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County Profiles

Birth and Unintended Pregnancy Statistics April 2004

Summary

This report, the fourth of its series, presents birth and unintended pregnancy statistics for each of the 39 counties in Washington State. These data include selected demographic and pregnancy related indicators obtained from vital statistics, Medicaid administrative records, and survey data collected on a sample of women giving birth. A separate report (Community Services Office - CSO Profiles, 2004) presents these measures for communities surrounding the Department of Social and Health Services Community Services Offices.

The measures presented here portray characteristics of births and abortions to women whose residence at the time of delivery was in the stated county within the State of Washington. This summary describes trends over time and similarities and differences among four groups of counties.

Over the past ten years, the number of births in Washington State has remained stable, 79,644 in 1990-1992 compared to 79,813 in 2000-2002. The proportion of births with Medicaid-paid maternity care increased from 36.1% to 43.1% during the same time period. Much of this increase occurred between 1989 and 1993 and is attributable to the expansion of Medicaid eligibility and improved prenatal access through the First Steps program. Medicaid births to noncitizens, which increased from 1,765 in 1990-92 to 6,160 in 2000-02, also contributed to the rise in the proportion of Medicaid births. Since 1993, the proportion of Medicaid-funded births has been stable, with an increasing proportion of births to non-citizens.

At the state level, some of the maternal characteristics reported here -average age of mothers with first births, mothers with less than 12 years of education at birth and the percent of mothers married at birth - remained relatively stable over the past ten years. Similarly, the differences in birth outcomes during the same time period were small.

The most notable changes between 1990-92 and 2000-02 occurred in three measures: maternal smoking and the live birth and abortion rates. In Washington State, the proportion of Medicaid women who reported that they smoked while pregnant decreased by 36.0% from 29.2% in 1990-92 to 18.7% in 2000-02. Among non-Medicaid women, the proportion of smokers during pregnancy decreased by 56.9%, from 11.6% to 5.0% during the same time period. The amount of change varied in different areas of the state. For Medicaid women, the greatest decreases in smoking occurred in the counties of San Juan (-85.1%), Franklin (-63.5%), Whatcom (-58.3%) and Chelan (-55.4%).

The birth rate for women 15-44 decreased from 67.4 per 1,000 in 1990-92 to 61.4 per 1,000 in 2000-02. The decrease was much greater for younger women. Women 15-17 years of age experienced a 41.5% decrease in their birth rate between 1990-92 and 2000-02. Similarly women 18-19 experienced a 28.0% decrease. In contrast, birth rates for women 35-39 and 40-44 years of age increased by 23.6% and 43.1%, respectively. The declining birth rates of young women and the increasing birth rates among older women of childbearing age experienced in Washington State are a nationwide phenomenon.

According to national data, the birth rate for the U.S. decreased from 69.3 births per 1,000 women aged 15-44 in 1991 to 64.8 births in 2002. This represents a decrease of 6.5%. The teen birth rate in the United States decreased 30% during the same time period, from 61.8 births per 1,000 women 15-19 years of age to 43.0 births. Using data comparable across states, the birth rate for teenagers 15-19 in Washington decreased by 39%, from 53.7 in 1991 to 33.0 in 2002. Only five other states (Alaska, California, Maine, Michigan and New Hampshire) experienced greater declines in their birth rates to teenagers 15-19 years of age (Martin et al., 2003).

Many researchers have concluded that the decreasing trend among teenagers nationwide is likely due to increased abstinence and increased use of condoms and other methods of contraception such as hormonal injections, implants and other more effective methods of birth control among sexually active teenagers. Research also suggests that the increased economic growth experienced in the United States in the 1990s has had an effect on declining teenage birth rates. Increased economic opportunities experienced by millions of Americans may have encouraged teenagers to invest in more education and better career opportunities and postpone parenthood (AECF, 2001; Ventura, Mathews and Hamilton, 2001; Darroch and Singh, 1999).

In Washington State, counties with the highest birth rates in 2000-02 were Franklin (109.9 live births per 1,000 women), Adams (102.1), Grant (90.9), and Yakima (89.9). Counties with the lowest birth rates in 2000-02 were Whitman (33.9 live births per 1,000 women), Kittitas (42.6), Wahkiakum (43.7), San Juan (43.8), and Jefferson (49.9).

In Washington, the abortion rate decreased by 21%, from 24.9 per 1,000 in 1990-92 to 19.7 per 1000 in 2000-02. The abortion rate decreased among all age groups except women 40-44 years of age. The largest decreases from 1990-92 to 2000-02 were experienced by younger women. Abortion rates decreased by 42.5% among women 15-17 years of age and 34.9% among women 18-19 years of age.

Between 1990 and 2000, the nationwide abortion rate decreased 33% from 24 abortions per 1,000 women aged 15-44 years in 1990 to 16 in 2000. In 1990, 22.4% of abortions were to women less than 20 years of age while in 2000 women less than 20 accounted for 18.8% of abortions (Elam-Evans et al., 2003).

Counties with the highest abortion rates in 2000-02 were Pierce (24.3 abortions per 1,000 women), King (23.7), and Thurston (20.8). Counties with the lowest abortion rates in 2000-02 were Garfield (5.0 abortions per 1,000 women), Wahkiakum (6.6), Skamania (7.3), Douglas (8.4), Stevens (8.5), and Lincoln (8.9).

The county profiles may help to guide targeted interventions for high-risk women such as smoking cessation in counties with high levels of maternal smoking and reduction of unintended pregnancies in counties with high birth rates.

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Modified: Tuesday January 17 2006

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