Live Births In 2006, there were 12,415 births in Delaware, 11,335 were to Delaware residents and 1,080 were to non-residents. Additionally, 563 births to Delaware residents occurred out of state, for a total of 11,898 Delaware resident births, 295 more than in 2005. Delaware’s general fertility rate was 65.8 live births per 1,000 females aged 15-44 years in 2002-2006. However, when broken down into specific age groups, birth rates and trends varied substantially; comparing birth rates in 1990-1994 and 2002-2006 displayed a shift toward older mothers in the distribution of birth rates. The teen (15-19) birth rate varied by county and specific teen age groups. With the exception of New Castle County teens ages 18-19, birth rates for all county and teen age groups declined from 2001- 2005 to 2002-2006. Sussex County had the highest rates for both the 15-17 and 18-19 age groups. The overall trend for births to women of all races and ethnicities, ages 35 and older, has been generally increasing. Overall, the rate of plural births increased 43 percent between 1989-1993 and 2002-2006, and the impact of mother’s age on the plural birth rate became more pronounced. In 2002-2006, older mothers (35+) had the highest plural birth rates, at 57 twins per 1000 births, more than double that of mothers under 20, and 50 percent higher than mothers 20-34. After increasing steadily through the 1990s and leveling off in the last four time periods, first trimester prenatal care attainment in Delaware decreased from 84.7 to 82 percent. Each of the three counties and Wilmington experienced decreases in the percentage of mothers receiving prenatal care attainment in the first trimester, though in Sussex county the decline had begun in 1998-2002. In 2002-2006, prenatal care attainment in the first trimester ranged from 68 percent in Sussex county to 88 percent in New Castle county. The graph below illustrates how the percentages of prenatal care differ among the counties and racial and ethnic groups. New Castle county had the highest rates of women receiving prenatal care in the first trimester, regardless of race; isolating Wilmington produced similar results. With the exception of Sussex county, black mothers and mothers of Hispanic origin received very similar percentages of prenatal care in the first trimester. Not only did Sussex County have the lowest percentage of mothers receiving prenatal care in the first trimester, but it also had the greatest difference between Hispanic mothers and white and black mothers. The graph below illustrates how the percentages of prenatal care differ among the counties and racial and ethnic groups. New Castle county had the highest rates of women receiving prenatal care in the first trimester, regardless of race; isolating Wilmington produced similar results. With the exception of Sussex county, black mothers and mothers of Hispanic origin received very similar percentages of prenatal care in the first trimester. Not only did Sussex County have the lowest percentage of mothers receiving prenatal care in the first trimester, but it also had the greatest difference between Hispanic mothers and white and black mothers. The graph below illustrates how the percentages of prenatal care differ among the counties and racial and ethnic groups. New Castle county had the highest rates of women receiving prenatal care in the first trimester, regardless of race; isolating Wilmington produced similar results. With the exception of Sussex county, black mothers and mothers of Hispanic origin received very similar percentages of prenatal care in the first trimester. Not only did Sussex County have the lowest percentage of mothers receiving prenatal care in the first trimester, but it also had the greatest difference between Hispanic mothers and white and black mothers. In 2006, 95 percent of live births had either private insurance or Medicaid listed as the primary source of payment; the remaining 5 percent were split between other government coverage and self-pay. -Medicaid was the primary source of payment for the majority of mothers under 20, covering 76 percent of both white and black mothers, and 63 percent of mothers of other races. -Among women of all ages, Medicaid covered more than half of all deliveries for both Hispanic and black mothers. Marital status has a tremendous effect on the use of Medicaid as the primary source of payment for delivery: -18.5 percent of white married women used Medicaid as their primary source of payment, but that number nearly quadrupled, to 71.9 percent, for single white women. -27.1 percent of black married women used Medicaid as their primary source of payment, but that number nearly tripled, to 73.7 percent, for single black women. -62.1 percent of Hispanic married women used Medicaid as their primary source of payment; that number increased to 85.6 percent for single Hispanic women. -19.2 percent of married women of other races used Medicaid as their primary source of payment, but that number was nearly four times higher, at 76.3 percent, if the mother was single. The percent of births to unmarried women rose again in 2006, to 45.3 percent of all births. The steadily increasing trend began in 1991, when 31.8 percent of all births were to unmarried women. However, this shift in the distribution of mother’s marital status was only apparent in births to white and Hispanic women, whose percentage of births to unmarried women increased from 16 percent to 38 percent, and 42 percent to 62 percent from 1989 to 2006. During this same time period, the percent of births to unmarried black women has remained stable, at approximately 71 percent. From 1997 to 2006, the rate of cesarean deliveries increased 45 percent, to 30.5 per 100 live births. Both preterm and term births demonstrated increasing trends in cesarean deliveries during this same period; although the cesarean section rate for term (37+ weeks of gestation) births rose 48 percent, to 29, the c-section rate for preterm (<37 weeks gestation) births remained significantly higher, at 40.2 per 100 live births. From 1994 to 2006, the percentage of Delaware mothers who used tobacco while pregnant decreased in the three counties and in the city of Wilmington. In 2006, as in 1994, Kent County had the highest percentage of mothers who smoked while pregnant (14.3). The largest percent of mothers who smoked while pregnant were in the 20-24 age group, regardless of race. In the under 20 and 20-24 age groups, white mothers were more likely than black mothers to smoke while pregnant. In the 25-29 age group, black mothers were more likely to smoke while pregnant, and in the 30-34 and 35+ age groups, black and white mothers had similar proportions of mothers who smoked. In 2006, 13.9 percent of Delaware women who smoked while pregnant gave birth to low birthweight babies (< 2500 grams), versus the significantly lower percentage (8.8) of non-smokers who gave birth to low birthweight babies. The percent distribution of births by birthweight did not differ significantly between 1990 and 2006 The greatest percentage of births fell within the 3000 to 3499 gram range. From 2001-2005 to 2002-2006, the five-year percent of low birthweight (LBW) births was unchanged at 9.4; very low birthweight (VLBW) births also remained relatively stable at 2.0. Percentages of LBW births were greatest for mothers 15-17 (12.2 percent). Black mothers of every age group had higher percentages of LBW births than white or Hispanic mothers. Among mothers of all ages, black mothers had the highest percentage of LBW and VLBW births, at 14.6 percent and 3.6 percent respectively. There was an increase in the percentage of LBW births from 1990-1994 to 2002-2006 for both black and white infants. During the same time period, the percentage of LBW births to Hispanic women decreased. Printed copies of tables, graphs, and charts can by obtained by contacting: Delaware Health Statistics Center Delaware Division of Public Health Department of Health and Social Services 417 Federal Street Dover, Delaware 19901 (302) 744-4541 http://www.dhss.delaware.gov/dhss/dph/hp/healthstats.html