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Natality Narrative

2013 Natality Narrative

In 2003, HHS Secretary Tommy Thompson approved the revision to the U.S. Standard Certificate of Live Birth and encouraged all states to adopt it. The process involved in this revision, as well as details of what was revised, can be found athttp://www.cdc.gov/nchs/nvss/vital_certificate_revisions.htm.

Texas adopted the new U.S. Standard Certificate of Live Birth in 2005. This revision includes changes to items such as onset of prenatal care, maternal smoking history, race/ethnicity, etc. For details regarding race/ethnicity computation for birth data, see Table 44.

Births and Birth Rates

There were 387,110 live births to Texas residents in 2013, an increase of 1.2 percent (4,672 more births) from 2012, and an increase of 2.6 percent (9,736 more births) from 2003.

Figure 4

(Figure 4 data)

In the ten-year period from 2003 through 2013, the proportion of births to white* mothers increased from 40.6 percent of all births in 2003 to 40.7 percent in 2013. At the same time, the proportion of births to Hispanic mothers decreased from 48.4 percent of births in 2003 to 47.9 percent in 2013. The number of Hispanic births has exceeded the number of white* births since 1998. The proportion of births to black mothers increased from 11.1 percent in 2003 to 11.4 percent in 2013.

* Includes women of other and unknown race/ethnicity.

The 2013 crude birth rate of 14.6 births per 1,000 Texas residents is the lowest on record. The crude birth rate has dropped from 17.1 in 2003 to 14.6 in 2013. The rate for whites* dropped from 12.7 in 2003 to 12.1 in 2013. The crude birth rate for blacks declined from 16.4 in 2003 to 14.5 in 2013. The Hispanic rate also declined from 24.2 to 17.9.

Figure A

(Figure A data)

The general fertility rate for Texas, which is the number of live births to Texas residents per 1,000 women ages 15 through 44, was 69.6 in 2013. In 2003, it was 76.7 (Figure B). Like crude birth rates, race/ethnicity-specific general fertility rates have been highest among Hispanics and lowest among blacks (Figure B). In 2003, the general fertility rates of whites*, black, and Hispanics were 61.3, 67.6, and 100.9, respectively. In 2013, fertility rates for white* females increased slightly to 63.5 while the rates for Black and Hispanic females decreased to 63.4 and 77.8, respectively.

Figure B

(Figure B data)

Mother’s Age and Father’s Age

Around half (53.6 percent) of Texas resident live births in 2013 were to mothers 20 to 29 years of age, and around one-quarter (23.4 percent) were to mothers 30 to 34 years old (Table A). Mothers aged 10-17 accounted for 3.2 percent of the births in 2013, compared to 3.5 percent in 2012. The percentage of mothers aged 18 and 19 also decreased from 7.2 percent in 2012 to 6.7 percent in 2013. The percentage of births to mothers 30-34 increased slightly from 23.0 percent in 2012 to 23.4 percent in 2013 and births to mothers aged 35-39 likewise increased from 10.5 percent in 2012 to 10.7 percent in 2013.

Table A.1. Percent of Live Births** by Mother's Age Groups and Race/Ethnicity 
Texas Residents, 2013
Age White* Black Hispanic All Races
10-14 0.0 0.2 0.2 0.1
15-19 5.5 10.7 13.0 9.7
20-24 19.8 31.7 28.8 25.5
25-29 30.5 26.4 26.4 28.1
30-34 29.0 19.8 19.5 23.4
35-39 12.2 8.9 9.7 10.7
40+ 2.8 2.3 2.4 2.5
* Includes women of other and unknown race/ethnicity. 
** Denominator for percent excludes missing data. 
Note: due to rounding, percents may not sum to 100%

 

Table A.2. Percent of Live Births for Selected Mother's Age Groups by Race/Ethnicity 
Texas Residents, 2013
Age White* Black Hispanic All Races
10-17 1.4 3.4 4.6 3.2
18-19 4.1 7.5 8.6 6.7
20-29 50.4 58.0 55.2 53.6
30-34 29.0 19.8 19.5 23.4
35+ 15.1 11.2 12.1 13.2
* Includes women of other and unknown race/ethnicity. 
Note: Due to rounding, percents may not sum to 100%

Mothers' ages ranged from 11 to 62 years; the mean mother's age was 27.4 years. Among birth certificates that included information on the father's age (86.0 percent of all birth certificates), fathers ranged in age from 12 to 82. The mean father's age was 30.3 years.

Age-specific birth rates, calculated as the number of live births per 1,000 women in the specified age group, were highest among women aged 25-29, followed by women aged 20-24 for all races combined (Table B). Hispanic women aged 20-24, followed by Hispanic women aged 25-29 and black women aged 20-24 had the highest age-specific birth rates for individual race/ethnicities. White women were the only race/ethnicity whose highest age-specific birth rate occurred in the 25-29 age group. Age-specific birth rates for Hispanics were higher than rates for whites or blacks at every age group except 10-14 years and 30-34 years. Whites in the youngest three age groups had the lowest fertility; blacks had the lowest fertility in the remaining age groups.

Table B. Age-Specific Birth Rates1 by Race/Ethnicity 
(Live Births Per 1,000 Women in the Race/Ethnicity and Age Group) 
Texas Residents, 2013
Age White* Black Hispanic All Races
10-14 0.2 0.7 0.8 0.5
15-19 22.4 39.9 54.1 39.5
20-24 78.9 113.8 127.2 105.1
25-29 113.6 105.4 124.6 117.3
30-34 103.9 74.1 90.5 94.6
35-39 46.9 35.4 47.8 45.9
40-44 9.8 8.9 12.3 10.7
All Ages^ 54.5 54.4 64.5 58.8
* Includes women of other and unknown race/ethnicity. 

^ The general fertility rate. Numerator includes mothers of unknown ages; denominator is women 15-44 years of age. 

Note: Rates were calculated using population data from the Texas State Data Center. Births of unknown race/ethnicity, and of racial/ethnic groups other than white, black or Hispanic were included with white for the purposes of calculating birth and fertility rates.

Marital Status

Overall, 57.6 percent of mothers reported being married. However, there were large differences in marriage rates across age groups and race/ethnicities (Table C). In general, white mothers were most likely to be married and black mothers least likely to be married. Very few mothers aged 14 and younger were married. The likelihood of being married generally increased with the mother's age for all race/ethnicities, although marriage rates for most mothers dropped slightly at age 40 and up.

Table C. Percent Married** by Mother's age and Race/Ethnicity 
Texas Residents, 2013
Age White* Black Hispanic All Races
10-14 1.5 0.0 0.5 0.6
15-19 18.4 3.3 14.3 13.9
20-24 48.5 14.7 36.7 37.3
25-29 79.6 39.1 56.9 65.0
30-34 89.0 58.8 67.1 77.4
35-39 89.2 65.3 69.7 78.4
40+ 86.8 68.6 69.5 77.2
All ages^ 74.2 34.4 49.0 57.6
* Includes women of other and unknown race/ethnicity. 
** Denominator for percent excludes missing data.
^ Numerator and denominator include mothers of unknown ages. 

Prenatal Care

Beginning with 2001 data, Vital Statistics annual reports do not include tables or data based on the Kessner Index. (These data may still be obtained by request.) Please see the sources at the end of this chapter for more information regarding strengths and weaknesses of various prenatal care utilization indexes 1, 2 . The Kessner index data in Table 13 has been replaced with data on the mother's marital and educational status.

This annual report still includes data on the month in which prenatal care began because it is one of the indicators suggested by the CDC's Healthy People 2020 initiative 3. However, due to implementation of a new birth certificate for 2005 data, onset of prenatal care within the first trimester is not directly comparable to years prior to 20054.

The percentage of mothers beginning prenatal care in the first trimester decreased from 62.6 percent in 2012 to 62.5 percent in 2013 (Table D). Increasing from 4.2 percent in 2012 to 4.9 percent in 2013, many mothers did not receive prenatal care in 2013. White* women were more likely than black or Hispanic women to have early onset of prenatal care.

Table D. Percent of Live Births** 
by Trimester Prenatal Care Began, 
Texas Residents, 2013
Trimester White* Black Hispanic All Races
1st 70.5 53.5 57.6 62.5
2nd 21.3 30.7 28.9 25.9
3rd 5.2 9.5 7.3 6.7
No Care 3.1 6.2 6.2 4.9
* Includes women of other and unknown race/ethnicity. 
** Denominator for percent excludes missing data. 
Note: due to rounding, percents may not sum 100%. 

Place of Delivery and Birth Attendant

Nearly all Texans who gave birth in 2013 did so in a hospital (98.7 percent). A small number occurred in licensed birthing centers (0.7 percent) or at home (0.5 percent), or other locations (negligible, 0.1 percent).

Physicians delivered 95.3 percent of infants born to Texas residents. Certified nurse-midwives attended 3.1 percent of all births and lay midwives attended 0.7 percent. The remainder, about 0.6 percent, were delivered by other types of attendants, such as EMS workers or relatives.

Low Birth Weight and Very Low Birth Weight

There were 27,001 low birth weight (<2,500 grams) infants born to Texas residents in 2013, which is 7.0 percent of live births (Table E). This is a decrease from 8.3 percent in 2012. Since 2003, low birth weight infants have decreased from 8.3 percent to 7.0 percent of live births.

The risk of giving birth to a low birth weight infant remains much higher for black mothers (10.5 percent) than for Hispanic mothers (6.5 percent) or white mothers (6.6 percent). The incidence of low birth weight infants is higher among the youngest and oldest mothers. In 2013, 9.1 percent of births to mothers ages 14 and younger and 10.7 percent of births to mothers ages 40 and older were low birth weight.

A total of 5,377 births (1.4 percent of live births) were very low birth weight (<1,500 grams). This rate is the same as the rate in 2003 (1.4 percent). As with low birth weight, the risk of having a very low birth weight infant was highest for black mothers (2.8), for mothers aged 10-14 years (2.7), and mothers aged 40 and up (2.5). The percentage of births to women 40 and over is up from 2003, when 2.1 percent of the women in that age group gave birth to very low birth weight infants.

 

Table E.1. Low Birth Weight and Very Low Birth Weight by Mother's Race/Ethnicity 
Texas Residents, 2013
Race/
Ethnicity
VLBW 
Number of
Births
VLBW 
Percent of
Births
LBW 
Number of 
Births
LBW 
Percent of 
Births
White* 1,813 1.2 12,129 7.7
Black 1,226 2.8 5,837 13.2
Hispanic 2,321 1.3 14,209 8.3
All Races 5,360 1.4 32,175 8.3
* Includes women of other and unknown race/ethnicity.

 

Table E.2. Low Birth Weight and Very Low Birth Weight by Mother's Age, 
Texas Residents, 2013
Age VLBW 
Number of
Births
VLBW 
Percent of
Births
LBW 
Number of 
Births
LBW 
Percent of 
Births
10-14 14 2.7 62 11.8
15-19 504 1.3 3,384 9.0
20-24 1,243 1.3 8,039 8.2
25-29 1,296 1.2 8,092 7.4
30-34 1,281 1.4 7,209 8.0
35-39 782 1.9 4,100 9.9
40+ 239 2.4 1,288 13.1
Unknown 1 6.7 4 26.7
Total 5,360 1.4 32,175 8.3

Other Birth Characteristics

In 2013, male infants accounted for 51.2 percent of all births (198,109) and female infants accounted for 48.8 percent (189,001). The majority of all births were either first children (37.9 percent) or second children (31.1 percent). Third children accounted for 18.1 percent of all births, and fourth children 8.0 percent.

There were 374,436 singleton births, accounting for 96.7 percent of all births. Twin births accounted for 3.1 percent of all births. All other multiple births occurred in less than 0.1 percent of all births.


  1. Kogan MD, Martin JA, Alexander GR, Kotelchuck M, Ventura SJ, Frigoletto FD. The changing pattern of prenatal care utilization in the United States, 1981-1995, using different prenatal care indices. JAMA , 279:1623-1628.
  2. Alexander GR, Kotelchuck M. Quantifying the adequacy of prenatal care: a comparison of indices. Public Health Rep 1996 Sep-Oct;111(5):408-18.
  3. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=26#.
  4. Technical Appendix from Vital Statistics of the United States, 2004. Natality in the Documentation of the Detail Natality Public Use File for 2004

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2013 Annual Report Table of Contents
Annual Reports for Other Years
Center for Health Statistics

Last updated September 3, 2015