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United States Maternity Care Facts and Figures
April 2010


This fact sheet updates various national maternity statistics provided in Evidence-Based Maternity Care: What It Is and What It Can Achieve (1) with new data now available.


Size of the Population Involved

In 2008, there were more than 4.2 million births in the United States, down 2% from the largest number ever registered in 2007 (2).


Hospital Care of Childbearing Women and Newborns
Of those discharged from U.S. hospitals in 2007, 25% were childbearing women and newborns. Care of childbearing women and their newborns was by far the most common reason for hospitalization (4).

Six of the ten most common hospital procedures in 2007 were maternity-related (4):

Rank Among 

Cumulative Increase 

Maternal and Newborn Procedures 

All Procedures

1997-2007

prophylactic vaccinations and inoculations

 2

189%

cesarean section

 3

 85%

repair of obstetric laceration

 5

 27%

circumcision 

 7

 12%

fetal monitoring

 8

 25%

artificial rupture of membranes to assist delivery

10

 56%

Cesarean section was the most common operating room procedure in the country in 2007 (4). The 2008 cesarean rate of 32.3% marked the 12th consecutive year of increase and a record-level national rate (2). The cesarean rate varied across states in 2007, from a low of 22.2% in Utah to a high of 38.3% in New Jersey. It reached 49.2% in Puerto Rico (3). In 2006, the cesarean section rate varied by payer — from private insurance (33.7%) to Medicaid (29.8%) to uninsured women (25.4%) (5).

The rate of vaginal birth after cesarean (VBAC) within childbirth-related hospitalizations was 9.7% in 2006, a decline of 73% from 1997, when the VBAC rate was 35.3% (5).


Maternity Outcomes
The rate of preterm birth has generally risen for more than two decades. This rate was 10.6% in 1990, reached 12.8% in 2006, and declined modesty in 2008 to 12.3% (2). Across states, the preterm birth rate in 2006 ranged from 9.2% in Vermont to 18.3% in Mississippi. It reached 19.4% in Puerto Rico (3).

The rate of low birthweight has been rising fairly steadily over a quarter century. This rate was 6.7% in 1984, reached 8.3% in 2006, and declined modestly in 2007 to 8.2% and remained steady at 8.2% in 2008 (2).

In comparison with both non-Hispanic white and Hispanic infants, non-Hispanic black infants experienced much higher rates of both preterm birth and low birthweight (3).


Paying for Maternity Care

All payers. In 2006, combined facility charges billed for "mother's pregnancy and delivery" and "newborn infants" ($86 billion) far exceeded charges for any other hospital condition in the United States (6).

Medicaid. In 2006, 42% of all maternal childbirth-related hospital stays were billed to Medicaid (5). The two most common conditions billed to Medicaid as the primary payer in 2007 were pregnancy and childbirth (28%) and newborns (26%), which together comprised 53% of discharges billed to Medicaid (4). Between 1997 and 2007, newborn discharges billed to Medicaid increased by 55%, and pregnancy and childbirth discharges increased by 47% (4).

"Mother's pregnancy and delivery" and "newborn infants" were the two most expensive conditions billed to Medicaid in 2006, involving 29% of hospital charges to Medicaid, or $39 billion (6).

Private insurance. In 2006, half of all maternal childbirth-related hospital stays were billed to private insurers (5). The two most common conditions billed to private insurance as the primary payer in 2007 were pregnancy and childbirth (18%) and newborns (17%), which together comprised 35% of discharges billed to private insurance (4). There were no significant changes in the number of newborn or pregnancy and childbirth discharges with private insurance as the expected payer between 1997 and 2007 (4).

"Mother's pregnancy and delivery" and "newborn infants" were the first and third most expensive conditions billed to private insurance in 2006, involving 14% of hospital charges to private insurers, or $41 billion (6).



References

1.  Sakala C, Corry MP. Evidence-based Maternity Care: What It Is and What It Can Achieve. New York: Milbank Memorial Fund, 2008.

2.  Hamilton BE, Martin JA, Ventura SJ. Births: Preliminary Data for 2008. National Vital Statistics Reports 58(16) Hyattsville, Maryland: National Center for Health Statistics, April, 2010.

3.  Hamilton BE, Martin JA, Ventura SJ. Births: Preliminary Data for 2007. National Vital Statistics Reports 57(12) Hyattsville, MD: National Center for Health Statistics, March 2009. 

4.  Levit K, Wier L, Stranges E, Ryan K, Elixhauser A. HCUP Facts and Figures: Statistics on Hospital-based Care in the United States, 2007. Rockville, MD: Agency for Healthcare Research and Quality, 2009.   

5.  Russo CA, Wier L, Steiner C. Hospitalizations Related to Childbirth, 2006. Rockville, MD: Agency for Healthcare Research and Quality, 2009. (HCUP Statistical Brief, 71.)
 
6.  Andrews RM. The National Hospital Bill: The Most Expensive Conditions by Payer, 2006. Rockville, MD: Agency for Healthcare Research and Quality, 2008. (HCUP Statistical Brief, 59.)
Most recent page update: 4/22/2010


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