Contained in this report:
The 2017 Indiana Natality Report includes information on
live births to Indiana
residents that occurred during calendar year 2017. Information is presented at the state, county, and city level (for the 35 Indiana cities with populations over 25,000
in the 2010 census). This
report includes data by age, race, and marital status of the parents; characteristics of the newborn, e.g., birth order and
age of mother; and outcome indicators, e.g., tobacco use during pregnancy, gestation length, and birthweight.
The ISDH, through provisions in
Indiana Code 16-37-1, administers "...a system of vital
statistics for Indiana." The ISDH Vital Records Division compiles data from original birth certificates filed with the
ISDH and from transcripts of original certificates for Indiana residents giving birth in other states. The Data Analysis Team
in the Epidemiology Resource Center compiles these data and produces standard statistical reports.
Figure and table specifications:
Medicaid Reporting: In 2012, the Indiana Natality Report began including the number of births to mothers
on Medicaid. Since alcohol use is no longer reported on the revised birth certificate effective in 2007, Medicaid data are now provided in Tables 22, 23, and 32.
A map of the percent of Medicaid births by county of residence that are significantly different from the State
percentage can be found in Figure 34.
The 2017 Indiana Natality Report also includes information on the number of reported pregnancies by county of residence
and age of mother. Reported pregnancies include resident live births, fetal deaths, and terminated pregnancies (performed in Indiana). Rates
per 1,000 females in selected age groups are also provided.
In this report, the number
and percent/rate of births and pregnancies at the county and city subgroup level
are suppressed when there are fewer than 5, including 0, events in order to protect the confidentiality of individuals.
Rates or percents based on less than 20 in the numerator are considered
unstable and should be interpreted with caution. These rates or percents are marked with a "U".
Indiana began using the 2003 US Standard Certificate of Live
Birth (the 2003 "revised" certificate) on January 1, 2007.
Although much of the information collected from the mother remained the same, some
questions were rephrased or the information was gathered in a different manner.
This resulted in significant changes in some variables.
The major variables affected were month prenatal care began, smoking during pregnancy,
place of birth, and alcohol use during pregnancy.
Mother's alcohol use is no longer collected. The 2007–2017 data on prenatal care, tobacco use,
place of delivery,
primary cesarean delivery, and vaginal birth after previous cesarean delivery are
not considered comparable to data prior to 2007 due to the significant changes
in wording on the
certificates. These changes are detailed below:
Prenatal Care: The month prenatal care began has been changed
from a box asking for the month of pregnancy in which prenatal care began to
questions asking for the date of last normal menses and the date of the first
prenatal visit. The month prenatal care began is then calculated from
these two variables. If the day of the month was unknown, the day of the
month was imputed using a program that the National Center for Health Statistics (NCHS) has developed.
The NCHS has
observed a decrease in the
percent of mothers receiving care in the first month for all states that have
adopted the revised certificate and considers it to be the
result of better reporting.
Tobacco Use: Prior to 2007, the birth certificate
included the question "Did mother smoke during pregnancy?"
Depending on the response, the facility would check one of the following boxes: Yes, No, or Unknown. Starting in 2007,
more detailed information
was collected—the average number of cigarettes (or packs of cigarettes) that were smoked during
the three months prior to becoming pregnant, the first trimester of pregnancy, the second trimester
of pregnancy, and the last trimester of pregnancy. If the mother smoked at any time
during her pregnancy,
she was considered to be a smoker for this report.
Primary Cesarean and Vaginal Birth after Previous Cesarean (VBAC):
Prior to 2007,
the birth certificate included check boxes
for the method of delivery, which included VBAC. The certificate now contains check boxes for
vaginal/spontaneous, vaginal/forceps, vaginal/vacuum, and cesarean delivery. Under cesarean, the question, "Was a trial of labor attempted?" is asked with check boxes for Yes and No. To determine if the method
of delivery was a primary cesarean, repeat cesarean, or VBAC, a new
risk factor was checked: "Mother had a previous cesarean delivery." If the box was
checked, the number of previous cesareans was reviewed.
Weight Gain: Prior to 2007, weight gain during pregnancy was asked
directly. Starting in 2007, two new questions were asked instead—the
mother's pre-pregnancy weight and the mother's weight at delivery. Weight gain
was then calculated based
on those two responses.
Place of Birth: The place of birth information has
been expanded and classified into slightly different categories. In
particular,
home births are now subdivided into intended and unintended
home births.
Race
of Mother and Father: Indiana now uses the 1997 Office of Management
and Budget (OMB) standards for collecting data on race and ethnicity.
Starting with the 2007 birth certificate, mother and father can
check more than one box for race. All racial and ethnicity information is now sent to NCHS which imputes a single ("bridged") race to the mother and
father based on the combination of races, Hispanic origin, sex, and age. This
"bridged" race is what is used in this report.
Ethnicity
of Mother and Father: Indiana now uses the 1997 OMB standards for collecting data on race and ethnicity.
Starting with the 2007 birth certificate, mother and father can
check more than one box for ethnicity. All racial and ethnicity information is now sent to NCHS which imputes a single ("bridged")
ethnicity to the mother and
father based on the combination of races, Hispanic origin, sex, and age. This
"bridged" ethnicity is what is used in this report. Because
Hispanic can be of any race, you should not make direct comparisons across race
and ethnicity.
The
relationship between the two OMB standards and the terms used to
report race and ethnicity in this report are as follows: