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Teen Births Rise for Second Year

Overall Births Reached Record High in 2007

By Salynn Boyles
WebMD Health News

Reviewed By Louise Chang, MD

Dec. 21, 2009 -- For the second year in a row, the birth rate among teens increased in 2007, raising concerns that efforts to curb teen pregnancies are not working as well as they once did.

Teen births increased 5% between 2005 and 2007, following a 34% drop between 1991 and 2005.

In 2007 -- the last year for which figures are available -- the birth rate among teens rose by about 1%, with 42.5 babies born for every 1,000 teens aged 15 to 19.

The overall birth rate also increased by 1% between 2006 and 2007, with a record 4.3 million babies born in the U.S.

The record number of births is the result of the growing population and is not indicative of a new baby boom, says CDC chief of reproductive statistics Stephanie J. Ventura, MA.

"The average woman is still having two children," she tells WebMD. "That hasn't really changed much in recent years."

Other Major Birth Trends

Among the other trends highlighted in the new report by the CDC's National Center for Health Statistics:

  • In 2007, there were 69.5 births for every 1,000 women of childbearing age in the United States.
  • Nearly 1 in 3 babies -- 31.8% -- were delivered by cesarean section, up 2% from the previous year.
  • The percentage of births to unmarried women increased from 38.5% in 2006 to 39.7% in 2007.
  • The rate of twin and higher-order multiple births remained unchanged between 2005 and 2006.
  • The infant mortality rate in 2007 did not change significantly from the 2006 rate of 6.77 deaths per 1,000 live births. But this rate is still much higher than in most other developed nations.
  • Life expectancy for a child born in 2007 reached a record high of 77.9 years.

The report appears in the January issue of the journal Pediatrics.

Teen Births a 'Cause for Concern'

Although the rate of increase in births among teenagers was similar to that seen in older women, there is cause for concern, Ventura says.

The 14-year decline in teen birth rates began to slow early in the decade.

At its peak in 1991, there were close to 62 births per 1,000 teens. By 2005, that number had declined to 40.5.

"We certainly don't want to see this upward trend continue," she says. "Even though we have made a lot of progress in this area, we still have a long way to go. The birth rate among teens in the U.S. is still much higher than in most other developed countries."

A recent analysis of data from a national survey of young people conducted by CDC showed declines in sexual activity and improvements in contraceptive use among teens between 1991 and 2003, with no significant changes in these behaviors since.

Researcher John Santelli, MD, MPH, who chairs Columbia University's Clinical Population and Family Health department, led the team that conducted the analysis.

He tells WebMD the 14-year decline in births among teens was largely driven by a big increase in condom use resulting from public health campaigns warning about the risks of HIV and other sexually transmitted diseases posed by unprotected sex.

He blames the increase in births on the shift away from public funding for AIDS education in favor or "abstinence-only" programs starting early in the decade.

"We have raised a generation of young people who don't have basic information about contraception," he says.

Record Number of C-Sections

The C-section rate in the U.S. is now at its highest, rising in 2007 for the eleventh straight year.

This represents a more than 50% increase in surgical deliveries in the past decade.

C-section rates increased for most age groups and racial and ethnic groups in every state in the U.S., Ventura says.

One clear reason for this is the trend away from vaginal birth after cesarean delivery, known as VBAC.

Many smaller hospitals have banned VBACs because of malpractice concerns and regulations that require a surgical team to be in place to perform an emergency C-section, if needed.

But many experts believe the steady increase in C-section deliveries has been largely driven by issues that have little to do with the health of the mother or baby, such as doctor convenience and patient preference.

C-section delivery is the most common surgery performed in the U.S.

National Center for Health Statistics statistician Fay Menacker, DrPH, says research is needed to identify the causes of the increase in surgical deliveries and their impact on outcomes.

"This is major abdominal surgery and it is really important to look at the risks and benefits, both long and short term, for both the mother and the infant," she tells WebMD.

SOURCES: Heron, M. Pediatrics, January 2010; vol 125: pp 4-15.

Stephanie J. Ventura, MA, chief of the reproductive statistics branch, CDC.

Fay Menacker, DrPH, statistician, National Center for Health Statistics.

John Santelli, department chairman and professor of clinical population and family health, Mailman School of Public Health and professor of clinical pediatrics, College of Physicians and Surgeons, Columbia University.

News release, American Academy of Pediatrics.

Santelli, S.J., Journal of Adolescent Health, July 2009; vol 45: pp 25-32.

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