Table of Contents

BIRTHS

In 2000, 6,501 babies were born to Vermont residents. This represents a decrease of 59 births from 1999. The number of babies born to Vermont residents has declined every year since 1989. The crude birth rate in 2000 was 10.7 per 1,000 Vermont residents, compared to 11.0 in 1999 and 11.1 in 1998. The U.S. white birth rate for 2000 was 14.1. Comparisons are made to the U.S. white rate because 97.6 percent of Vermont resident births were to white mothers in 2000 (Table B-5). The Vermont birth rate peaked in 1955 at 24 per 1,000 residents, then dropped for two decades, remained relatively stable from the late 1970's through the 1980's, and has been slowly and steadily decreasing since 1989.

FERTILITY

Although the crude birth rate is based on the total population, a better measure birth patterns is the fertility rate which is based on the population of women ages 15 through 44, the peak child-bearing years. The 2000 Vermont fertility rate was 49.7 per 1,000 women ages 15 through 44, a slight decrease from the 1999 rate of 50.0. The U.S. white fertility rate was 66.5 in 2000. The fertility rate in Vermont peaked in 1960 at 126, declined through the 1960's and 1970's, leveled off slightly in the 1980's and has declined through the 1990's. Age-specific fertility rates have declined among the younger age groups, and increased among the older age groups.

FIGURE 5

AGE-SPECIFIC FERTILITY RATES, SELECTED YEARS 1980-2000

*1999 rates have been updated using revised intercensal population estimates, and do not match those printed in last year's publication.

AGES/YEAR

1980 1990 1999*

2000

TOTAL

63.3

60.5

50.0 49.7

15 - 19

38.5

34.1

24.8

23.4

20 - 24

102.4

93.9

76.0

74.1

25 - 29

113.0

114.6

100.3

102.1

30 - 34

60.2

79.5

82.5

84.0

35 - 44

12.5

19.6

20.9

21.3

Slightly less than half of all births (48.0%) in 2000 were to women in their twenties (Table B-7), down from 56.1 percent in 1990. Women age 30 and over accounted for 43.9 percent of births, up from 35.4 percent in 1990. Women age 15 through 19 accounted for 8.0 percent of births, down from 8.5 percent in 1990.

BIRTH WEIGHT

The median birth weight for all resident births in 2000 was 3,430 grams (7 pounds 9 ounces). Low birth weight infants are those born weighing less than 2,500 grams (5 pounds 8 ounces). They are much more likely than heavier babies to suffer short and long term disabilities, and to die in infancy. In 2000, 6.1 percent of Vermont resident births were low birth weight (Table B-16) and 1.1 percent were very low birth weight (less than 1,500 grams or 3 pounds 5 ounces). The U.S. white low birth weight rate for 2000 was 6.5 percent. The Vermont low birth weight and very low birth weight rates remain above the Healthy Vermonters 2010 goals of 5.0 percent and 0.9 percent, respectively.

Low birth weight rates vary by age groups: in Vermont in 2000, the low birth weight rate among women under age 20 was 8.8 percent compared to 6.2 percent of births among women age 20-29 and 5.6 percent of births among women age 30 or older.

Infant birth weight is also positively associated with maternal weight gain: mothers who do not gain adequate weight during pregnancy are more likely to deliver low birth weight infants. On the other hand, there are risks associated with gaining too much weight including delivery complications, maternal and infant obesity. Although the weight gained by 18.4 percent of Vermont mothers in 2000 fell below the range recommended by the American College of Obstetricians and Gynecologists, 49 percent gained above the recommended range (Table B-31).

But the single most important preventable risk factor for low birth weight is smoking during pregnancy. The low birth weight rate among women who smoked cigarettes during their pregnancy was 9.3 percent compared to 5.3 percent among women who did not smoke during pregnancy (Table B-28). About one in five women reported smoking during their pregnancy in 2000, and among those who smoked before pregnancy or during the first trimester, 22.3 percent quit.

PRENATAL CARE

Early, comprehensive, and high quality prenatal care is essential for a healthy pregnancy and birth. Through prenatal care, pregnant women are screened for medical conditions and counseled on nutrition, behavioral risks (such as using tobacco and alcohol), and domestic violence.

In 2000, 88.4 percent of the babies were born to mothers who began prenatal care in the first three months of pregnancy (Table B-20). The Healthy Vermonters 2010 goal for first trimester prenatal care is 90 percent. The percentage of women receiving first trimester prenatal care has been increasing, slowly but steadily since 1987. Eighty-five percent of U.S. white births in 2000 were to women who began prenatal care in the first trimester.

The proportion of births in 2000 to Vermont mothers who delayed care to the third trimester or received no prenatal care was 2.0 percent, down slightly from 1999. The proportion of women receiving late or no prenatal care in 2000 was 3.3 percent for U.S. white mothers. As in previous years, the age of the mother is closely associated with the time of entry to prenatal care with young women seeking care later than older women.

MEDICAL RISK FACTORS

Of the births in 2000, 70.1 percent of mothers had no reported medical risk factors for pregnancy (Table B-29). Of those with medical risk factors reported, the most common were pregnancy-associated hypertension, diabetes, previous pre-term or small-for-gestational-age infant, uterine bleeding, acute or chronic lung disease. In 2000, 58.0 percent of births had no complications of labor and/or delivery reported. Of those with complications, the most common complications of labor and/or delivery were meconium, dysfunctional labor, prolonged labor, fetal distress, and premature rupture of membrane.

DELIVERIES

Of babies born in Vermont hospitals in 2000, 17.9 percent were delivered by cesarean section (Table B-27) compared to 22.8 percent for U.S. white women in 2000. The primary cesarean section rate was 13.3 percent in Vermont for 2000, compared to 15.9 percent for white mothers nationally in 2000. Of mothers delivering in Vermont hospitals in 2000 who had a previous delivery by cesarean section, 40.6 percent had vaginal births, compared to 20.4 percent for U.S. white mothers in 2000.