NBC News
While the fertility rate continues to collapse in the United States, a new report contains surprising data on women in two opposite age groups: more and more women over 40 are having children and the number of adolescents who give birth is less than ever.
The report, published earlier this month by the National Center for Health Statistics (NCHS) shows that the fertility rate – the average number of children born during a woman’s reproductive years – continued a fall that has lasted decades until 2023. That year, American women had an average of 1.62 children, compared to the rate of 1.66 recorded in 2021 and 2022.
In general, the rate has decreased by 14% since 1990, and has been largely driven by women under 30 who are having less children.
For the first time in 2023, there were more births among women 40 years or older, than among adolescents. This trend that is aligned with public health objectives to reduce births among adolescents, and with medical advances that have allowed older women to have healthy pregnancies.
“There has been a change in the distribution by ages,” said Elizabeth Wildsmith, demographer and sociologist of Child Trends, a non -partisan research group.
In 1990, adolescents represented almost 13% of all births, while in 2023 they were 4%. And what is more important, the fertility rate among children under 10 to 14 years was reduced from 1.4 to almost zero, something that Wildsmith described as a “success story” from the point of view of public health.
At the same time, demographers are still trying to discern why many women decide to get pregnant and give birth later. The most recent data show that most births are now produced in women aged 30 to 34, while the group is most likely to give birth was between 25 and 29 years old.
According to the NChs, which is part of the Centers for Disease Control and Prevention (CDC) and that counts all known births in the United States, as the average age of maternity has increased, many more women of 35 years or more also have children. From 1990 to 2023, the fertility rate of women aged 35 to 39 increased 71%, and women from 40 to 44 years, 127%.
The researchers pointed out that there are several possible explanations for the gradual increase in the age of first -time mothers, including the evolution of expectations and social values, technological advances and behavior in love quotes, the economic burden of the raising of children, and the increase in university registration among women.
“All these conditions determine the moment when people want to start having children,” said Wildsmith, who also said that “women are able to control their fertility,” it is easier to access professional, political and economic opportunities.
Fall of births between adolescents
Although the national descent of adolescents has been acclaimed by those responsible for public health, that decrease has not been uniform in all states, according to federal data.
The southern states, from West Virginia to Texas, have birth rates in adolescents higher than other regions, and the birth rate in adolescents in Mississippi, Arkansas and Louisiana double the national rate.
In Mississippi, for example, 53% of high school students did not use a condom the last time they had sex, according to a state survey on risk behaviors among young people. Teenage mothers are less likely to finish high school and, in Mississippi, approximately half of the adolescents who give birth get a secondary diploma.
Even so, the adolescent birth rate in Mississippi has fallen from 46.1 in 2012 to 23.6 in 2021, according to state data.
Dr. Samuel Jones, family doctor and director of the Clinic of the Student Health Center of the Jackson State University, said that students can receive free or low -cost contraceptives, including pills and methods of prolonged action such as injections and patches.
“We are defenders of healthy children,” he said. “Unwanted pregnancies can affect our university students.
Jones, who have been exercising family medicine for long in Mississippi for a long time for patients who knew about children are now parents, said that longest contraceptives, including supply depo, an injectable of prolonged action, have proven to be popular among adolescent patients, and among their parents.
“The pills were somewhat problematic because the abandonment rate was greater,” he said, adding that the routine injections of Depo Supporta give many parents the peace of mind that their children will be protected from unwanted pregnancies.
The affordable health care law, signed by former president Barack Obama in 2010, marked the beginning of a new era in the prevention of teenage pregnancy. The Federal Law required that preventive health care, which included all contraceptive products, was included without co -payment or franchises.
Among the states with the lowest adolescent birth rates are New England, Minnesota, New Jersey, New York, Utah, Washington, California and Wisconsin, where there seems to be a connection between the lowest rates and integral sex education, according to Dr. Aisha Mays, founder of the Dream Youth Clinic of Oakland (California) and clinical researcher of the center UCSF global reproductive health bixby.
The elements of these programs included a medically precise education about the anatomy of fertility, contraception, sexual consent and sexual disposition.
And just as vital for adolescents, Mays added, it is the insurance coverage and access to contraception without the consent of the parents “so that young people can speak freely with a medical supplier.”
Risky pregnancies increase with age
Although many women get pregnant without medical intervention, advances in reproductive technology and the expansion of insurance coverage for preservation and treatment of fertility have allowed women and couples “to give priority to their professional and vital objectives,” said Dr. Arianna Cassidy, a specialist in maternal-feetal medicine at the University of California in San Francisco.
The risk of various complications of pregnancy and the fetus progressively increases in women over 35 years. This includes the risk of certain genetic and chromosomal anomalies, such as Down syndrome, and the risk of preeclampsia, gestational diabetes and postpartum bleeding.
“There is no switch that is activated at 35 by which all these things are going to happen, it is rather a continuous process,” he added.
Some of these risks can be mitigated with proactive medical care, such as aspirin taking during pregnancy for women with risk factors for preeclampsia, medication prescription to control blood pressure and gestational diabetes, and greater awareness about the dangers of postpartum bleeding.
Adverse results are still rare. The risk of preeclampsia, a dangerous little known hypertensive disorder but remains one of the main causes of maternal and perinatal mortality worldwide, is less than 5% among the general population of pregnant women.
Among women over 40, according to Cassidy, the risk doubles up to about 10%.
“We see more and more people who arrive in pregnancy with 40 years and who already have hypertension, kidney disease or diabetes,” he explained. “Age is not something modifiable.”
