Recent Birth Trends from a State and National Perspective: An Overview Mark Flotow Illinois Center for Health Statistics NAPHSIS/NCHS Joint Annual Meeting 4 June 2013 Phoenix, AZ

Factors Affecting Fertility Decisions and Outcomes: A Partial Listing Cultural/Societal: - general education, family influences, income, insurance/healthcare availability, public environment, religion, support network, cultural background/influences Personal/Physical: - partner factors, “intendedness,” frequency and timing of intercourse, infertility issues/sterility, personal beliefs and desires, age, personal economics & economic perception, contraceptive use and/or availability Pregnancy Outcomes: - fetal demise (stillbirth/spontaneous abortion, induced abortion, maternal mortality) and live birth Take-home Message: It’s Complicated, making Fertility Forecasting a Fickle Affair

Recent History of Resident Births for Selected States 200, , ,000 ** Year B I R T H S

Now, Add Some More Recent History , , ,000 B I R T H S Year **

And Now, Add the Most Recent History , , ,000 B I R T H S Year **

So, What’s Different Lately? To paraphrase a politician: “It’s the economy, stupid,” right? While the previous graph had only a sample of our jurisdictions, this sort of synchronicity in trends has not been seen since perhaps the “baby boom” of the 1950s and 1960s This birth trend session is about the “whats,” not the “whys” or the “hows” In late 2012, a handful of national reports and publications pointed out recent declining birth numbers, especially as they translate into fertility rates. NAPHSIS members represent a primary source of such numbers; thus we collectively have our finger close to the fertility pulse of the nation. And our timeliness can matter.

And This Is Important Because... ? To paraphrase another politician: a falling/rising/changing tide affects all boats (or what I call “cascading consequences”) - Birthing hospitals/NICUs - Birth certificate sales (of all types and stripes) - Immunizations, newborn screening, WIC, MCH, etc. - School enrollment - Who’s going to pay for my Social Security? It’s all part of a “demographic glacier” in motion that’s bigger than us in this room, and it is part of the individual decisions made across our nation, or even the world, that collectively impacts our lives, both professionally and personally.