Disparities in maternal health persist even the birth rates slowed. 

New federal data shows that while the number of births in the United States ticked upward in 2024, longstanding maternal health disparities — especially for Black, Native, and rural women — remain a serious concern.

The Vital Statistics Rapid Release Report No. 38, published by the National Center for Health Statistics (NCHS), provides provisional data on births by race, maternal age, delivery method, and preterm birth rates.

Background and Purpose

The 2024 provisional birth data, based on nearly 100% of birth records received by the NCHS, show that the number of U.S. births rose by 1% over 2023, reaching 3,622,673. The general fertility rate increased slightly to 54.6 births per 1,000 women aged 15–44.

The report notes that although birth totals have fluctuated since 2020, the overall fertility rate remains below replacement level. The total fertility rate (TFR) was 1,626.5 births per 1,000 women, far below the 2,100 needed to maintain population levels without immigration.

“Despite small increases, the United States has remained below replacement fertility since 2007,” the report states.

Racial and Ethnic Shifts in Birth Rates

Changes in birth rates varied across racial and ethnic groups.

According to the NCHS report:

• Births declined by 4% for Black women, 3% for American Indian and Alaska Native women, and less than 1% for White women.
• Births increased by 4% for Hispanic women and 5% for Asian women.
• The birth rate for Native Hawaiian and Other Pacific Islander women remained essentially unchanged.

“General fertility rates declined for Black and American Indian and Alaska Native women, and rose for Hispanic and Asian women from 2023 to 2024,” the report found.

Maternal Age and Health Outcomes

The 2024 data shows women are continuing to have children later in life:

• Birth rates decreased for women under 25 and increased for women aged 25–44.
• Teen birth rates dropped to 12.7 per 1,000 females aged 15–19, a record low.

However, maternal health indicators show persistent challenges:

• The cesarean delivery rate increased to 32.4% nationally, with Black women having the highest rate at 37.5%.
• The preterm birth rate stayed level at 10.41%, but rose slightly for Black mothers to 14.86%.

“The cesarean delivery rate has increased almost every year from 2020 to 2024, reaching the highest point since 2013,” the report noted.

Tying Federal Trends to Texas Efforts

The national trends align with ongoing concerns in Texas, where rural and underserved populations face significant barriers to maternal care.

House Bill 514, introduced by Rep.Lalani Suleman , D-Fort Bend County, proposes a maternal health workforce campaign to increase the number of trained maternal care providers across Texas, particularly in maternity care deserts.

A March of Dimes report cited that 28.4% of rural Texas women live more than 30 minutes from a birthing hospital, compared to 3.8% of women in urban areas.

According to the NCHS report, Texas had:

• 390,506 births in 2024, one of the highest totals nationwide.
• A cesarean delivery rate of 34.5%, above the national average.
• A preterm birth rate of 11.09%, also above the national figure.

Future Implications

Although the modest increase in births signals slight growth, public health experts emphasize that disparities in maternal health care and outcomes must be addressed through policy initiatives.

The Vital Statistics report concludes:
“While the number of births rose slightly in 2024, disparities in cesarean delivery and preterm birth rates by race and ethnicity persist.”

While national birth numbers may be stabilizing, the report emphasizes the importance of not just how many babies are born — but where and how those births happen.

HB 514, now pending in the Texas Legislature, aims to help bridge these gaps by investing in a larger, better-trained maternal health workforce across the state.