteristics of women

Race—Race refers to the race of the woman interviewed and is reported as black, white, or other. In Cycle

III, race was classified according to the woman’s choice of

which race best described her. In Cycles I and II, race was

classified by the observation of the interviewer. Comparisons of the results of Cycle III using both definitions

indicate that results of both methods of classification are

very similar.

Hispanic origin—A respondent was classified as being

of Hispanic origin if she reported that her only or principal

national origin was Puerto Rican, Cuban, Mexican American, Central or South American, or other Spanish. In tables

presenting data for women by race, women of Hispanic

origin are included in the statistics for white and black

women who were classified as such by race.

Region of residence—Data are classified by region of

residence into the four major census regions: Northeast,

Midwest, South, and West. The sample size greatly restricts

the possibility of meaningful analyses by social characteristics among smaller geographic divisions. The areas constituting these four major geographic regions are as folfowx

Geographic region

and division States included

Northeast

New England . . . . . . . . . . Maine, New Hampshire,

Vermont, Massachusetts,

Rhode Island, Connecticut

NOTE A list of references follows the text.

Middle Atlantic . . . . . . . .

Midwest

East North Central . . . . .

West North Central . . . . .

South

South Atlantic.. . . . . . . . .

East South Central. . . . . .

West South Central . . . . .

West

Mountain . . . . . . . . . . . . . .

Pacific . . . . . . . . . . . . . . . .

New York, New Jersey,

Pennsylvania

Ohio, Indiana, Illinois,

Michigan, Wisconsin

Minnesota, Iowa, Missouri,

North Dakota, South

Dakota, Nebraska, Kansas

Delaware, Maryland,

District of Columbia,

Virginia, West Virginia,

North Carolina, South

Carolina, Gecmgia, Florida

Kentucky, Tennessee,

Alabama, Mississippi

Arkansas, Louisiana,

Oklahoma, Texas

Montan~ Idaho, Wyoming,

Colorado, New Mexico,

Arizona, Utah, Nevada

Washington, Oregon,

California

Pkzce of Resz21ence-Data are classitied by place of

residence into two categories, metropolitan and nonmetropolitan, using 1980 census population counts. A respondent’s place of residence is metropolitan if the census gave

the area as part of a standard metropolitan statistical area

(SMSA), as established by the U.S. Office of Management

and Budget, and nonmetropolitan if it is not in an SMSA.

Nonmetropcditan areas may include both rural and urban

places.

Education–Education was classified according to the

highest grade or year of regular school or college completed. Determination of the highest year completed was

based on responses to a series of questions concerning the

last grade or year of school attended and whether that

grade or year was completed.

Poveq level income-The poverty index ratio was calculated by dividing the total family income by the weighted

average threshold income of families whose head of household was under 65 years of age, based on the poverty levels

shown in table A-3 in the U.S. Bureau of the Census

Cuwent Population Repotis, Series P-60, No. 140, “Money

Income and Poverty Status of Families and Persons in the

U.S., 1982.” This definition takes into account the sex of the

family head and the number of persons in the family. Total

family income includes income from all sources for all

members of the respondent’s family. For a substantial

number of respondents (22 percent), total family income

was not ascertained. These missing values were imputed

using a known value of another similar, randomly selected

respondent. Because of these high levels of missing data,

69
small differences by poverty level income should be

interpreted with caution.

Most recent occup&”on—Women who were working at

the date of interview were asked:

● What is your occupation? That is, what is your job

called?

. What are your most important activities or duties?

● What kind of business or industry do you work for?

That is, what do they make or do?

Women who had worked in the past but were not

currently working were asked:

. What was your last occupation? That is, what was your

job called?

. What were your most recent activities or duties?

● What kind of business or industry did you work for?

That is, what did they make or do?

The answers to these questions were recorded verbatim and used by specially trained occupation coders in

finding the most appropriate standard job title in the 1980

U.S. Census classification. Where more than one occupation

was given, the primary or first-mentioned occupation was

coded. Occupations were coded using the 3-digit codes

used by the U.S. Bureau of the Census; for this report,

however, they have been grouped into major categories,

according to Bureau practice.

Medicaid status-Women were asked, “Are you yourself now covered by Medicaid (STATE NAME FOR

MEDICAID), or do you have a card that looks like this?”

The respondent was then shown a Medicaid card for her

State. In this report, women who said that they were

covered by Medicaid or had a Medicaid card at the date of

interview were classified as “receives Medicaid.” All other

women were classified as “does not receive Medicaid.”

70
Appendix !11

Items on the 1982

National Survey of

Family Growth

questionnaire related

to health aspects of

pregnancy and

childbirth

ALL PREGNANCIES

B-19.

r

HAWI

CARD

7

Thinking about your (1 st/2nd/etc. ) pregnant y,

in which of the ways shown cm this card did

the pregnsncy end? (CIRCLE CODE HERE —AfKI

W B&P RECORD. )

A. Still birth . . . . . . . . . . . .

B. Miscarriage . . . . . . . . . . . .

C. Abortion . . . . . . . . . . . . .

D. Birth by Cesarean section. . . . .

E. BirLh by normal (vaginal) delivery

IF MIH. TIPLE OUTCONE, CIRCLE FIRST OUTCOtf

AGOVE AtWI ENTER LET IER FOR OTHER OUTCOF!L(S)

ON LINE . . . . . . . . . . . . . . . . . . . .

B-20. Was the baby a boy or a girl?

Boy . . . . . . . . . . . . . . . . .

Girl . . . . . . . . . . . . . . . . .

Twins, both bode . . . . . . . . . . .

Twins, tdhgirls . . . . . . . . . .

Twins, one boy, one girl. . . . . . .

0-21. hhat did you name (her/him)? (ENTER MRE

—AhO ON B&P RECORD. )

&22. O) what dmke (was [CHILD] born/did that pregnancy end)? (ENTER lfRE fig ON B&P RECORD. )

FIRST

PREGNANCY

. . . ...* 1 (B-22)

. . . . . . . 2 (B-22)

. . . . . . . 3 (B-22)

. . . . . . . 4 (G-20)

. . . . . . . 5 (0-20)

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

. . . . . . . 4

. . . . . . . 5

NAHE

I I

—T)43 YR

SECOND

PREGNANCY

. . . . . . . 7 (B-22)

. . . . . . . 2 (o-22)

. . . . . . . 3 ( B-22)

. . . . . . . 4 (520)

. . . . . . . 5 (13-20)

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

. . . . . . . 4

. . . . . . . 5

NANE

N4NE

I I

—Tm YR

BOX 7. IF PREGNANCY ENDED BEFORE JANUARY 1979, SKIP TO BOX 8.

lF PREGNANCY ENOED JANUARY 1979 OR LATER, CONTINUE.

&23. During this pregnancy, did you ever visit

a doctor or clinic for prenatal care?

Yes . . . . . . . . . . . . . . 1 (B-24) . . . . . . . 1 (B-24)

. . . . . . . . . . . ...0. 2 (60x a) . . . . . ..2(BOXB)

B-24 . HOW many muntha pregnant were you tin you

first vibfted a doctor or clinic for prenatal

care? KINTHS M3NTHS

71
B-25. TO which of the places on the card did you

go for your first visit?

El HAND

CARD

3

A.

B.

c.

D.

E.

F.

G.

H.

J.

K.

Community health center clinic . .

Public health department clinic. .

Family planning clinic . . . . . .

Abortion clinic. . . . . . . . . .

Student health service clinic. . .

Military health service clinic . .

Hospital clinic. . . . . . . . . .

Private doctor . . . . . . . . . .

Private group practice, co-op,

or private clinic. . . . . . . . .

Other (spECIFY). . . . . . . . . .

B-26. Between your first visit and the end of the

pregnancy, how often did you visit a doctor

or clinic for prenatal care? Was it once

a month or more, or less often than that?

Once a month or more. . . . . .

Less often than once a month. .

Pregnancy ended within month of

first visit . . . . . . . . .

. . .

. . .

. . .

B-27. During your pregnancy, did a doctor ever

tell you to remain in bed for one or more

weeks because of some problem related to

your pregnancy?

Ye9. . . . . . .

No. . . . . . . .

FIRST

PREGNANCY

. . . . . . . 01

. . . . . . . 02

. . . . . . . 03

. . . . . . . 04

. . . . . . . 05

. . . . . . . 06

. . . . . . . 07

. . . . . . . 08

. . . . . . . 09

. . . . . . . 10

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

. . . . . . . 1

. . . . . . . 2

SECOND

PREGNANCY

● ✎ ✎ ✎ ✎ ✎ ✎ 01

. . . . . . . 02

. . . . . . . 03

. . . . . . . 04

. . . . . . . 05

. . . . . . . 06

. . . . . . . 07

. . . . . . . 08

. . . . . . . 09

. . . . . . . 10

. ..*... 1

. . . . . . . 2

. . . . . . . 3

. . . . . . . ?

. . . . . . . 2

BOX 8. IF PREGNANCY ENDED IN:

LIVE BIRTH, GO TO B-2B, PAGE 12.

ABORTION, GO TO B-39, PAGE 18.

MISCARRIAGE OR STILLBIRTH, GO TO B-47, PAGE 22.

72
LIY

CHILD’s NANE

B-28. tbw much did (CHILD) weigh at birth?

B-29. Did (s/he) weigh more than 5 7/2 pounds or

less?

More. . . . . . .

5 1/2 or less . .

BIRTHS

Pregnancy No. ]——I I Pregnancy No. I——I 1

FIRST BIRTH I

SECOW BIRTH

I (Box 9) I (BOX 9)

LB.5. OZ. -iiEn — Oz.

OK. . . . . . 9898 (B-29) IOK. ..... 9898 (B-29) I

. . . . . . . 1

. . . . . . . 2

. . . . . . . 1

. . . . . . . 2

●

BOX 9. IF CHILD BORN BEFORE JANUARY 1979, SKIP TO BOX 10.

IF CHILD BORN JANUARY 1979 OR LATER, CONTINUE.

B-30. This card Iists some of the waya in which

medical bills can be paid. Wan (CHILD)

was born, in which of these ways was the

bill paid? (CIRCLE ALL THAT APPLY AND

PROBE : Mat other ways?)

A

HAND

A.

CARD

B

B.

c.

D.

E.

F.

G.

H.

Your (or your husband’a) on

income. . . . . . . . . . . . . .

Partner/boyfriend or his family. .

Insurance (which you carry or

is carried for you). . . . . . . .

No charge -- pRid by Medicaid. . .

Government assistance other

than Medicaid (state or local) . .

Military . . . . . . . . . . . . .

Parents or other relatives . . . .

Some other way (SPECIFY) . . . . .

B-31 . Did (CHILD) come home from the hospitaI at the

same time you did, or did s/he have to stay

longsr for medical reasons?

Came home with mother . . . . . . . .

Stayed longer . . . . . . . . . . . .

Child given up for adoption . . . . .

Not born in hospital. . . . . . . . .

Child died at hospital. . . . . . . .

B-32. In the first six months of (her/his) life, did

you ever take (CHILD) to the doctor or clinic

for a well-baby or routine checkup?

Yes . . . . . . .

No. . . . . . . .

. . . . . . . 07

. . . . . . . 02

..,.*** 03

. . . . . . . 04

. . . . . . . 05

. . . . . . . 06

. . . . . . . 07

. ..*.. . OB

I

. . . . . . . 1 (8-32)

● . ...0. 2 (B-32)

. . . . . . . 3 (Box 12,

PAGE 16)

. . . . . . . 4 (B-32)

. . . . . . . 5 (8-36)

. . . . . . . 1

. . . . . . . 2

. . . . . . . 01

. . . . . . . 02

. . . . . . . 03

. . . . . . . 04

. . . . . . . 05

. . . . . . ● 06

. . . . . . . 07

. . . . . . ● 08

. . . . . . . 1 (B-32)

. . . . . . . 2 {B-32)

. . . . . . . 3 (Box 12,

PAGE 16)

. . . . . . . 4 (B-32)

. . . . . . . 5 (B-36)

. . . . . . . 1

. . . . . . . 2

73
Box 33. ● IF R NEVER PREGNANT, GO TO BOX 34.

m IF R EVER PREGNANT, CONTINUE.

*

C-63 . There has recently been a great deal of discussion about cigarette smoking end women’s health. On the average, during your (last) pregnancy, how many cigarette par day (did/have) you smoke(d), if any?

Nxmtoneadey orless. . . . . . . . ...01

Just afew(2-4) . . . . . . . . . . . ...02

tiouthalf apack (5-14)... . . . . ...03

Pboutapeck (15-24) . . . . . . . . . . ..o4

About 1 1/2 packa (25-34). . . . . . . . . . 05

Mout2packs (35-44). . . . . . . . . ...06

Mcrethan 2packs (45+).... . . . . ...07

Didn’t amoka during (laet/currant)

pregnancy . . . . . . . . . . . . . . ...96

66-67

C-64. During your (last) pregnancy,

wine, or liquor? (Waa/Is) it

u

HAND

CARD

17

how often (did/do) you usually drink alcoholic beverages, that ia, beer,

. . .

A. Every day, . . . . . . , . . . . . . ...1

B. Afewdays s week, . . . . . . . . . ...2

C.. ilnceaneek, . . . . . . . . . . . . ...3

D. Once a month, . . . . . . . . . . . ...4

68

E. Less thanonce a month, . . . . . . ...5

F. Or never? . . . . . . . . . . . . . ...6

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Vital and Health Statistics

series descriptions

SERIES 1.

SERIES 2.

SERIES 3.

SERIES 4

SERIES 5.

SERIES 10.

SERIES 11.

SERIES 12.

SERIES 13.

Programs and Collection Procedure* Reports descrlbmg the

general programs of the National Center for Health Stalisttcs

and its offices and d!wslons and the data collection methods

used They also include def!nlflons and other material necessary

for understanding the data.

Data Evaluation and Methoda ResearckStudles of new statistical methodology tncludmg experimental tests of new survey

methods, studies of vital statmtics collection methods, new analyf -

cal techniques, ob]ectwe evaluations of rehablhty of collected

data, and contributions to statlst!cal theory. Studies also include

comparison of U.S. methodology with those of other countnes.

Analytical snd Epidemiologicel Stude*Reports presenting

analyftcal or interpretive studies based on vital and health statlstlcs, carrying the analysis further than the expository types of

reports m the other series.

Documents and Committee Reports-Fmal reports of major

committees concerned with vital and health statistics and documents such as recommended model wtal regwtration laws and

revised birth and death certlftcates.

Comparative International Vial and Health Statistics Reports-Analyflcal and descnptwe reports comparing U.S. wtal

and health statistics with those of other countries.

Data From the National Health Interview Survey-Stat@lcs

on illness, accidental injuries, dlsabtlity, use of hospital. medical,

dental, and other services, and other health-related top!cs, all

based on data collected m the contmumg national household

interwew survey.

Date From the National Heatth Examination Survey and the

National Health and Nutrition Examination Survey-Data from

direct examination, testing, and measurement of national samples

of the civihan nonmstitutlonalized population provide the basis

for (1) estimates of the medically defined prevalence of speclflc

diseases m the United States and the distributions of the population

w!th respect to phystcal, physiological, and psychologlcal characteristics and (2) analysis of relationships among the various measurements without reference to an explicit finite umverse of persons.

Date From the Inatitutionaliied Population Surveye-Dlscontmued m 1975. Reports from these surveys are included m Series

13.

Data on Health Resources Ufilition-Statistics on the utd!zation of health manpower and facdties prowdmg long-term care,

ambulatory care, hospital care, and family planning services.

SERIES 14.

SERIES 15.

SERIES 20.

SERIES 21.

SERIES 22.

SERIES 23.

Data on Health Resources: Manpower and Facitiiie*Statstics on the numbers, geographic distribution, and characteristics

of health resources mcludmg physlclans, denksts, nurses, other

health occupations, hospitals, nursing homes, and outpatient facdties.

Data From Special Suweye-Statistics on health and healthrelated topics collected m spec!al surveys that are not a parl

of the contmumg data systems of the National Center for Health

Stat@lcs.

Data on Morialiiy-Various statistics on mortahty other than

as included m regular annual or monthly reports. Special analyses

by cause of death, age, and other demographic variables; geographic and time series analyses; and statistics on characteristics

of deaths not avadable from the wtal records based on sample

surveys of those records.

Data on Natetii, Marriage, and Divor~Vanous statistics

on natahty, marriage, and d!vorce other than as included m regular

annual or monthly reports. Spec(al analyses by demographic

variables; geographic and time series analyses; studies of fertility;

and statistics on characteristics of births not avadable from the

wtal records based on sample surveys of those records.

Data From the National Mo~ality and Natality Surveye-Discontmued in 1975. Reports from these sample surveys based

on vital records are included in Series 20 and 21, respectwely.

Data From the National Suwey of Famiiv Growth-Statistics

on fertillty, famdy formation and dissolution, family planning, and

related maternal and infant health topics derived from a periodtc

survey of a nationwide probablhty sample of women 15-44 years

of age.

For answers to questions about this report or tor a list of titles of reports

publlshed m these series, contact:

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National Center for Health Stat@cs

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