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Declining Birth Rate Requires Fewer Diaper Changes Birth rates are decreasing both statewide and nationally. According to recently collected data from the Ohio Department of Health (ODH), Ohio births have fallen from 152,457 births in 1998 to 145,807 births in 2002, despite a slight increase in 2000. According to the U.S. Department of Health and Human Services, the U.S. birth rate in 2002 was at its lowest since the collection of national data began in 1909. Although the national 2002 birth rate declined only one percent from 2001, it represents a 17 percent decline since 1991. As the number of births decrease in Ohio and throughout the nation, the state’s rate of C-section births is growing. It increased almost three percent between 2001 and 2002, the largest increase in one year since 1997, according to ODH. Ohio follows the U.S. trend in this area as well, with 26.1 percent of children born in the United States in 2002 delivered by C-section—the largest number of Cesarean births on record. The number of first-time mothers undergoing C-sections also increased, going up seven percent from 2001 to 2002 in the United States. Contributing to the declining birth rate, fewer teenagers in Ohio and across America are having babies. Although the teenage birth rate remains high—in 2001, 22 percent of all women having babies were between the ages of 15 and 17—the number of teens having babies in Ohio continues to steadily decline. ODH reports that the teenage birth rate decreased more than two percent between 1999 and 2002. According to a National Vital Statistics Report published in 2002, Ohio remains below the national average of 25.3 births per 1,0001 females by almost three percent and has experienced a 24.6 percent decrease in teenage births since 1991. Between 2001 and 2002, the U.S. birth rate of women between the ages of 15 and 19 declined five percent, adding to the 28 percent drop since 1990. Teenage mothers also have an increased risk of delivering a low-birth-weight baby and increased chance of requiring a C-section delivery. Other factors with possible influence on the declining birth rate are a lower number of women of childbearing age as the baby boomers continue to age and a delay in when women choose to have children. Since 1970, the average age of first- time mothers has increased from 24.6 to 27.2. More women have also entered the workforce since 1970, and the number of women completing college has almost doubled as more women opt for additional educational opportunities and career choices.2 Though teen pregnancy rates are falling, they still represented almost 13 percent of all births in 1997 in the United States.3 This population, and women waiting until later in life to have children, also face the increased possibility of complications with childbirth, which may contribute to the increase in the number of Cesarean births. The number of overall C-sections also has been bolstered by fewer women trying to give birth vaginally after a previous C-section. In Ohio, the vaginal birth after C-section (VBAC) rate fell to 22.1 percent in 2002. Much of this decrease can be attributed to recommendations released by the American College of Obstetrics and Gynecology (ACOG)* in 1999 that only facilities equipped to respond to emergencies with a surgeon and anesthesiologist immediately available should offer VBAC.4 ACOG emphasized the associated risk involved with VBAC, including ruptured uterine walls and tears at the site of a previous C-section. Since these recommendations, the VBAC rate in Ohio has dropped 10 percent. As birth rates continue to fluctuate with time, hospitals learn to adapt with the changing trends, aided by technology and innovative services. Hospitals continue to equip themselves to serve pregnant women regardless of their age, needs or preferences.
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