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Birth rate reaches record low as premature deliveries rise

Analysis by Dr. Joseph Mercola Fact Checked

premature birth

Story at-a-glance -

  • Information from the Centers for Disease Control and Prevention's National Vital Statistics System reveals the overall number of new births is down 2% in 2018 compared to 2017; the birth rate for women from 20 to 24 years has dropped an average of 4% each year since 2007
  • Some attribute this trend to economic instability while others were surprised as they expected the economic growth in past years to spark stabilization or growth in the number of babies born. The answer may be related to multiple factors, including exposure to environmental toxins and falling vitamin D levels
  • The rate of teen births is also down 7% in 2018 as compared to 2017, 60% since 2007 and 72% since 1991; at the same time 41% of high school students are sexually active and of those only 59% use a condom, 19% use birth control pills and 1.6% used an IUD or implant to prevent pregnancy
  • The number of premature births is also rising, which may lead to loss of vision, infection, respiratory distress syndrome or death. Evidence supports a link between low vitamin D levels in the mother and premature birth, pre-eclampsia and gestational diabetes; protect your health and your pregnancy — request a vitamin D test from your health care provider

The question of whether to start a family or not is one that weighs on the minds of many people. However, like all big decisions there is a range from those who have been positive they wanted children from the time they were teens to those who question whether following in their parents’ footsteps is the right decision for them.

You may have read stories of infertile men and women who are characterized as “desperate for children,”1 when in fact they are experiencing what generations before thought was a normal and natural desire.

In other words, while many agree human beings are programmed to desire sex,2 not all believe sex must lead to procreation. However, without children, the human race will slowly die out and the Earth will be taken over by plants and animals that are continuing in nature’s plan of procreation.

Having children is not a decision to be made lightly. If the conclusions of the most recent Centers for Disease Control and Prevention study3 on birth rates is to be believed, it appears there are more people purposefully deciding to live their lives without the pitter patter of little feet.

Low birth rate means generation may not replace itself

One of the goals of the CDC's National Vital Statistics System4 is to track vital events, including births, deaths, marriages, divorces and fetal deaths. Working with state partners, the NVSS analyzes the data and publishes it electronically.5

In their most recent analysis, they provide provisional data for 2018 on the number of births and preterm births, as well as prenatal care, cesarean delivery and low birth weight births. According to the CDC,6 the data is based on 99.73% of recorded births for 2018. So, while the study is provisional, the majority of records have been received.

The researchers compared the data7 against 2017 and previous years, finding significant differences. In comparison to 2017, the researchers found the number of births in 2018 was down 2% in total, which is the fourth year the total number of births declined, and the lowest number of births recorded since 1986.

According to the report the general fertility rate (GFR) was 59.0 births per 1,000 women from 15 to 44 years.8 There are three commonly used indicators when researchers discuss birth rate and fertility.9

The GFR is the annual rate women are presently having children, the completed fertility is the number of children they ultimately have and the total fertility rate (TFR) is the hypothetical number they might have based on present fertility patterns. For the first time in two decades, the GFR and the TFR indicate fertility has hit a record low.10

A TFR of 2.1 children per woman of childbearing age is called replacement level fertility as it represents the average number of children needed to sustain a population and replace a generation.11 According to the CDC report the TFR in 2018 was 1,728 births per 1,000 women, which fell 2% from the rate in 2017.12

The news came as a surprise to those who track these trends as they expected the economic growth of the past eight years would have sparked stabilization or even a rise in the number of babies born in 2018.13

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Fewer babies and more premature births

Women from 20 to 24 years had a birth rate of 67.9 births per 1,000 women, down 4% since 2017, another record low. Since 2007, the rate for this age group has also declined an average of 4% each year. The number in the following two age brackets also declined, 3% in those 25 to 29 and 1% in those 30 to 34 years.14

However, the provisional data for women 35 to 39 and 40 to 44 did rise between 2017 and 2018. In general, the CDC found the rate from 40 to 44 years has continued to increase an average of 3% each year since 1982.15

The total number of women receiving first trimester prenatal care remained relatively stable from 77.5% in 2018 and 77.3 percent in 2017. The difference between cesarean deliveries from 2018 to 2017 varied only by 0.1%. However, the preterm birth rate rose for the fourth year in a row, having risen 5% since 2014.16

The overall rise was found to be an increase in late preterm birth, delivered 34 to 36 weeks gestation, while early preterm — those born before 34 weeks gestation — declined. The CDC data also identified the number of births by state. California had the highest number of births in 2018, followed closely by Texas, which also had the lowest percentage of first trimester prenatal care.17

Fewer teen births may be difficult to explain

According to the World Health Organization,18 there are approximately 16 million girls from 15 to 19 years and 2.5 million under 16 years who have children every year in developing countries. Complications related to pregnancy and birth are the leading cause of death for girls 15 to 19 years old globally.

But in the U.S., according to the CDC report, the birth rate for American teens in 2018 had also fallen 7% from 2017, which represented another record low for this age group. The report found the birth rate in teens has dropped nearly 8% each year since 2007, 60% since 2007 and 72% since 1991.19

If you look at the number of teens who are having sex, the Resource Center for Adolescent Pregnancy Prevention may show some light on one reason teen pregnancy rates are slipping.20 The center reports data from 2015 showed 41% of high school students reported sexual intercourse and 30% reported being sexually active; 46% of high school seniors were sexually active and 21% who had intercourse in the past three months also consumed alcohol or drugs beforehand.

But, compared to numbers in 1991, when statistic collection on teen sexual behavior began, those numbers have fallen quite a bit. Using data from the Guttmacher Institute and the CDC,21,22,23 the center reports:24

  • Between 1991 and 2015 the number teens who ever had sex declined from 59% to 41%
  • The percent of adolescents having sex at earlier ages decreased since 1988
  • Reported contraceptive use has increased since the 1990s
  • Many adolescents are reporting engaging in sexual behaviors other than vaginal sex

As suggested in the report, these factors together certainly may be contributing to lower teen pregnancy and birth rates.

The center also found 59% of sexually active students used a condom. However, condom use was higher in ninth graders than it was in high school seniors. Only 19% used birth control pills and 1.6% used an IUD or implant to prevent pregnancy.25

According to the CDC,26 teen births may also be related to the number of teens who use the least effective types of birth control. The CDC says condoms and birth control pills are less effective for preventing pregnancy when they are not used consistently or correctly.

In combination with the 21% of teens under the influence drugs27 and alcohol28 prior to sex, birth control methods may not be used correctly, or at all. In other words, while there likely is some overlap, these statistics indicate there is a percentage of sexually active high school students who are not using birth control in one of the most fertile times of their lives — which could point to other contributing factors for low fertility rates that have nothing to do with sexual activity.

Is it environmental toxins, vitamin D or economics?

Although many point to a correlation between declining birth rates and the financial stability of people in their 20s and 30s following the 2008 economic crash as a reason for delaying childbearing,29,30 declining fertility may also be significantly affected by low vitamin D levels and rising levels of environmental toxins.

Researchers from other developed countries have also found a decline in birth rate. In Canada,31 the TFR in 2017 was 1,496.1 births per 1,000 people from 1,581.8 in 2014. In England and Wales32 the rate in 2017 declined for five straight years from 1.94 in 2012 to 1.76 in 2017.

As birth rates are declining, other factors affecting fertility are also changing, such as the rising amounts of environmental toxins being dumped in the water and food supply and falling levels of vitamin D

In an effort to stem exposure to growing children, the American Academy of Pediatrics33 has asked parents to limit their children's exposure to dangerous plastic chemicals from food packaging and chemical food additives, warning these can damage children's health for years. In their policy statement they write:34

“Today, more than 10,000 chemicals are allowed to be added to food and food contact materials in the United States, either directly or indirectly, under the 1958 Food Additives Amendment to the 1938 Federal Food, Drug, and Cosmetic Act (FFDCA) (public law number 85-929).

Many of these were grandfathered in for use by the federal government before the 1958 amendment, and an estimated 1,000 chemicals are used under a “generally recognized as safe” (GRAS) designation process without US Food and Drug Administration (FDA) approval.”

Nearly 80% of the 4,000 additives intentionally added to food lack enough information to determine how much could be safely eaten and only 6.7% had reproductive toxicology data.35 In other words, many of the additives intentionally put into the food supply don't have enough information about how they affect the reproductive capacity of the children and adults ingesting them.

Additionally, more young teens and millennials in prime reproductive years are spending nearly 90% of their time indoors.36 Sensible sun exposure triggers the production of vitamin D in your body, which is linked to the prevention of a number of health conditions, including premature birth.37,38,39

Low vitamin D levels associated with premature birth

Premature birth increases the risk of your child having more health problems, including long-term health problems that can affect them their whole lives. According to the March of Dimes,40 10% of children are born prematurely in the U.S. each year.

Health problems associated with premature birth include an increased risk of infection, retinopathy of prematurity leading to loss of vision, necrotizing enterocolitis (destruction of the bowels by bacteria), respiratory distress syndrome and intraventricular hemorrhage (bleeding in the brain).41

Scientific evidence supports the link between low vitamin D levels in the mother and the increased risk for preterm premature birth.42,43,44,45,46 In one study47 involving 1,064 women, researchers analyzed specific vitamin D levels and found women with levels of 40 nanograms per milliliter (ng/mL) or higher had a 62% reduced risk compared to those who had levels below 20 ng/mL.

Even after adjusting for socioeconomic factors, the relationship remained.48 However, the implication of vitamin D deficiency during pregnancy goes even further. Pregnancy is a time of great physiological changes for the woman and her developing baby that has lifelong implications for both.

Vitamin D has a significant effect on these processes including preterm birth, pre-eclampsia, gestational diabetes and asthma in the child.49 Monitoring vitamin D levels should be a standard of care during pregnancy, but testing is not yet widespread.

You can request a vitamin D blood test from your health care provider or enroll in GrassrootsHealth’s Protect Our Children NOW! Project, which seeks to resolve vitamin D deficiency among pregnant women and children and raise global awareness about the health risks associated with vitamin D deficiency.

Protect your fertility and child’s future

Whether or not you decide to have children should be something you have the right to decide. You may improve your chances of protecting your fertility and the health of your future family by taking steps to reduce your exposure to environmental toxins and optimize your vitamin D levels. Discover several strategies that could reap big rewards over time in my articles:

+ Sources and References