National Vital Statistics Reports Volume 72, Number 1 January 31, 2023

National Vital

Statistics Reports

Volume 72, Number 1 January 31, 2023

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

National Vital Statistics System

Births: Final Data for 2021

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

and Claudia P. Valenzuela, M.P.H., Division of Vital Statistics

Abstract

Objectives—This report presents 2021 data on U.S. births

according to a variety of characteristics. Trends in fertility

patterns and maternal and infant characteristics are described

and interpreted.

Methods—Descriptive tabulations of data reported on the

birth certificates of the 3.66 million births that occurred in 2021

are presented. Data are presented for maternal age, live-birth

order, race and Hispanic origin, marital status, tobacco use,

prenatal care, source of payment for the delivery, method of

delivery, gestational age, birthweight, and plurality. Selected data

by mother's state of residence and birth rates by age also are

shown. Trend data for 2010 to 2021 are presented for selected

items and by race and Hispanic origin for 2016–2021.

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm.

Rate per 1,000 women aged 15–44

Number of births (millions)

NOTE: Rate for 2020 has been revised and differs from that published in "Births: Final Data for 2020."

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality.

100

2021

202020152010200520001995

Number

Rate

19901985198019751970

Figure 1. Live births and general fertility rates: United States, 1970–2021

2 National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023

Results—A total of 3,664,292 births were registered in the

United States in 2021, up 1% from 2020. The general fertility rate

rose 1% from 2020 to 56.3 births per 1,000 women aged 15–44

in 2021. The birth rate for females aged 15–19 fell 7% between

2020 and 2021; birth rates declined 3% for women aged 20–24

and rose 2% to 5% for women aged 25–44. The total fertility rate

rose 1% to 1,664.0 births per 1,000 women in 2021. Birth rates

declined for unmarried women but increased for married women

from 2020 to 2021. Prenatal care beginning in the first trimester

rose to 78.3% in 2021; the percentage of women who smoked

during pregnancy declined to 4.6%. The cesarean delivery rate

increased to 32.1% in 2021; Medicaid was the source of payment

for 41.0% of births. The preterm birth rate rose 4% to 10.49%;

the low birthweight rate also rose (to 8.52%). Increases in the

twin birth rate (31.2 per 1,000 births in 2021) and the triplet and

higher-order multiple birth rate (80.0 per 100,000 births) were

not significant.

Keywords: birth certificate • maternal and infant health • birth

rates • maternal characteristics • National Vital Statistics

System

Introduction

This report presents detailed data on numbers and

characteristics of births in 2021, birth and fertility rates, maternal

demographic and health characteristics, medical and health

care utilization, source of payment for the delivery, and infant

health characteristics. Reports of provisional birth statistics for

2021 presented overall and monthly data on selected topics are

based on a sample of nearly all (99.94%) 2021 births (1–3); a

National Center for Health Statistics Data Brief presented selected

characteristics based on final data for 2021 births (4).

In addition to the tabulations included in this report, more

detailed analysis is possible by using the annual natality public-

use file. The data file may be downloaded from: https://www.cdc.

gov/nchs/data_access/Vitalstatsonline.htm (5). The public-use

file does not include geographic detail; a file with this information

may be available by request (6). Birth data may also be accessed

through the Centers for Disease Control and Prevention’s

(CDC) Wide-ranging Online Data for Epidemiologic Research

(WONDER). WONDER is a user-friendly, web-based data query

system that makes several CDC information resources available

to public health professionals and the public (7).

2003 revision of U.S. Standard Certificate of

Live Birth

Starting in 2016, all 50 states, the District of Columbia

(D.C.), Puerto Rico, Guam, Commonwealth of the Northern

Marianas, and U.S. Virgin Islands reported data based on the

2003 U.S. Certificate of Live Birth. American Samoa continued to

report based on the 1989 birth certificate revision.

Detailed tables of many topics are included in this report.

Internet-only tables on a number of additional topics, such as

births by attendant and place and delivery, mean age of mother

by live-birth order, maternal prepregnancy body mass index,

infections during pregnancy, and maternal morbidity, are also

available; see List of Internet Tables. For information on data

quality, see reports that assessed the quality of selected medical

and health data from the 2003 revised birth certificate and the

"User Guide to the 2021 Natality Public Use File" (8–10).

Methods

Data shown in this report are based on 100% of the birth

certificates registered in all states and D.C. More than 99% of

births occurring in the United States are registered (10). Tables

showing data by state also provide separate information for

Puerto Rico, Guam, U.S. Virgin Islands, and Commonwealth of

the Northern Marianas. These areas, however, are not included in

totals for the United States. Data for American Samoa were not

available for 2021.

The 2003 revision of the U.S. Standard Certificate of Live

Birth allows the reporting of more than one race (multiple races)

for each parent (11), according to the revised standards issued

by the Office of Management and Budget (OMB) in 1997 (12).

Starting in 2016, all 50 states, D.C., Puerto Rico, Guam, Northern

Marianas, and U.S. Virgin Islands reported race data according

to these 1997 OMB standards that allow for the reporting of a

minimum of five race categories either by single race (reported

alone) or in combination (more than one race or multiple races)

(12). The race and Hispanic-origin groups shown in this report

follow the 1997 standards and differ from the bridged-race

categories shown in most previous reports that are based on

data from 2015 and earlier. (13). The categories are non-Hispanic

single-race White, non-Hispanic single-race Black or African

American, non-Hispanic single-race American Indian or Alaska

Native (AIAN), non-Hispanic single-race Asian, non-Hispanic

single-race Native Hawaiian or Other Pacific Islander (NHOPI),

and Hispanic; for brevity, text references to non-Hispanic White

or non-Hispanic Black women omit the term “single-race.”

Because single-race data are not available for the entire United

States before 2016, only race data for 2016–2021 are shown in

this report. For more information on differences between single-

and bridged-race groups, see “Births: Final Data for 2016” (14).

Race and Hispanic origin are reported independently on the

birth certificate and reporting of Hispanic-origin ethnicity was

not affected by the change to the 1997 OMB standards. Most

tables in this report show data for the categories non-Hispanic

single-race White, non-Hispanic single-race Black, and Hispanic.

Selected tables also include data for the categories non-Hispanic

single-race AIAN, non-Hispanic single-race Asian, and non-

Hispanic single-race NHOPI. Data are also presented in some

tables for specific Hispanic groups: Mexican, Puerto Rican,

Cuban, Dominican, Central and South American, and Other and

unknown Hispanic (includes Hispanic origins not categorized,

including Spaniards). Before 2018, data for the Dominican

subgroup had been included in the category “Other and unknown

Hispanic.”

Trend tables included in the detailed tables for this report

include the years 2010–2021; see List of Detailed Tables. Longer-

term trends previously shown in this report series can be found in

earlier-year reports (for example, “Births: Final Data for 2015”) (13).

National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023 3

In this report, the total number of births includes births

to women up to age 64. In tables that include age of mother,

the oldest age groups shown (40–54, 45–49, 45–54, or 50–54)

include births to mothers up to age 64 (births to mothers 55–64

are included in the 50–54 age group).

For information on levels of incomplete reporting by

state, see the 2021 User Guide (10). For information on the

measurement of data items shown in this report, and the Internet

Tables, imputation techniques used, computation of derived

statistics, and definitions of terms, see the 2021 User Guide (10).

Birth and fertility rates for 2020 shown in this report have

been revised and may differ from those published in ‘‘Births:

Final Data for 2020’’ and elsewhere (1,15). Previously published

birth and fertility rates for 2020 were based on postcensal

population estimates derived from the 2010 census. The revised

rates shown here are based on revised population estimates

consistent with the 2020 census, as of April 1.

Demographic Characteristics

(Tables 1–12)

Births and birth rates

Number of births

In 2021, 3,664,292 births were registered in the United

States, up 1% (or 50,645) from 2020, following a decline of

4% from 2019 to 2020 (Table 1, Figure 1). For 2014–2019, the

number of births had declined by an average of 1% per year.

Previously, the number of births declined by an average of 2%

per year from 2007 to 2013 and increased 1% in 2014 (13).

Despite the increase from 2020 to 2021, the number of births in

2021 remained lower than the number in 2019.

Among the race and Hispanic-origin groups, the number of

births rose 2% for non-Hispanic White and Hispanic women from

2020 to 2021, and declined 2% for non-Hispanic Black and non-

Hispanic Asian women and 3% for non-Hispanic AIAN women

(Tables 1, 3, and 6). The decline in the number of births for

non-Hispanic NHOPI women (1%) was not significant. Among

the specified Hispanic groups, births rose 1% for Mexican and

Puerto Rican women, 3% for Other and unknown Hispanic origin

women, 5% for Cuban and Central and South American women,

and 6% for Dominican women (Tables 4 and 7).

Fertility rate

The general fertility rate (GFR) for the United States in

2021 was 56.3 births per 1,000 women aged 15–44, up 1%

from 2020 (55.7) (Table 1). This is the first increase in the GFR

since 2014; the rate declined 4% from 2019 to 2020 and by an

average of 2% per year from 2014 to 2019. From 2007 to 2013,

the GFR declined steadily by an average of 2% per year and then

increased 1% between 2013 and 2014 (13).

Among the race and Hispanic-origin groups, the GFR rose

1% for Hispanic and 3% for non-Hispanic White women from

2020 to 2021 and declined 2% for non-Hispanic Asian and 3%

for non-Hispanic Black and non-Hispanic AIAN women. The

decline in the rate for non-Hispanic NHOPI women (1%) was

not significant.

Age of mother

Birth rates declined for women in age groups 15–24, rose

for women aged 25–44, and were unchanged for the youngest

(10–14) and the oldest (45–49) women from 2020 to 2021.

Teenagers—The birth rate for females aged 15–19 in the

United States in 2021 was 13.9 births per 1,000 females, down

7% from 2020 (15.0) and another record low (Table 2, Figure 2)

(13,16,17). Since 2009, the teen birth rate has fallen to a new

low each year. The rate for this group has declined 67% since

2007 (41.5), the most recent high, and 78% since the 1991

high (61.8). The number of births to teenagers aged 15–19 was

146,973 in 2021, down 7% from 2020 (158,043) (15).

The 2021 birth rates for teenagers aged 15–17 and 18–19

were 5.6 and 26.6 births, respectively, down 8% and 6% from

2020, record lows for both groups. Rates for these age groups

have fallen 74% and 63%, respectively, since 2007, and by 85%

and 72% since 1991. The birth rate for females aged 10–14 was

unchanged in 2021 at 0.2 births per 1,000 females.

Among race and Hispanic-origin groups, the birth rates for

teenagers aged 15–19 declined for most groups, down 7% for

non-Hispanic White, 8% for non-Hispanic Black and Hispanic,

and 9% for non-Hispanic Asian females from 2020 to 2021. The

declines in rates for non-Hispanic NHOPI (1%) and non-Hispanic

AIAN (4%) females were not significant.

Women in their 20s—The birth rate for women aged 20–24

was 61.5 births per 1,000 women in 2021, down 3% from 2020

(63.3), and another record low (Table 2) (13,16). The rate for

women in this age group has declined since 2006. The number

of births to women in their early 20s also declined 3% from

2020 (15). The rate for women aged 25–29 was 93.0 births, up

2% from 2020 (90.9). The rate for women in this age group has

declined for all but one year from 2007 to 2020 (13). The number

of births to women aged 25–29 was essentially unchanged from

2020 to 2021 (see Tables 3 and 4 for 2020 data) (15).

Women in their 30s—The birth rate for women aged 30–34

was 97.6 births per 1,000 women in 2021, up 3% from 2020

(94.9); this follows an annual decline in the rate from 2017 to

2020 (13,16). The 2021 rate for women aged 30–34 was higher

than the rate for women aged 25–29 for the sixth consecutive

year since reliable national records were available (1940) (13,16).

The number of births to women aged 30–34 rose 4% from 2020

to 2021. The birth rate for women aged 35–39 was 53.7 births in

2021, up 5% from 2020 (51.3) (Table 2). The number of births

to women aged 35–39 rose 5% in 2021 (see Tables 3 and 4 for

2020 data) (15).

Women in their 40s—The birth rate for women aged 40–44

was 12.0 births per 1,000 women in 2021, up 2% from 2020

(11.8) (Table 2); this increase follows a decline in the rate for

this group in 2020, the first since 1981 (13,16). The number of

births to women in their early 40s rose 5% from 2020 to 2021.

The birth rate for women aged 45–49 (includes births to women

aged 50 and over) was 0.9 births in 2021, unchanged from 2020.

The number of births to women aged 45 and over was essentially

unchanged from 2020 to 2021.

4 National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023

Women aged 50 and over—The birth rate for women aged

50–54 was unchanged at 1.0 births per 10,000 women in 2021.

Because of the small number of births to women in this age

group, the birth rate for women aged 50–54 is expressed per

10,000 women. For rates shown elsewhere in this report, births

to women aged 50 and over are included with births to women

aged 45–49 when computing birth rates by age of mother (the

denominator for the rate is women aged 45–49). There were

1,041 births to women aged 50 and over in 2021, up from 995

in 2020, a nonsignificant increase (Table 3) (15). The number of

births to women in this age group has generally increased since

1997 (when 144 births were reported).

Live-birth order

The first-birth rate for the United States was 21.5 births per

1,000 women aged 15–44 in 2021, up 1% from 2020 (21.3) (see

Tables 3 and 4 for the number of births and Table 5 for birth

rates). First-birth rates declined for females in their teens (7%

for females aged 15–19) and early 20s (2% for women aged 20–

24) and rose for women in their late 20s (4% for women aged

25–29), 30s (4% for women aged 30–34 and 5% for women

aged 35–39), and early 40s (4% for women aged 40–44). The

rate rose from 0.2 to 0.3 for women aged 45–49. The first-birth

rate for females aged 10–14 was unchanged in 2021 (0.2) (15).

Mean age of mother

In 2021, the mean age of mothers at first birth was 27.3

years, an increase from 27.1 in 2020, and another record high

for the nation (Tables 11, 12, and I–6) (13,16). The mean age

at first birth is the arithmetic average of the age of mothers at

the time of birth and is computed directly from the frequency

of first births by age of mother. The increase in the mean age in

2021 reflects, in part, the decline in the number of first births to

women in their teens and early 20s and the concurrent rise in

first births to women in their late 20s, 30s, and 40s (15).

Mean age at first birth increased for nearly all race and

Hispanic-origin groups in 2021, rising to 25.5 years for Hispanic

and non-Hispanic Black, 28.1 for non-Hispanic White, and 31.2

for non-Hispanic Asian women (15). The increases in the average

age at first birth for non-Hispanic AIAN women, to 23.9 in 2021,

and non-Hispanic NHOPI women, 25.2, were not significant.

Among the specified Hispanic groups, average ages increased to

25.0 for Mexican, 25.6 for Puerto Rican, 26.4 for Dominican, and

28.5 for Cuban women (15). The age at first birth for Central and

South American women was unchanged in 2021 at 26.3.

Total fertility rate

The total fertility rate (TFR) for the United States in 2021

was 1,664.0 births per 1,000 women, up 1% from 2020 (1,641.5)

(Table 2). This is the first increase in the TFR since 2014 (up

by less than 1% between 2013 and 2014). Although it follows

Rate per 1,000 women

NOTES: Rates for 2020 have been revised and may differ from those published in "Births: Final Data for 2020." Rates are plotted on a logarithmic scale.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality.

40–44

35–39

30–34

25–29

20–24

15–19

2021

20202015201020052000

100

200

19951990

Figure 2. Birth rates, by selected age of mother: United States, 1990–2021

National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023 5

a 4% decline from 2019 to 2020, the rate had declined by an

average of 2% per year from 2014 to 2019 and by an average of

2% per year from 2007 to 2013. The TFR estimates the number

of births that a hypothetical group of 1,000 women would have

over their lifetimes, based on age-specific birth rates in a given

year. Because it is calculated from age-specific birth rates, TFR is

age adjusted and can be compared for populations across time,

population groups, and geographic areas.

Among the race and Hispanic-origin groups, the TFR rose

1% for Hispanic and 3% for non-Hispanic White women from

2020 to 2021 and declined 2% for non-Hispanic Black and non-

Hispanic Asian and 3% for non-Hispanic AIAN women. The

decline in the rate for non-Hispanic NHOPI women (less than

1%) was not significant.

The TFR for the nation in 2021 remained below “replacement,”

the level at which a given generation can exactly replace itself

(generally considered to be 2,100 births per 1,000 women). The

U.S. TFR has generally been below replacement since 1971 and

has consistently been below replacement since 2008 (13,16).

The TFR was below replacement for all race and Hispanic-origin

groups in 2021, except for non-Hispanic NHOPI women (2,131.0

births) (Table 2).

Births and birth rates by state

The GFR, the number of births per 1,000 women aged 15–44,

rose in 16 states from 2020 to 2021 and declined in 1 state,

New Mexico. Increases of 1% to 2% were reported in 10 states

(California, Colorado, Florida, Minnesota, North Carolina, Oregon,

Pennsylvania, Tennessee, Virginia, and Wisconsin), of 3% to 4%

in 3 states (New Jersey, New York, and Rhode Island), and of

5% to 6% in 3 states (Connecticut, Massachusetts, and New

Hampshire). GFRs were essentially unchanged in the remaining

33 states and D.C. Rates among the states ranged from 44.9

births per 1,000 women aged 15–44 in Vermont to 68.6 in South

Dakota. (See Tables 6 and 7 for the number of births and Table 8

for birth rates). Among the U.S. territories, the GFR declined in

Guam; declines in Puerto Rico, U.S. Virgin Islands, and Northern

Marianas were not significant. For the number of births by state

in 2021, see Tables 6 and 7.

Birth rates for teenagers by state

In 2021, the birth rate for teenagers aged 15–19 declined in 29

states (Arizona, California, Colorado, Florida, Georgia, Idaho, Illinois,

Indiana, Kansas, Maine, Maryland, Michigan, Mississippi, Missouri,

Nevada, New Hampshire, New Jersey, New Mexico, New York, North

Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas,

Utah, Virginia, Washington, and Wisconsin), with declines ranging

from 3% for New York to 24% for Maine. Rates were essentially

unchanged in the remaining 21 states and D.C. Rates among the

states ranged from 5.4 births per 1,000 in New Hampshire to 26.5

in Arkansas (Table 8). The wide range in state-specific teen birth

rates is consistent with patterns observed in previous analyses

(17,18). Teen birth rates declined for Puerto Rico and Guam and

were essentially unchanged for the U.S. Virgin Islands and Northern

Marianas. Rates among the territories ranged from 13.2 births per

1,000 teenagers in Puerto Rico to 23.8 in Guam.

Births to unmarried women

The birth rate for unmarried women was 37.8 births per

1,000 unmarried women aged 15–44 in 2021, down 2% from

2020 (38.4) (Table 10). The 2021 nonmarital birth rate was 27%

lower than the peak of 51.8 in 2007 and 2008 (13). (See Technical

Notes for a description of the adjustments to calculations of rates

by marital status beginning with 2017).

The birth rate for married women increased in 2021, up

3% to 83.6 per 1,000 married women aged 15–44, from 80.8

in 2020. The marital birth rate declined 4% over the period

2005–2010 but rose 6% from 2010 to 2016 before declining 6%

through 2020 (13).

The percentage of all births to unmarried women was

40.0% in 2021, down 1% from 2020 (40.5%) (Table 9) (15). The

percentage of all births to unmarried women peaked in 2009 at

41.0% (13,15).

The percentage of nonmarital births in 2021 increased from

2020 for non-Hispanic Asian (12.6% in 2021) and Hispanic

(53.2%) women. The percentage decreased for non-Hispanic

White (27.5%), non-Hispanic Black (70.1%), and non-Hispanic

AIAN (68.5%) women. The percentage was unchanged for non-

Hispanic NHOPI women (51.8%). The number of nonmarital

births was essentially unchanged from 2020 (1,464,121) to

2021 (1,464,455) (15).

Nonmarital birth rates declined from 2020 to 2021 for

women in age groups under 30, with the rate for teenagers

aged 15–19 dropping 7% (to 13.0 per 1,000 in 2021), and the

rate for females aged 15–17 declining to another all-time low

(5.6). Conversely, the nonmarital birth rate reached a historic

peak of 38.2 for women aged 35–39. The rates were essentially

unchanged for women aged 30–34 (58.5) and 40–44 (11.4).

Compositional differences by race and Hispanic origin and

maternal age among states are major contributing factors to the

geographic variation in the percentage of births to unmarried

mothers (Table I–7). In 2021, the percentages of unmarried

births ranged from about one in five births in Utah (19.5%) to

more than one in two births in Louisiana (54.5%), Mississippi

(54.8%), and New Mexico (52.4%).

Cigarette Smoking Before and During

Pregnancy (Tables 13–15)

Of the women who gave birth in 2021, 4.6% reported

smoking cigarettes (tobacco only) at any time while pregnant,

a 16% decline from 2020 (5.5%) (Table 15) (15). Cigarette

smoking was most common earlier in pregnancy: 4.5% of

women smoked in their first trimester, 3.9% in their second, and

3.7% in their third. Of the 5.9% of women who reported smoking

in the 3 months before becoming pregnant, 23.3% quit smoking

before pregnancy.

By race and Hispanic origin, 6.7% of non-Hispanic White

women reported smoking any time during pregnancy, down

17% from 2020; 3.8% of non-Hispanic Black women reported

smoking any time during pregnancy, down 16%; 1.2% of

Hispanic women reported smoking during pregnancy, down 14%

from 2020. See Tables 13 and 14 for 2021 smoking levels among

6 National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023

other race and Hispanic-origin groups. Rates of quitting smoking

before pregnancy also varied by race and Hispanic origin: 21.5%

of non-Hispanic White, 24.1% of non-Hispanic Black, and 36.8%

of Hispanic women who smoked during the 3 months before

pregnancy did not smoke while pregnant.

By maternal age, smoking rates during pregnancy were

highest among women aged 20–24 (6.0%), women aged 25–29

(5.2%), and women under age 20 (4.5%). Tobacco use during

pregnancy was less common among older women, with 3.3% of

women aged 40–54 and 3.6% of women aged 35–39 reporting

smoking during pregnancy (Table 15).

Medical and Health Services Utilization

and Source of Payment for the Delivery

(Tables 13–19)

Use and timing of prenatal care

Among women who gave birth in 2021, 78.3% began

prenatal care in the first trimester of pregnancy, up from 77.7%

in 2020. Late (beginning in the third trimester) or no prenatal

care increased in 2021 to 6.3%, from 6.2% in 2020 (Table 16)

(15).

Prenatal care beginning in the first trimester increased for

the three largest race and Hispanic-origin groups: non-Hispanic

White (from 82.8% in 2020 to 83.2% in 2021), non-Hispanic

Black (from 68.4% to 69.7%), and Hispanic (from 72.3%

to 72.5%) (Table 16) (15). Late or no prenatal care increased

for non-Hispanic White (4.5% to 4.6%) and Hispanic (7.9%

to 8.4%) women and was unchanged for non-Hispanic Black

women (9.1%). Timing of prenatal care continued to vary by

race and Hispanic origin in 2021. First trimester care ranged

from 51.5% for non-Hispanic NHOPI women to 83.5% for non-

Hispanic Asian women; late or no prenatal care ranged from

4.1% for non-Hispanic Asian women to 21.0% for non-Hispanic

NHOPI women (Table 13).

Initiation of prenatal care in the first trimester was higher

in 2021 than in 2020 for women in all age groups, increasing

from 61.5% to 61.6% (change was not significant) for women

under age 20, from 71.4% to 72.3% for women aged 20–24, and

from 77.9% to 78.6% for women aged 25–29. For women in

age groups over 30, first trimester care increased from 82.0% to

82.2% for women aged 30–34, from 81.4% to 81.7% for women

aged 35–39, and from 77.6% to 78.0% for women aged 40 and

over (Table 16) (15).

Method of delivery

Cesarean delivery

In 2021, the cesarean delivery rate increased 1% to 32.1%,

from 31.8% in 2020; this is the second increase in a row after

the rate had declined in 2018 and 2019 (Table 17). The cesarean

delivery rate peaked in 2009 at 32.9%, after increasing every

year since 1996 (20.7%) (13).

The cesarean delivery rate increased 1% for each of the three

largest race and Hispanic-origin groups, from 30.8% in 2020 to

31.0% in 2021 for non-Hispanic White women, from 36.3% to

36.8% for non-Hispanic Black women, and from 31.4% to 31.6%

for Hispanic women. Non-Hispanic Black women continued to

have the highest cesarean delivery rate (36.8%) in 2021. Tables

13 and 14 show cesarean delivery rates for more detailed race

and Hispanic-origin groups.

Changes from 2020 to 2021 in cesarean delivery rates

varied by maternal age group (Table 18). Women aged 20–24

and in their 30s were more likely to have a cesarean delivery in

2021 than in 2020 (25.3% to 25.4% for women aged 20–24,

33.7% to 33.8% for women aged 30–34, and 39.7% to 39.9%

for women aged 35–39). Rates for other age groups were

essentially unchanged. Cesarean delivery continued to be higher

among older women compared with younger mothers; women

aged 40 and over were more than twice as likely to deliver by

cesarean section (47.5%) than women under age 20 (19.4%).

Low-risk cesarean delivery—The low-risk cesarean

delivery rate increased 2% in 2021, from 25.9% (2020) to

26.3%. The low-risk cesarean delivery rate is cesarean delivery

among nulliparous (first birth), term (37 or more completed

weeks based on the obstetric estimate), singleton (one fetus),

and cephalic (head-first) births. See Tables 13, 14, 17, and 18 for

details by age and race and Hispanic origin of the mother.

Primary cesarean delivery—In 2021, the primary cesarean

delivery rate, which measures cesarean deliveries among women

who have not had a previous cesarean delivery, was 22.3%, up 2%

from 21.9% in 2020 (Tables 17 and 18). A recent report describes

recent trends in primary and repeat cesarean delivery (19).

Vaginal birth after previous cesarean delivery (VBAC)—

The VBAC rate measures vaginal births among women with a

previous cesarean delivery. In 2021, 14.2% of women with

a previous cesarean delivered vaginally, up 2% from 13.9%

in 2020; the rate has increased every year since 2016, when

national data became available. See a recent report for changes

in VBAC by race and Hispanic origin and see Tables 17 and 18

for details (4).

Source of payment for the delivery

The principal source of payment for the delivery of most

births in 2021 continued to be either private insurance or Medicaid;

however, the percentage of births covered by private insurance

increased from 2020 (from 50.6% to 51.7%), and the percentage

of births covered by Medicaid declined (from 42.0% to 41.0%).

The category “self-pay,” generally considered to indicate uninsured

deliveries, accounted for 3.9% of 2021 births, unchanged from

2020. The remainder of births were covered by other insurance

(3.4% of births, down from 3.5% in 2020); other insurance includes

Indian Health Service, CHAMPUS or TRICARE, other government

(federal, state, or local), or charity (Table 19) (15).

The percentage of births covered by private insurance

increased from 2020 to 2021 for each of the three largest race

and Hispanic-origin groups (15). In 2021, the percentage of

mothers using private insurance was 30.8% for non-Hispanic

Black women and 32.1% for Hispanic women, compared with

65.0% for non-Hispanic White women. The percentage of births

National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023 7

covered by Medicaid decreased from 2020 to 2021 for each of

the three largest race and Hispanic-origin groups (15). In 2021,

Medicaid coverage ranged from 28.1% for non-Hispanic White

women to 58.1% for Hispanic women and 64.0% for non-

Hispanic Black women. See Tables 13 and 14 for information for

additional race and Hispanic-origin groups.

By age of mother, Medicaid as the source of payment

increased for women under 20 (78.4% to 78.8%); decreased

for women aged 25–29 (44.7% to 43.9%), aged 30–34 (29.9%

to 29.4%), aged 35–39 (27.6% to 26.8%), and aged 40–54

(30.6% to 30.0%); it remained unchanged for women aged

20–24 between 2020 and 2021 (15). The percentages of births

with Medicaid as the source of payment ranged from 26.8% for

women aged 35–39 to 78.8% for women under age 20. Private

insurance as the source of payment for the delivery increased

in 2020 for women aged 20–54. Percentages with private

insurance ranged from 14.7% for women under age 20 to 66.3%

for women aged 35–39.

Infant Health Characteristics

(Tables 20–25)

Period of gestation

The U.S. preterm birth rate rose 4% in 2021 to 10.49%,

the highest level reported since at least 2007. (National data

based on the obstetric estimate of gestation are available only

from 2007 [20]; see Technical Notes.) The preterm birth rate

(percentage of all births delivered at less than 37 completed

weeks of gestation) declined steadily from 2007 (10.44%) to

2014 (9.57%) (13), rose 7% through 2019 and then declined

1% between 2019 (10.23%) and 2020 (10.09%) (Table 20) (21).

Increases of 4% between 2020 and 2021 were seen among

infants born early preterm (less than 34 weeks), up from 2.70%

to 2.81%, and late preterm (34–36 weeks), from 7.40% to

7.67%. The early preterm rate is the highest reported since 2012;

the late preterm birth rate is the highest since comparable data

have been available (2007) (13,20).

Changes in the distribution of births delivered at term and

later (37 weeks and higher) were also observed from 2020

to 2021. Following trends generally observed since 2014, the

percentage of infants born early term (37–38 weeks) rose by

4% in 2021, from 27.78% to 28.76%, whereas full-term births

(39–40 weeks) declined by 2% (from 57.00% to 55.90%) and

late-term births (41 weeks) by 6% (4.88% to 4.61%). From 2007

to 2014, the early-term birth rate had generally declined, and the

full-term rate had increased (13). The percentage of post-term

(42 weeks and higher) births generally declined from 2007 to

2019 but has been unchanged at 0.25% for 2019–2021 (Table 20).

Increases in early-term and declines in full- and late-term births

were seen for the three largest race and Hispanic-origin groups

for 2020–2021.

Preterm birth rates rose by 3%–4% for births to non-

Hispanic White mothers (from 9.10% to 9.50%), non-Hispanic

Black mothers (14.36% to 14.75%), and Hispanic mothers

(9.84% to 10.23%) between 2020 and 2021 (Table 20). For

2021, preterm birth rates for the race and Hispanic-origin groups

ranged from a high of 14.75% for births to non-Hispanic Black

mothers to a low of 9.23% among non-Hispanic Asian mothers

(Table 13). Preterm levels for the Hispanic subgroups ranged

from 9.78% (Central and South American) to 11.55% (Puerto

Rican) (Table 14).

It can also be important to analyze births in singleton

deliveries separately from all births because of the shorter

average gestations of multiple births and their accordant potential

influence on preterm birth rates (also see “Multiple births” in this

report). The 2021 preterm birth rate for singleton births only

was 8.76%, up 4% from the 2020 level of 8.42%. From 2007 to

2014, the singleton preterm rate declined from 8.59% to 7.74%

but then rose 8% from 2015 (7.82%) to 2019 (8.47%) (see Table

for 2021 data) (13,15).

Increases in preterm birth rates were observed in 26 states

between 2020 and 2021. Nonsignificant increases were reported

for an additional 20 states and D.C and nonsignificant declines

were reported in 4 states; see Figure 3 and Table I–19 for 2021

data.

Birthweight

The percentage of infants born low birthweight (LBW; less

than 2,500 grams or 5 pounds, 8 ounces) rose 3% in 2021 to

8.52%, from 8.24% in 2020. The LBW rate had declined from

Table. Gestational age and birthweight characteristics, by plurality: United States, 2021

Plurality Number of births Early preterm

Preterm

Very low birthweight

Low birthweight

Percent

All births . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,664,292 2.81 10.49 1.38 8.52

Singletons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,547,198 2.20 8.76 1.09 6.93

Twins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114,161 20.28 62.05 9.44 55.92

Triplets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,785 65.61 98.60 34.91 95.36

Quadruplets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 97.74 99.25 69.92 99.25

Quintuplets and higher-order multiples . . . . . . . . . . . 15 100.00 100.00 73.33 100.00

Less than 34 completed weeks of gestation.

Less than 37 completed weeks of gestation.

Less than 1,500 grams.

Less than 2,500 grams.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality.

8 National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023

2019 (8.31%) to 2020. The LBW rate had risen nearly 20% from

1990 to 2006, declined from 2007 to 2012, and rose 4% from

2014 (8.00%) to 2019 (Tables 22 and 23) (13).

The very low birthweight (VLBW; less than 1,500 grams)

rate rose to 1.38% in 2021 after declining to 1.34% in 2020,

returning to levels reported for 2018 and 2019. These VLBW

rates are down from the high of 1.49% for 2005–2007 (13). The

percentage of moderately low birthweight infants (1,500–2,499

grams) increased 3% in 2021 to 7.14% from 6.90% in 2020;

moderately low birthweight levels for 2016–2021 have matched

or surpassed the peak reported for 2006 (6.77%) (Table 22) (13).

Between 2019 and 2020, LBW rates rose among births

to each of the largest race and Hispanic-origin groups: non-

Hispanic White (6.84% to 7.03%), non-Hispanic Black (14.19%

to 14.66%), and Hispanic (7.40% to 7.82%) women. Since 2016,

LBW rates have fluctuated for all groups but have increased a

total of 1% for non-Hispanic White women (from 6.97%) and

7% for non-Hispanic Black (from 13.68%) and Hispanic (7.32%)

women (Table 22). See Tables 13, 14, I–21, and I–22 for 2020

VLBW and LBW rates by state and by race and Hispanic origin.

The LBW rate among singleton births only increased

4%, from 6.68% in 2020 to 6.93% in 2021 (15); see Table for

2021 data. It can be informative to examine births in singleton

deliveries separately because multiple births tend to be born

smaller than singleton births, and changes in multiple-birth

incidence can influence overall LBW levels.

Multiple births

The 2021 twin birth rate was 31.2 twins per 1,000 births,

a nonsignificant increase from the 2020 rate of 31.1 (Tables 24

and 25). The twinning rate (births in twin deliveries per 1,000

total births) rose 76% from 1980 to 2009 (from 18.9 to 33.2 per

1,000), was generally stable from 2009 to 2012, and then rose

for 2013 and 2014 before declining 8% from 2014 to 2020. The

2020 and 2021 rates are the lowest in almost 2 decades (13).

The triplet and higher-order multiple birth rate (triplet/+)

was 80.0 per 100,000 births for 2021, a nonsignificant increase

from 2020 (79.6). The 2021 rate of triplet/+ births is down 59%

from the 1998 peak (193.5) (13). The triplet/+ birth rate (number

of triplets, quadruplets, and quintuplets and other higher-order

multiples per 100,000 births) rose more than 400% from 1980

to 1998 (Tables 24 and 25) (13).

There were 114,161 infants born in twin deliveries in

2021, an increase of 2% from the number in 2020 (Table 25).

The number of triplet/+ infants born in 2021 also rose by 2%

from 2020 to 2,933. The number of triplet/+ births is down 62%

since the 2003 high when 7,663 triplet/+ births were reported

(13). The 2021 number included 2,785 triplets, 133 quadruplets,

and 15 quintuplet and higher-order multiple births. See Table for

the number of births and percentages of preterm and LBW births

by specified plurality.

Figure 3. Change in preterm birth rates, by state: United States, 2020 and 2021

U.S. rate increased 4%

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality.

Increase

Nonsignificant Increase

Nonsignificant decline

National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023 9

Twin birth rates were essentially unchanged for the largest

race and Hispanic-origin groups from 2020 to 2021: non-Hispanic

White (from 32.6 to 32.5 per 1,000), non-Hispanic Black (40.7 to

40.6), and Hispanic (23.9 to 24.2) women. Triplet/+ birth rates

remained essentially unchanged for non-Hispanic White (90.3

to 93.3 per 100,000) and Hispanic (56.3 to 62.5) women and

declined for non-Hispanic Black women (98.3 to 81.9) (Table 24;

also see Tables 13 and 14 for 2021 twin and triplet/+ rates for

additional race and Hispanic-origin groups). For state-specific

twin and triplet/+ rates, see Table I–23.

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xlsx.

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data.census.gov/mdat/#/.

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29. Ventura SJ, Bachrach CA. Nonmarital childbearing in the United

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Hyattsville, MD: National Center for Health Statistics. 2000.

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1-year estimates (st31002_2021_010_flags), by sex, age, nativity,

and Hispanic origin. Population estimates for 2021 based on

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Jr JF, et al. National Center for Health Statistics data presentation

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gov/nchs/data/series/sr_02/sr02_175.pdf.

32. National Center for Health Statistics. User guide to the 2010

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UserGuide2010.pdf.

33. National Center for Health Statistics. Guide to completing the

facility worksheets for the certificate of live birth and report of fetal

death (2003 revision). 2022 update. Available from: https://www.

cdc.gov/nchs/data/dvs/GuidetoCompleteFacilityWks.pdf.

National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023 11

List of Detailed Tables

Report tables

1. Births and birth rates: United States, 2010–2021, and by

race and Hispanic origin: United States, 2016–2021 ...... 12

2. Birth rates, by age of mother: United States, 2010–2021,

and by age and race and Hispanic origin of mother:

United States, 2016–2021 .......................... 13

3. Births, by age of mother, live-birth order, and race and

Hispanic origin of mother: United States, 2021 .......... 15

4. Births, by age of mother, live-birth order, and Hispanic

origin of mother: United States, 2021 ................. 17

5. Birth rates, by age of mother, live-birth order, and race and

Hispanic origin of mother: United States, 2021 .......... 19

6. Births, by race and Hispanic origin of mother: United States,

each state and territory, 2021 ....................... 21

7. Births, by Hispanic origin of mother: United States, each

state and territory, 2021 ............................ 23

8. Birth rates, by age of mother: United States, each state and

territory, 2021 ................................... 25

9. Births to unmarried women, by age and race and Hispanic

origin of mother: United States, 2021 ................. 27

10. Birth rates for unmarried women: United States, 2010–2021,

and by age and race and Hispanic origin of mother:

United States, 2016–2021 .......................... 28

11. Selected demographic characteristics of births, by race and

Hispanic origin of mother: United States, 2021 .......... 29

12. Selected demographic characteristics of births, by Hispanic

origin of mother: United States, 2021 ................. 30

13. Selected medical and health characteristics of births, by race

and Hispanic origin of mother: United States, 2021 ....... 31

14. Selected medical and health characteristics of births, by

Hispanic origin of mother: United States, 2021 .......... 32

15. Mothers who smoked for the 3 months before pregnancy

and anytime during pregnancy and those who quit before

and during pregnancy, by age and race and Hispanic origin

of mother: United States, 2021.

...................... 33

16. Trimester prenatal care began, by age and race and Hispanic

origin of mother: United States, 2021 ................. 35

17. Births, by method of delivery: United States, 2010–2021,

and by race and Hispanic origin of mother: United States,

2016–2021. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

18. Births, by method of delivery and age and race and Hispanic

origin of mother: United States, 2021 ................. 38

19. Principal source of payment for the delivery, by age and race

and Hispanic origin of mother: United States, 2021 ....... 39

20. Births, by gestational age: United States, 2010–2021,

and by race and Hispanic origin of mother: United States,

2016–2021. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

21. Births, by gestational age and age and race and Hispanic

origin of mother: United States, 2021 ................. 42

22. Births, by birthweight: United States, 2010–2021, and

by race and Hispanic origin of mother: United States,

2016–2021. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

23. Births, by birthweight and age and race and Hispanic origin

of mother: United States, 2021 ...................... 46

24. Twin, triplet, and higher-order multiple births: United States,

2010–2021, and by race and Hispanic origin of mother:

United States, 2016–2021 .......................... 48

25. Births, by plurality and age and race and Hispanic origin of

mother: United States, 2021 ........................ 49

List of Internet Tables

(Available from: https://www.cdc.gov/nchs/data/nvsr/

nvsr72/nvsr72-01-tables.pdf.)

I–1. Time of birth, by day of week of birth and race and Hispanic

origin of mother: United States, 2021

I–2. Births and seasonally adjusted birth rates, by month:

United States, 2021

I–3. Births, by day of week and method of delivery: United States,

2021

I–4. Births, by attendant, place of delivery, and race and Hispanic

origin of mother: United States, 2021

I–5. Births occurring at home, by state: United States and each state,

2021

I–6. Mean age of mother, by live-birth order: United States,

2010–2021, and by race and Hispanic origin of mother:

United States, 2016–2021

I–7. Births to unmarried women, by race and Hispanic origin of

mother: United States, each state and territory, 2021

I–8. Educational attainment of mother, by age and race and Hispanic

origin of mother: United States, 2021

I–9. Maternal prepregnancy body mass index, by age and race and

Hispanic origin of mother: United States, 2021

I–10. Live births by interval since last live birth, by age and race and

Hispanic origin of mother: United States, 2021

I–11. Mother received WIC food for herself during this pregnancy and

infant was being breastfed at discharge, by age and race and

Hispanic origin of mother: United States, 2021

I–12. Pregnancy risk factors, by age and race and Hispanic origin of

mother: United States, 2021

I–13. Infections present or treated during this pregnancy, by age and

race and Hispanic origin of mother: United States, 2021

I–14. External cephalic version, by age and race and Hispanic origin of

mother: United States, 2021

I–15. Characteristics of labor and delivery, by age and race and

Hispanic origin of mother: United States, 2021

I–16. Total cesarean delivery and low-risk cesarean delivery, by race

and Hispanic origin of mother: United States, each state and

territory, 2021

I–17. Method of delivery, by age and race and Hispanic origin of

mother: United States, 2021

I–18. Maternal morbidity, by age and race and Hispanic origin of

mother: United States, 2021

I–19. Preterm births, by race and Hispanic origin of mother:

United States, each state and territory, 2021

I–20. Late preterm births, by race and Hispanic origin of mother:

United States, each state and territory, 2021

I–21. Low birthweight births, by race and Hispanic origin of mother:

United States, each state and territory, 2021

I–22. Very low birthweight births, by race and Hispanic origin of

mother: United States, each state and territory, 2021

I–23. Twin, triplet, or higher-order multiple births, by state:

United States and each state, 2019–2021

I–24. Abnormal conditions of the newborn, by age and race and

Hispanic origin of mother: United States, 2021

I–25. Congenital anomalies of the newborn, by age of mother:

United States, 2021

12 National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023

Table 1. Births and birth rates: United States, 2010–2021, and by race and Hispanic origin: United States, 2016–2021

[Birth rates are births per 1,000 population in specified group. Fertility rates are births per 1,000 women aged 15–44 in specified group. Populations based on counts

enumerated as of April 1 for census year and estimated as of July 1 for all other years]

Race and Hispanic origin and year Number Birth rate Fertility rate

All races and origins

2021. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,664,292 11.0 56.3

2020. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,613,647 10.9 55.7

2019. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,747,540 11.4 58.3

2018. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,791,712 11.6 59.1

2017. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,855,500 11.8 60.3

2016. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,945,875 12.2 62.0

2015. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,978,497 12.4 62.5

2014. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,988,076 12.5 62.9

2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,932,181 12.4 62.5

2012. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,952,841 12.6 63.0

2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,953,590 12.7 63.2

2010. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,999,386 13.0 64.1

Non-Hispanic, single race

White:

2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,887,656 9.7 54.4

2020 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,843,432 9.4 53.0

2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,915,912 9.8 55.3

2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,956,413 10.0 56.3

2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,992,461 10.2 57.2

2016 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,056,332 10.5 58.8

Black:

2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 517,889 12.5 57.4

2020 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 529,811 12.8 58.9

2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 548,075 13.4 61.4

2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 552,029 13.6 62.0

2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 560,715 13.9 63.1

2016 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 558,622 14.0 63.3

American Indian or Alaska Native:

2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26,124 10.8 50.8

2020 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26,813 11.1 52.6

2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28,450 11.9 56.2

2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29,092 12.2 57.7

2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29,957 12.6 59.5

2016 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31,452 13.3 62.7

Asian:

2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213,813 11.2 49.6

2020 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219,068 11.6 50.4

2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238,769 13.0 55.3

2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240,798 13.2 55.6

2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249,250 13.8 58.0

2016 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254,471 14.6 61.1

Native Hawaiian or Other Pacific Islander:

2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,531 15.8 71.5

2020 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,626 16.1 72.5

2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,770 17.0 74.9

2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,476 16.6 73.0

2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,426 16.7 72.8

2016 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,342 16.8 72.9

Hispanic

2021. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 885,916 14.1 63.4

2020. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 866,713 14.0 62.9

2019. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 886,467 14.6 65.3

2018. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 886,210 14.8 65.9

2017. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 898,764 15.2 67.6

2016. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 918,447 16.0 70.6

Includes births to race and origin groups not shown separately, such as Hispanic single-race White, Hispanic single-race Black, and non-Hispanic multiple-race women, and births with origin

not stated.

Race and Hispanic origin are reported separately on birth certificates; people of Hispanic origin may be of any race. In this table, non-Hispanic women are classified by race. Race categories

are consistent with the 1997 Office of Management and Budget standards; see Technical Notes in this report. Single race is defined as only one race reported on the birth certificate.

Includes all people of Hispanic origin of any race; see Technical Notes.

NOTE: Rates for 2020 have been revised and may differ from those published in "Births: Final Data for 2020"; see Technical Notes.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality.

National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023 13

Table 2. Birth rates, by age of mother: United States, 2010–2021, and by age and race and Hispanic origin of mother:

United States, 2016–2021

[Total fertility rates are sums of birth rates for 5-year age groups multiplied by 5. Birth rates are births per 1,000 women in specified group. Populations based on

counts enumerated as of April 1 for census years and estimated as of July 1 for all other years]

Race and Hispanic origin

and year

Total fertility

rate

Age of mother

10–14

15–19

20–24 25–29 30–34 35–39 40–44 45–49

Total 15–17 18–19

All races and origins

2021. . . . . . . . . . . . . . . . . . . . . . . 1,664.0 0.2 13.9 5.6 26.6 61.5 93.0 97.6 53.7 12.0 0.9

2020. . . . . . . . . . . . . . . . . . . . . . . 1,641.5 0.2 15.0 6.1 28.2 63.3 90.9 94.9 51.3 11.8 0.9

2019. . . . . . . . . . . . . . . . . . . . . . . 1,706.0 0.2 16.7 6.7 31.1 66.6 93.7 98.3 52.8 12.0 0.9

2018. . . . . . . . . . . . . . . . . . . . . . . 1,729.5 0.2 17.4 7.2 32.3 68.0 95.3 99.7 52.6 11.8 0.9

2017. . . . . . . . . . . . . . . . . . . . . . . 1,765.5 0.2 18.8 7.9 35.1 71.0 98.0 100.3 52.3 11.6 0.9

2016. . . . . . . . . . . . . . . . . . . . . . . 1,820.5 0.2 20.3 8.8 37.5 73.8 102.1 102.7 52.7 11.4 0.9

2015. . . . . . . . . . . . . . . . . . . . . . . 1,843.5 0.2 22.3 9.9 40.7 76.8 104.3 101.5 51.8 11.0 0.8

2014. . . . . . . . . . . . . . . . . . . . . . . 1,862.5 0.3 24.2 10.9 43.8 79.0 105.8 100.8 51.0 10.6 0.8

2013. . . . . . . . . . . . . . . . . . . . . . . 1,857.5 0.3 26.5 12.3 47.1 80.7 105.5 98.0 49.3 10.4 0.8

2012. . . . . . . . . . . . . . . . . . . . . . . 1,880.5 0.4 29.4 14.1 51.4 83.1 106.5 97.3 48.3 10.4 0.7

2011. . . . . . . . . . . . . . . . . . . . . . . 1,894.5 0.4 31.3 15.4 54.1 85.3 107.2 96.5 47.2 10.3 0.7

2010. . . . . . . . . . . . . . . . . . . . . . . 1,931.0 0.4 34.2 17.3 58.2 90.0 108.3 96.5 45.9 10.2 0.7

Non-Hispanic, single race

White:

2021 . . . . . . . . . . . . . . . . . . . . . 1,598.5 0.1 9.4 3.2 18.7 52.0 91.8 102.3 52.8 10.5 0.8

2020 . . . . . . . . . . . . . . . . . . . . . 1,551.0 0.1 10.1 3.4 19.9 53.1 88.2 98.2 49.7 10.1 0.7

2019 . . . . . . . . . . . . . . . . . . . . . 1,610.5 0.1 11.4 3.8 22.3 56.1 90.8 101.5 51.1 10.3 0.8

2018 . . . . . . . . . . . . . . . . . . . . . 1,640.0 0.1 12.1 4.1 23.6 57.8 92.9 103.1 51.1 10.2 0.7

2017 . . . . . . . . . . . . . . . . . . . . . 1,666.5 0.1 13.2 4.6 26.0 59.8 95.3 103.7 50.6 9.9 0.7

2016 . . . . . . . . . . . . . . . . . . . . . 1,719.0 0.1 14.3 5.2 27.7 62.4 99.3 106.2 51.1 9.7 0.7

Black:

2021 . . . . . . . . . . . . . . . . . . . . . 1,675.0 0.3 21.8 9.3 40.6 79.1 91.9 79.7 48.2 12.8 1.2

2020 . . . . . . . . . . . . . . . . . . . . . 1,713.5 0.3 23.7 10.5 42.7 84.0 93.4 80.4 47.1 12.7 1.1

2019 . . . . . . . . . . . . . . . . . . . . . 1,775.5 0.4 25.8 11.1 46.4 88.3 96.4 82.9 47.6 12.6 1.1

2018 . . . . . . . . . . . . . . . . . . . . . 1,792.0 0.4 26.3 11.9 46.9 90.0 97.1 84.1 47.1 12.3 1.1

2017 . . . . . . . . . . . . . . . . . . . . . 1,824.5 0.4 27.5 12.5 49.8 94.2 99.5 84.5 46.1 11.7 1.0

2016 . . . . . . . . . . . . . . . . . . . . . 1,832.5 0.5 29.3 13.7 52.5 95.8 100.8 83.0 45.0 11.1 1.0

American Indian or Alaska Native:

2021 . . . . . . . . . . . . . . . . . . . . . 1,477.0 0.3 24.2 11.3 44.1 78.7 81.9 66.1 36.2 7.5 0.5

2020 . . . . . . . . . . . . . . . . . . . . . 1,520.5 0.4 25.2 11.0 46.3 82.2 83.2 68.8 35.9 8.1 0.3

2019 . . . . . . . . . . . . . . . . . . . . . 1,611.5 0.3 29.2 13.5 51.8 86.7 89.1 72.0 36.6 8.0 0.4

2018 . . . . . . . . . . . . . . . . . . . . . 1,650.5 0.2 29.7 13.5 52.9 87.7 94.4 73.2 36.1 8.3 0.5

2017 . . . . . . . . . . . . . . . . . . . . . 1,702.0 0.5 32.9 15.7 58.1 93.6 96.4 72.1 36.3 8.2 0.4

2016 . . . . . . . . . . . . . . . . . . . . . 1,794.5 0.5 35.1 16.8 62.6 97.2 103.4 77.1 37.1 8.2 0.3

Asian:

2021 . . . . . . . . . . . . . . . . . . . . . 1,351.5 * 2.0 0.7 3.8 17.7 60.4 105.0 67.9 15.8 1.5

2020 . . . . . . . . . . . . . . . . . . . . . 1,379.0 * 2.2 0.8 4.3 20.4 63.9 105.5 66.6 15.5 1.7

2019 . . . . . . . . . . . . . . . . . . . . . 1,511.0 * 2.7 0.9 5.2 23.1 71.4 115.6 71.0 16.5 1.9

2018 . . . . . . . . . . . . . . . . . . . . . 1,525.0 * 2.8 1.0 5.4 24.1 73.0 116.5 70.7 16.1 1.8

2017 . . . . . . . . . . . . . . . . . . . . . 1,597.0 * 3.3 1.1 6.5 26.6 79.6 120.1 71.5 16.5 1.8

2016 . . . . . . . . . . . . . . . . . . . . . 1,690.5 * 3.9 1.4 7.5 28.9 87.0 127.4 72.8 16.4 1.7

Native Hawaiian or

Other Pacific Islander:

2021 . . . . . . . . . . . . . . . . . . . . . 2,131.0 * 21.9 7.3 44.6 116.1 124.7 95.8 51.2 15.0 1.3

2020 . . . . . . . . . . . . . . . . . . . . . 2,134.5 * 22.2 7.7 44.5 120.5 125.3 91.6 51.5 14.6 *

2019 . . . . . . . . . . . . . . . . . . . . . 2,178.0 * 26.2 7.7 53.8 121.4 123.5 95.3 54.1 14.2 *

2018 . . . . . . . . . . . . . . . . . . . . .

2,106.5 * 26.5 8.2 53.7 118.5 118.9 91.9 49.2 15.4 *

2017 . . . . . . . . . . . . . . . . . . . . . 2,085.5 * 25.5 8.7 50.6 113.3 115.7 94.0 54.6 13.1 *

2016 . . . . . . . . . . . . . . . . . . . . . 2,076.5 * 28.6 11.0 55.3 109.5 115.5 96.0 49.9 14.7 *

See footnotes at end of table.

14 National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023

Table 2. Birth rates, by age of mother: United States, 2010–2021, and by age and race and Hispanic origin of mother:

United States, 2016–2021—Con.

[Total fertility rates are sums of birth rates for 5-year age groups multiplied by 5. Birth rates are births per 1,000 women in specified group. Populations based on

counts enumerated as of April 1 for census years and estimated as of July 1 for all other years]

Race and Hispanic origin

and year

Total fertility

rate

Age of mother

10–14

15–19

20–24 25–29 30–34 35–39 40–44 45–49

Total 15–17 18–19

Hispanic

2021. . . . . . . . . . . . . . . . . . . . . . . 1,899.0 0.3 21.1 9.3 39.8 82.3 108.3 97.5 54.9 14.4 1.0

2020. . . . . . . . . . . . . . . . . . . . . . . 1,879.5 0.3 23.0 10.3 42.5 83.8 105.8 94.4 53.4 14.2 1.0

2019. . . . . . . . . . . . . . . . . . . . . . . 1,940.0 0.3 25.3 11.5 46.2 88.0 108.0 96.3 54.6 14.5 1.0

2018. . . . . . . . . . . . . . . . . . . . . . . 1,959.0 0.3 26.7 12.4 48.5 89.3 108.9 96.6 54.5 14.5 1.0

2017. . . . . . . . . . . . . . . . . . . . . . . 2,006.5 0.3 28.9 13.6 52.7 93.8 111.8 96.4 54.6 14.5 1.0

2016. . . . . . . . . . . . . . . . . . . . . . . 2,092.5 0.4 31.9 15.6 57.3 98.4 117.4 99.2 55.8 14.5 0.9

* Estimate does not meet National Center for Health Statistics standards of reliability.

Birth rates computed by relating births to women aged 45 and over to women aged 45–49; see Technical Notes in this report.

Includes births to race and origin groups not shown separately, such as Hispanic single-race White, Hispanic single-race Black, and non-Hispanic multiple-race women, and births with origin

not stated.

Race and Hispanic origin are reported separately on birth certificates; people of Hispanic origin may be of any race. In this table, non-Hispanic women are classified by race. Race categories

are consistent with the 1997 Office of Management and Budget standards; see Technical Notes. Single race is defined as only one race reported on the birth certificate.

Includes all people of Hispanic origin of any race; see Technical Notes.

NOTE: Rates for 2020 have been revised and may differ from those published in "Births: Final Data for 2020"; see Technical Notes.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality.

National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023 15

Table 3. Births, by age of mother, live-birth order, and race and Hispanic origin of mother: United States, 2021

[Live-birth order refers to number of children born alive to mother]

Race and Hispanic origin of

mother and live-birth order All ages Under 15

15–19

20–24 25–29 30–34 35–39 40–44 45–49 50–54Total 15 16 17 18 19

All races and origins

Total . . . . . . . . . . . . . . . . . . . . . . . 3,664,292 1,877 146,973 4,471 10,298 20,773 40,169 71,262 648,484 1,023,989 1,115,055 592,179 126,332 8,362 1,041

1st child . . . . . . . . . . . . . . . . . . 1,392,468 1,840 124,844 4,344 9,782 18,949 34,552 57,217 356,752 394,903 348,964 136,628 25,996 2,240 301

2nd child . . . . . . . . . . . . . . . . . 1,172,716 27 19,459 119 484 1,694 5,062 12,100 202,388 339,249 378,183 195,552 35,409 2,146 303

3rd child . . . . . . . . . . . . . . . . . . 615,617 5 2,110 1 14 82 433 1,580 66,032 178,299 213,749 128,383 25,493 1,373 173

4th child . . . . . . . . . . . . . . . . . . 271,216 – 210 1 1 3 30 175 16,744 71,728 98,956 66,111 16,444 914 109

5th child . . . . . . . . . . . . . . . . . . 108,719 – 22 – 1 – 6 15 3,608 24,243 40,294 30,792 9,100 592 68

6th child . . . . . . . . . . . . . . . . . . 46,810 – 5 – – 1 2 2 719 8,162 17,394 15,041 5,110 342 37

7th child . . . . . . . . . . . . . . . . . . 21,343 – 2 – – – 1 1 173 2,614 7,726 7,736 2,872 206 14

8th child and over . . . . . . . . . . . 23,256 – 5 – – – – 5 233 1,497 6,033 9,609 5,358 492 29

Not stated . . . . . . . . . . . . . . . . . 12,147 5 316 6 16 44 83 167 1,835 3,294 3,756 2,327 550 57 7

Non-Hispanic, single race

White . . . . . . . . . . . . . . . . . . . . . . 1,887,656 449 50,203 1,177 2,762 6,191 13,672 26,401 286,140 532,001 633,212 321,036 60,388 3,803 424

1st child . . . . . . . . . . . . . . . . . . 740,517 441 43,228 1,150 2,643 5,742 12,009 21,684 161,653 226,581 213,600 79,802 13,957 1,127 128

2nd child . . . . . . . . . . . . . . . . . 632,451 5 6,210 22 112 411 1,510 4,155 88,803 177,571 226,812 113,212 18,602 1,105 131

3rd child . . . . . . . . . . . . . . . . . . 303,919 1 595 – 1 21 105 468 27,184 82,377 113,862 67,927 11,360 540 73

4th child . . . . . . . . . . . . . . . . . . 120,071 – 56 1 – 3 11 41 6,242 30,367 46,137 30,508 6,407 315 39

5th child . . . . . . . . . . . . . . . . . . 44,426 – 6 – 1 – 2 3 1,162 9,386 17,383 12,943 3,336 187 23

6th child . . . . . . . . . . . . . . . . . . 19,293 – 3 – – 1 1 1 203 2,920 7,589 6,517 1,933 115 13

7th child . . . . . . . . . . . . . . . . . . 9,227 – – – – – – – 53 819 3,397 3,638 1,236 80 4

8th child and over . . . . . . . . . . . 12,162 – – – – – – – 105 527 2,615 5,306 3,295 303 11

Not stated . . . . . . . . . . . . . . . . . 5,590 2 105 4 5 13 34 49 735 1,453 1,817 1,183 262 31 2

Black . . . . . . . . . . . . . . . . . . . . . . 517,889 506 31,231 1,107 2,341 4,547 8,498 14,738 117,698 148,309 130,788 70,073 17,802 1,283 199

1st child . . . . . . . . . . . . . . . . . . 181,525 493 26,253 1,069 2,209 4,113 7,208 11,654 63,951 45,885 28,683 12,696 3,153 345 66

2nd child . . . . . . . . . . . . . . . . . 147,847 11 4,291 38 123 406 1,136 2,588 34,955 47,369 38,072 18,562 4,229 293 65

3rd child . . . . . . . . . . . . . . . . . . 94,078 1 541 – 5 20 125 391 12,970 29,833 30,023 16,701 3,762 217 30

4th child . . . . . . . . . . . . . . . . . . 48,907 – 70 – – – 9 61 4,122 14,574 17,127 10,160 2,710 135 9

5th child . . . . . . . . . . . . . . . . . . 22,773 – 6 – – – 1 5 1,047 6,257 8,468 5,314 1,569 103 9

6th child . . . . . . . . . . . . . . . . . . 10,619 – – – – – – – 235 2,422 4,119 2,843 933 60 7

7th child . . . . . . . . . . . . . . . . . . 5,085 – – – – – – – 63 928 2,010 1,517 525 40 2

8th child and over . . . . . . . . . . . 5,187 – 1 – – – – 1 49 497 1,736 1,965 844 84 11

Not stated . . . . . . . . . . . . . . . . . 1,868 1 69 – 4 8 19 38 306 544 550 315 77 6 –

American Indian or

Alaska Native

. . . . . . . . . . . . . . . 26,124 26 2,117 88 160 353 572 944 6,939 7,537 5,987 2,925 562 25 6

1st child . . . . . . . . . . . . . . . . . . 8,051 26 1,753 84 153 308 487 721 3,247 1,727 870 362 65 1 –

2nd child . . . . . . . . . . . . . . . . . 7,067 – 323 4 6 38 82 193 2,363 2,352 1,398 543 84 2 2

3rd child . . . . . . . . . . . . . . . . . . 4,737 – 26 – – 3 2 21 934 1,767 1,318 574 110 7 1

4th child . . . . . . . . . . . . . . . . . . 2,827 – 2 – – – – 2 279 941 1,023 487 90 5 –

5th child . . . . . . . . . . . . . . . . . . 1,627 – 1 – – – – 1 65 446 655 371 85 2 2

6th child . . . . . . . . . . . . . . . . . . 822 – – – – – – – 11 187 341 238 43 1 1

7th child . . . . . . . . . . . . . . . . . . 462 – – – – – – – 4 53 213 153 35 4 –

8th child and over . . . . . . . . . . . 399 – – – – – – – 4 20 137 188 47 3 –

Not stated . . . . . . . . . . . . . . . . . 132 – 12 – 1 4 1 6 32 44 32 9 3 – –

See footnotes at end of table.

16 National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023

Table 3. Births, by age of mother, live-birth order, and race and Hispanic origin of mother: United States, 2021—Con.

[Live-birth order refers to number of children born alive to mother]

Race and Hispanic origin of

mother and live-birth order All ages Under 15

15–19

20–24 25–29 30–34 35–39 40–44 45–49 50–54Total 15 16 17 18 19

Non-Hispanic, single race

—Con.

Asian . . . . . . . . . . . . . . . . . . . . . . 213,813 12 971 17 57 130 232 535 10,166 42,848 88,988 57,569 12,218 907 134

1st child . . . . . . . . . . . . . . . . . . 94,850 12 828 16 54 118 200 440 6,517 24,602 41,526 17,627 3,375 311 52

2nd child . . . . . . . . . . . . . . . . . 79,940 – 118 1 3 11 25 78 2,677 12,633 34,135 25,497 4,572 270 38

3rd child . . . . . . . . . . . . . . . . . . 25,702 – 19 – – 1 6 12 711 3,732 8,945 9,573 2,540 161 21

4th child . . . . . . . . . . . . . . . . . . 8,250 – 2 – – – – 2 177 1,217 2,719 3,029 1,011 81 14

5th child . . . . . . . . . . . . . . . . . . 2,643 – – – – – – – 39 350 861 964 382 43 4

6th child . . . . . . . . . . . . . . . . . . 966 – – – – – – – 8 105 284 388 157 22 2

7th child . . . . . . . . . . . . . . . . . . 363 – – – – – – – 1 30 112 145 68 7 –

8th child and over . . . . . . . . . . . 363 – – – – – – – 1 28 111 137 74 10 2

Not stated . . . . . . . . . . . . . . . . . 736 – 4 – – – 1 3 35 151 295 209 39 2 1

Native Hawaiian or

Other Pacific Islander . . . . . . . . . 9,531 5 447 4 28 59 106 250 2,337 2,810 2,383 1,218 306 22 3

1st child . . . . . . . . . . . . . . . . . . 2,644 5 352 4 26 50 86 186 1,046 667 385 153 32 3 1

2nd child . . . . . . . . . . . . . . . . . 2,430 – 83 – 2 9 18 54 774 810 499 219 41 3 1

3rd child . . . . . . . . . . . . . . . . . . 1,685 – 8 – – – 2 6 334 598 504 190 48 3 –

4th child . . . . . . . . . . . . . . . . . . 1,190 – – – – – – – 107 396 416 217 50

3 1

5th child . . . . . . . . . . . . . . . . . . 669 – – – – – – – 27 179 259 159 42 3 –

6th child . . . . . . . . . . . . . . . . . . 395 – – – – – – – 10 84 155 110 35 1 –

7th child . . . . . . . . . . . . . . . . . . 209 – 1 – – – – 1 2 24 88 71 22 1 –

8th child and over . . . . . . . . . . . 187 – – – – – – – – 14 49 85 34 5 –

Not stated . . . . . . . . . . . . . . . . . 122 – 3 – – – – 3 37 38 28 14 2 – –

Hispanic

Total . . . . . . . . . . . . . . . . . . . . . . . 885,916 770 55,263 1,851 4,447 8,496 15,252 25,217 199,773 256,844 220,530 120,329 30,464 1,803 140

1st child . . . . . . . . . . . . . . . . . . 315,479 754 46,722 1,797 4,223 7,705 12,997 20,000 106,467 83,074 52,933 20,783 4,367 343 36

2nd child . . . . . . . . . . . . . . . . . 266,357 11 7,542 51 213 743 2,050 4,485 65,058 87,926 67,125 31,637 6,648 369 41

3rd child . . . . . . . . . . . . . . . . . . 166,123 3 828 1 7 34 174 612 21,238 53,943 53,184 29,776 6,800 333 18

4th child . . . . . . . . . . . . . . . . . . 80,781 – 73 – 1 – 8 64 5,134 21,554 28,350 19,763 5,596 292 19

5th child . . . . . . . . . . . . . . . . . . 32,710 – 8 – – – 3 5 1,103 6,671 11,273 10,051 3,383 209 12

6th child . . . . . . . . . . . . . . . . . . 12,940 – 2 – – – 1 1 220 2,085 4,272 4,420 1,815 118 8

7th child . . . . . . . . . . . . . . . . . . 5,219 – 1 – – – 1 – 47 647 1,614 1,964 877 67 2

8th child and over . . . . . . . . . . . 4,172 – 4 – – – – 4 63 357 1,193 1,600 888 66 1

Not stated . . . . . . . . . . . . . . . . . 2,135 2 83 2 3 14 18 46 443 587 586 335 90 6 3

– Quantity zero.

Includes births to race and origin groups not shown separately, such as Hispanic single-race White, Hispanic single-race Black, and non-Hispanic multiple-race women, and births with origin not stated.

Race and Hispanic origin are reported separately on birth certificates; people of Hispanic origin may be of any race. In this table, non-Hispanic women are classified by race. Race categories are consistent with the 1997 Office of Management and

Budget standards; see Technical Notes in this report. Single race is defined as only one race reported on the birth certificate.

Includes all people of Hispanic origin of any race; see Technical Notes.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality.

National Vital Statistics Reports, Vol. 72, No. 1, January 31, 2023 17

Table 4. Births, by age of mother, live-birth order, and Hispanic origin of mother: United States, 2021

[Live-birth order refers to number of children born alive to mother. Includes births with stated origin of mother only]

Origin of mother and

live-birth order All ages Under 15