After a decade of no improvement through the 1980's, there has been steady progress from 1989 when only 75 percent of women received timely prenatal care. The rate of cesarean deliveries declined for the sixth consecutive year, to 20.8 percent in 1995 compared with 22.8 percent in 1989, a drop of 9 percent. At the same time vaginal births after previous cesarean deliveries increased 46 percent during this same time period. New guidelines have encouraged women and their physicians to reduce repeat cesareans. Cigarette smoking during pregnancy - Tobacco use during pregnancy has declined steadily since 1989.
Maternal smoking has a strong adverse effect on infant birthweight.
Women who smoke are almost twice as likely to have a low birthweight infant as nonsmokers. Low birthweight increased among white mothers from 6.1 to 6.2 percent. Following a pattern similar to low birthweight, preterm births have increased among white mothers but declined among black mothers to the lowest level since the mid-1980's. However, black women are still almost twice as likely as white women to have a preterm birth. Similarly, the fertility rate dropped 2 percent to 65.6 births per 1,000 women aged 15-44 years.