The latest birth and fertility data are showing what I feared, the only age groups showing an increase in births were the 30-44 age groups. All groups under age 30 have been showing consistent and steady declines of late, with the 25-29 group finally succumbing after occasional blips upwards half a decade ago.
Lower under-18 births is ok, and that continues (and no it is not via more abortions, but less sex). But the shift towards having kids in your 30s as the norm continues apace. This is the modern Scandinavian model.
The plus side is that there’s more married childbearing in all racial groups. The unwed motherhood trend is going ever so slowly backwards, consistently. Black births to unwed mothers dropped while the total number of births increased, lowering their percentage of unwed births.
There’s a shift in the last decade where unwed mothers are finally seeing percentage and absolute decreases in their births, but married mothers are having more children.
Fewer women are having children, but the ones who get married first are having more third and up children than they used to five years ago. This is tricky though, because with women having all their kids in their 30s and 40s more, we can’t be sure we haven’t moved into a different fertility pattern of relative robustness for the women who can navigate waiting that long to marry and pop out 3 or more kids. It could be the latest dead cat bounce before we get yet another step down in higher order births.
For white non-Hispanics, a little over 600k births in 1992 were the third live baby or higher. This represented just under 1/4 of all births. Over 75% of all births for 1992 were first or second births.
The approximate distribution of the 600k higher birth orders (less than 100% due to rounding) was:
3rd order: 66%
4th order: 22%
5th order: 7%
6th order: 2.6%
7th order: 1%
8th order or higher: 1.1%
In 2014, there were over 50k fewer such births, a bit over 550k and that represented just OVER 25% of all births for that year.
The distribution of these 550k higher-order births over 20 years later was:
8th or higher: 2%
The total births for 1992 were around 2.5 million, while for 2014 they were around 2.1 million. So people were having fewer children overall, but the ones having many are chugging along pretty impressively. The problem is that there’s no filtering for how much of that chugging along is in little horse-powered buggies, so there’s that to keep in mind.
To put this distribution of higher-order births in context, here’s the “white” distribution for 1970, ten years after the Pill and IUDs were introduced.
Total white births: approx 3.1 million
Total third or higher order white births: approx 1 million
Percentage distribution of third and higher order births:
Admittedly this includes some Hispanics, but only about 4-5%, not enough to shift the overall pattern. This pattern from 1970 could be returning at the higher orders, but it’s too soon to tell.
This is an article about an analysis of births in Oregon, where homebirthing (and to a lesser extent use of birth centers) is extremely popular at rates above the national average, and where the women are mostly of more “slim” BMI and other conventional health markers. The takeaway is that infant mortality is rare homebirthing or birthing at a center, but occurs at a greater relative frequency than in hospitals. There was also a higher risk of neonatal seizures, needs for infant ventilators and blood transfusion need for mothers in out of hospital births. Minor complications like tears were lower, however.
This analysis excluded all the actual high-risk to OBs women (breech, twins, etc.), and that’s a big flaw, because women with “weird” (breech) or genuinely high-risk conditions are a big chunk of the homebirthing pool (not the birth center pool, since they are excluded from nearly all American birth centers) and that is one of the reasons there is so much antipathy towards homebirthing (even though those women doing so is itself a response to obstetric mismanagement with hospital birthing).
The basic takeaway is that if you’re a low risk, healthy woman, homebirthing or using a birth center is not unreasonable and probably will be easier overall in terms of recovery, but yes, your baby is more likely to die if you birth away from high-tech emergency equipment. By excluding the high-risk women who choose to homebirth, though, the discussion of how to improve obstetric management for those women remains left off the table.