Osterman, M. J. K., Hamilton, B. E., Martin, J. A., Driscoll, A. K., & Valenzuela, C. P. (2026). Births: Final Data for 2024. National Vital Statistics Reports. https://doi.org/10.15620/cdc/252440
Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP. Births: Final Data for 2024. National Vital Statistics Reports; 2026. doi:10.15620/cdc/252440
Osterman, Michelle J. K., et al. Births: Final Data for 2024. National Vital Statistics Reports, 2026.
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RRM Academy Synopsis
US births rose in 2024 while the fertility rate fell to a record low
The U.S. total fertility rate fell 1% to a record low in 2024, while births rose 1% to 3,628,934, this federal tabulation of all 2024 birth certificates among U.S. residents reports. Birth rates fell for women ages 15 to 34, and the rate for women ages 40 to 44 rose 2%, the highest since 1965.
Study at a glance, federal tabulation: US births rose 1% in 2024 while the fertility rate hit a record low. Source: Osterman MJK et al., 2026, PMID 42378845.
Key Findings
Births numbered 3,628,934 in 2024, up 1% from the 2023 record low of 3,596,017. The general fertility rate reached a record low of 53.8 births among every 1,000 women ages 15–44.
The total fertility rate reached 1,599.5 births per 1,000 women, a record low and 1% under the 2023 figure of 1,621.0. Replacement level is generally considered 2,100 births per 1,000 women.
Women ages 40–44 had 12.7 births per 1,000, up 2% from 12.5 and the highest since 1965. Mean age at first birth reached a record 27.6 years, compared with 27.5 in 2023.
The cesarean rate rose from 32.3% to 32.4%. The preterm birth rate stayed at 10.41%. Low birthweight declined from 8.58% to 8.52%.
Twin births ran at 30.1 per 1,000 births, down 2% and the lowest level in more than 20 years. Triplet and higher-order births were 71.3 per 100,000, a nonsignificant decline from 73.8.
Interpretation
Researchers at the National Center for Health Statistics tabulated all birth certificates registered to U.S. residents in 2024, a dataset that captures more than 99% of U.S. births. The report tracks levels and trends in births, fertility, and birth outcomes from 2010 through 2024. The authors note that single-race categories limit race-specific trends to the 2016 through 2024 period.
RRM Context
Restorative reproductive medicine evaluates both partners and treats the cause of reduced fertility, guided by the cycle. It works in a population where first births come later and fertility runs lower overall. National tabulations count births but record nothing about the cause of a couple's reduced fertility. Cause-level evaluation of each couple addresses that question.
Our editorial summary of this paper, not the article's abstract.
Abstract
Objectives
This report presents 2024 data on U.S. births by selected characteristics. Trends in fertility patterns and maternal and infant characteristics are described.
Methods
Descriptive tabulations based on birth certificates of the 3.63 million births registered in 2024 are shown for various maternal demographic and health characteristics; medical and healthcare utilization, including source of payment for the delivery; and infant health characteristics. Selected data by mother's state of residence and birth rates also are shown. Trends for 2010 to 2024 are presented for selected items and by race and Hispanic origin for 2016-2024.
Results
A total of 3,628,934 births occurred in the United States in 2024, an increase of 1% from the record low reported for 2023. The general fertility rate declined 1% from 2023 to 53.8 births per 1,000 females ages 15-44 in 2024. Birth rates declined for females ages 15-34 from 2023 to 2024, rose for women ages 40-44, and were unchanged for females ages 10-14 and women ages 35-39 and 45-49. The total fertility rate declined 1% to 1,599.5 births per 1,000 women in 2024, a record low. Birth rates declined for both unmarried and married women from 2023 to 2024. Prenatal care beginning in the first trimester declined to 75.5% in 2024. The percentage of women who smoked during pregnancy declined to 2.4%. The cesarean delivery rate increased by less than 1% to 32.4%. Private insurance as the source of payment for the delivery increased to 51.8% of births, while Medicaid deliveries declined to 40.2%. The preterm birth rate (10.41%) was unchanged from 2023; low birthweight births declined 1% (8.52%). The twin birth rate declined 2% in 2024 to 30.1 per 1,000 births; the triplet and higher-order multiple birth rate was 71.3 per 100,000 births compared with 73.8 for 2023.
