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INDIANA NATALITY REPORT
2015

Preface


Contained in this report:

The 2015 Indiana Natality Report includes information on live births to Indiana residents that occurred during calendar year 2015.  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. 

Summary of major changes:

In 2013, the Indiana State Department of Health (ISDH) added breastfeeding by county of residence in Table 32 and by city of residence in Table 35.  Breastfeeding is reported at the time the birth certificate is completed.  A map of breastfeeding at discharge can be found in Figure 37.  The ISDH also replaced Tables 27 and 27a (Congenital Anomalies) with the number and percent of live births by the method of delivery.  Table 27 is now the Number of Live Births by Method of Delivery, Age, and Race/Ethnicity of Mother for Indiana residents.  Table 27a is now the Percent of Live Births by Method of Delivery, Age, and Race/Ethnicity of Mother for Indiana residents.  Data on congenital anomalies can be found at http://www.in.gov/isdh/20218.htm.

Figure and table specifications:

In 2012, the Indiana Natality Report began including the number of births to mothers on Medicaid.  Alcohol use is no longer reported on the new birth certificate, which went into effect in 2007.  The data were provided in Tables 22, 23, and 32.  The Medicaid data are provided in those tables now.  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 2015 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.  This is done 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 20072015 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 who 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 three months of pregnancy, the second three months 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 is asked "Was a trial of labor attempted?" 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 sub-divided 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 the National Center for Health Statistics (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 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 ethnicity.  All racial and ethnicity information is now sent to the National Center for Health Statistics (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:

Race
1997 OMB standards (current)
1977 OMB standards (pre-2007)
This Report
American Indian or Alaska Native
American Indian or Alaska Native
Included in Other
Asian
Asian or Pacific Islander
Included in Other
Black or African American
Black
Black
Native Hawaiian or Other Pacific Islander
Asian or Pacific Islander
Included in Other
White
White
White

 

Ethnicity
1997 OMB standards (current)
1977 OMB standards (pre-2007)
This Report
Hispanic or Latino
Hispanic
Hispanic
not Hispanic or Latino
non-Hispanic
non-Hispanic

Most tables in this report will print on one page (8.5" x 11") if margins are set to 0.25" in all dimensions and the tables are viewed at the smallest font size.

The data file for this report was closed on November 3, 2016.