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State-Specific Pregnancy and Birth Rates Among Teenagers -- United States, 1991-1992

Pregnancy and childbearing rates for teenagers remain high in the United States despite well-documented associated adverse health, social, and economic consequences for many of these teenagers and their children. In 1990, approximately 835,000 (10%) teenagers aged 15-19 years became pregnant and either gave birth or had an abortion (CDC, unpublished data, 1995); an estimated 95% of such pregnancies are unintended (1). This report presents estimates of pregnancy rates among women aged less than or equal to 19 years for each state and the District of Columbia (DC) by age group, pregnancy rates for women aged 15-19 years by race, and birth rates for women aged 15-19 years by race and by Hispanic ethnicity for 1991-1992, and compares pregnancy rates for 1991 and 1992.

The numbers of pregnancies for 1991 and 1992 were estimated as the sum of live births and legal induced abortions among women aged less than or equal to 19 years (data were analyzed for women aged less than 15, 15-17, 18-19, and 15-19 years); estimates of spontaneous abortions and stillbirths were not included. Births were reported by state of residence; because abortion data by residence were not available for all states, abortions were reported by state of occurrence. * Denominators for rate calculations were obtained from intercensal population estimates provided by the U.S. Bureau of the Census (2). Rates for 15-19- year-olds were calculated as the number of pregnancies, abortions, or births per 1000 women aged 15-17, 18-19, and 15-19 years. Because almost all pregnancies (97% of births and 94% of abortions) among girls aged less than 15 years occur among those aged 13-14 years (3; CDC, unpublished data, 1993), the number of girls aged 13-14 years was used as the denominator when calculating rates for the less than 15-year age group. For each state included in rate calculations, the number of women who had abortions for whom age or race information was missing and the number who gave birth for whom ethnicity information was missing were included in age, race, or ethnicity categories based on the known distributions for abortions or births in that state. ** Differences in pregnancy, abortion, and birth rates for 1991 and 1992 were calculated and tested for statistical significance at p less than 0.05.

Although abortion totals were available for all states, age-specific abortion data were available from 42 states for both 1991 and 1992; race-specific data were available from 31 states for 1991 and from 34 states for 1992. Because Hispanic ethnicity information for women who had abortions was available for only 18 states for 1991 and 20 states for 1992, pregnancy rates by ethnicity are not included in this report. Information was available for birth rates by age and by race for all 50 states and DC and by ethnicity for 49 states and DC.

For both years and for all states for which data were available, pregnancy rates were higher for older teenagers than for younger teenagers. Rates for 15-19-year-olds in 1991 ranged from 54.3 per 1000 women (North Dakota) to 109.2 (Georgia) (Table_1), *** and in 1992, from 53.7 (Wyoming) to 106.9 (Georgia). For those aged less than 15 years, pregnancy rates in 1991 ranged from 1.8 per 1000 (Idaho) to 10.6 (Georgia) and in 1992 from 2.0 (Idaho) to 10.9 (Mississippi).

From 1991 through 1992, pregnancy rates for 15-19-year-olds decreased significantly in 31 of the 42 states for which age-specific data were available (range: 2%-15% decrease) (Table_1). In two states, rates increased significantly. Among states with decreases in pregnancy rates, the percentage decrease was generally greater for 15-17-year-olds than for other age groups. For those aged less than 15 years, pregnancy rates decreased significantly in one state and increased significantly in two.

Decreases in teenage pregnancy rates were reflected in both birth and abortion rates. More states had decreases in abortion rates than had decreases in birth rates, and the decreases generally were greater for abortion rates than for birth rates. For the 50 states and DC, birth rates for 15-19-year-olds decreased significantly in 20 states: by less than 5% in 11 states and by 5%-9% in nine states. Abortion rates decreased significantly in 31 of the 42 states for which data were available: rates decreased by less than 5% in two states, 5%-9% in six states, 10%-14% in eight states, and 15%-27% in 15 states.

Except in one state in 1992, pregnancy rates and birth rates by state for 15-19-year-olds were higher for blacks than for whites (Table_2 and Table_3). Among states with decreases in pregnancy rates, the percentage decrease generally was greater for whites than for blacks. Birth rates generally were higher for Hispanics than for non-Hispanics in both 1991 and 1992.

Reported by: Behavioral Epidemiology and Demographic Research Br, Statistics and Computer Resources Br, Div of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion; Natality, Marriage, and Divorce Statistics Br, Div of Vital Statistics, National Center for Health Statistics, CDC.

Editorial Note

Editorial Note: The estimates in this report indicate pregnancy rates for women aged 15-19 years decreased in 1992 from 1991 in many states; these changes were reflected in both abortion and birth rates. As a result, the national birth rate for 15-19-year-olds decreased by 2% in 1992 following a 24% increase from 1986 through 1991 (4). In conjunction with a continuing decrease in abortions (5), this change may signify a turning point in pregnancy trends among teenagers.

Changes in pregnancy rates for women aged 15-19 years may reflect shifts in the proportion of those who have had sexual intercourse and the proportion who use contraception effectively. The percentage of women in this age group who were sexually experienced remained stable from 1990 through 1993, while the percentage of sexually experienced teenagers who used condoms increased, and the percentage using oral contraceptives remained stable (6). The finding that significant decreases in pregnancy rates occurred both in states with relatively low 1991 rates and states with relatively high rates suggests that potential exists for all states to achieve lower rates of pregnancy among this age group. School-based programs that focus on the risks of unprotected sexual intercourse and assist students in developing appropriate values, self-efficacy, and negotiation skills appear to be effective in postponing initiation of sexual activity and in decreasing rates of unprotected intercourse (7). Some community-based programs emphasize development of self-esteem and orientation toward the future and provide sex education and family-planning services; such programs may be effective in decreasing rates of unprotected intercourse and potentially can reach teenagers who are not enrolled in school.

Pregnancy and birth rates did not decrease equally for all groups of teenagers. For example, pregnancy rates for those aged less than 15 years decreased significantly in only one state. In addition, percentage decreases in pregnancy rates for 15-19-year-olds were greater for whites than for blacks; consequently, both pregnancy and birth rates remained higher for blacks than whites. In addition, birth rates remained higher for Hispanics than for non-Hispanics. Differences in these rates by race and ethnicity may reflect differences in factors such as income, education levels, sexual activity, reproductive preferences, contraceptive use, and access to health care. Analysis of these factors could identify reasons for the differences in rates and suggest possible interventions to reduce these rates.

The estimation in this report of pregnancy rates for teenagers was limited by the lack of complete abortion data for some states. In addition, pregnancy totals based on births and legal induced abortions reported to CDC may underestimate the actual number of pregnancies. In 1990, approximately 835,000 live births and abortions among 15-19-year-olds were reported in the United States to CDC (CDC, unpublished data, 1995). In contrast, a recent analysis using alternative methodology and including fetal losses estimated approximately 1 million pregnancies among 15-19-year-olds in the United States during 1990 (8,9).

Accurate monitoring of pregnancy trends requires complete reporting of age, race, and Hispanic ethnicity for those who have abortions as well as those who give birth. Birth patterns cannot be used to estimate trends in pregnancy because the ratio of pregnancies to births varies by state, age, race, and ethnicity. Therefore, efforts by states to collect complete abortion data are essential for evaluating the progress of pregnancy-prevention programs for teenagers.

References

  1. Piccinino LJ. Unintended pregnancy and childbearing in the United States, 1973-1990. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, NCHS. (Advance data) (in press).

  2. Bureau of the Census. Estimates of the population of states, by age, race, sex, and Hispanic origin, 1990-92. Washington, DC: US Department of Commerce, Bureau of the Census, Statistical Information Office, Population Division (in press).

  3. NCHS. Vital statistics of the United States, 1992. Vol 1 -- natality. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC (in press).

  4. Ventura SJ, Martin JA, Taffel SM, et al. Advance report of final natality statistics, 1992. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1994. (Monthly vital statistics report; vol 43, no. 5, suppl).

  5. CDC. Abortion surveillance: preliminary data -- United States, 1992. MMWR 1994;43:930-3,939.

  6. CDC. Trends in sexual risk behavior among high school students -- United States, 1990, 1991, and 1993. MMWR 1995;44:131-2.

  7. Kirby D, Short L, Collins J, et al. School-based programs to reduce sexual risk behaviors: a review of effectiveness. Public Health Rep 1994;109:339-59.

  8. Henshaw SK, VanVort J. Abortion services in the United States, 1991 and 1992. Fam Plann Perspect 1994;26:100-12.

  9. Ventura SJ, Taffel SM, Mosher WD, et al. Trends in pregnancies and pregnancy rates: estimates for the United States, 1980-92. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1995. (Monthly vital statistics report; vol 43, no. 11, suppl).

* For 47 reporting areas, data were provided from the central health agency (state health departments and the health departments of DC, upstate New York, and New York City). Data from upstate New York and New York City were combined to produce totals for the state. For the other five states, data were provided from hospitals and other medical facilities. The word "state" in this report refers to both states and DC except where DC is mentioned explicitly. Wisconsin and DC reported age for those who had abortions among residents only. 

** Reasons for the exclusion of rates in some states are listed in the tables; the following hierarchy was used to determine whether data were excluded: 1) abortion data by age or race or birth data by Hispanic ethnicity were not reported by state; 2) less than 20 births or pregnancies or less than 1000 women were in the group; and 3) for greater than 15% of the abortion data, age or race of the women was unknown. 

*** DC is not included in these comparisons because it is an urban area, and pregnancy rates are generally higher in urban areas than in states.


Table_1
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TABLE 1. Teenage pregnancy rates, * by age group and reporting area, and percentage change +
for 15-19-year-olds -- United States, 1991-1992
===============================================================================================

                                                                             % Change @
                            1991                          1992               1991-1992
                -----------------------------   ---------------------------  ------------------
State           <15     15-17  18-19    15-19   <15  15-17    18-19   15-19     15-19
-----------------------------------------------------------------------------------------------
Alabama          8.9    63.2   143.1    97.0    9.1   60.8    139.4    93.2    - 3.9
Alaska           &       &       &       &      &      &        &       &         &
Arizona          5.5    66.3   163.5   106.2    5.5   64.5    163.1   103.5    - 2.5
Arkansas         7.2    60.2   152.0    98.2    7.0   56.0    141.1    90.7    - 7.6
California       &       &       &       &      &      &        &       &         &
Colorado         4.4    53.3   123.7    82.3    4.6   52.1    122.1    79.8    - 3.1
Connecticut      &       &       &       &      &      &        &       &         &
Delaware         &       &       &       &      &      &        &       &         &
District
 of Columbia    33.8     &       &     226.1   30.6    &        &     208.4    - 7.9
Florida          &       &       &       &      &      &        &       &         &
Georgia         10.6    72.9   158.4   109.2   10.6   69.6    159.9   106.9    - 2.1
Hawaii           6.4    56.7   133.1    89.0    6.6   56.4    126.6    86.4    - 3.0
Idaho            1.8    35.0   107.2    63.9    2.0   32.7    101.7    59.7    - 6.7
Illinois         &       &       &       &      &      &        &       &         &
Indiana          4.0    43.2   119.4    75.3    4.0   42.4    115.7    72.2     - 4.1
Iowa             &       &       &       &      &      &        &       &         &
Kansas           3.6    48.1   127.3    80.1    4.9   53.7    139.1    87.0       8.7
Kentucky         6.3    58.0   130.8    88.3    6.0   52.1    125.6    81.7    - 7.4
Louisiana        8.7    60.3   136.3    92.0    8.7   62.1    137.8    92.6       0.7
Maine            2.2    38.8    99.8    64.6    2.1   31.9     88.6    55.2    -14.7
Maryland         7.7    52.2   116.8    79.6    7.2   51.3    113.8    76.9    - 3.5
Massachusetts    4.8    44.8   109.4    74.0    4.9   42.4    106.3    69.5    - 6.0
Michigan         5.5    50.5   127.4    82.9    5.1   48.1    125.6    79.7    - 3.8
Minnesota        3.1    33.7    96.7    59.5    3.1   31.7     91.5    55.2    - 7.3
Mississippi     10.3    74.5   147.8   105.5   10.9   71.1    143.8   100.8    - 4.5
Missouri         5.4    49.2   129.8    82.6    4.7   47.0    124.6    78.0    - 5.6
Montana          2.7    42.9   126.3    75.6    3.6   43.4    112.5    70.2    - 7.1
Nebraska         3.2    40.9   109.9    69.4    3.3   35.4    105.2    63.4    - 8.7
Nevada           6.0    65.9   170.4   108.9    7.3   65.5    166.1   106.0     - 2.6
New Hampshire    &       &       &       &      &      &        &       &         &
New Jersey       5.7    47.3   113.2    74.6    5.8   44.0    107.6    69.7    - 6.5
New Mexico       4.5    66.1   158.2   103.0    4.9   66.9    155.0   101.8    - 1.2
New York         7.9    62.6   137.8    94.4    8.5   64.8    143.3    96.6       2.3
North Carolina   9.0    73.0   155.7   108.8    8.5   68.2    155.6   104.6    - 3.8
North Dakota     2.2    28.2    93.9    54.3    **    26.8     97.9    54.2    - 0.3
Ohio             4.5    48.1   125.8    80.9    4.5   44.3    118.7    74.6    - 7.7
Oklahoma         &       &       &       &      &      &        &       &         &
Oregon           4.7    53.9   143.4    89.5    4.0   48.8    132.3    81.0    - 9.5
Pennsylvania     5.9    49.1   111.7    75.9    6.3   46.5    107.8    71.7    - 5.6
Rhode Island     6.2    53.1   132.4    89.4    6.2   49.6    141.3    88.1    - 1.4
South Carolina   7.5    62.0   137.7    94.6    7.6   57.7    130.3    88.0    - 7.0
South Dakota     **     33.0    94.0    57.5    **    36.1     96.1    59.4       3.3
Tennessee        8.0    65.8   151.0   102.0    7.9   58.8    144.3    94.0    - 7.8
Texas            6.8    65.3   160.1   104.3    6.5   65.7    160.2   103.7    - 0.7
Utah             2.2    33.3    97.8    59.4    2.5   31.5     93.9    55.6    - 6.3
Vermont          2.9    47.7   117.3    78.0    2.9   38.6    112.0    68.7    -12.0
Virginia         6.5    53.2   125.7    84.8    6.1   49.2    119.8    79.0    - 6.8
Washington       5.2    56.3   143.3    91.7    4.3   54.3    132.1    85.1    - 7.2
West Virginia    2.8    36.0   102.8    63.9    3.2   38.9    106.2    66.1       3.4
Wisconsin        3.9    38.2   103.6    64.9    3.9   35.3    100.1    60.8    - 6.3
Wyoming          **     29.6   106.4    59.3    **    27.0     97.1    53.7    - 9.5
-----------------------------------------------------------------------------------------------
*  Per 1000 women in the appropriate age group (13-14 years for <15 years age group). Pregnancy
   rate was not calculated when age information was missing for >15% of women who had
   abortions.
+  Percentage change in rate from 1991 to 1992.
@  Italic type indicates that the difference is statistically significant at p<0.05.
&  Pregnancy rate or percentage change could not be calculated because the state did not
   provide abortion data by age.
** Pregnancy rate is not shown for groups with <20 pregnancies or <1000 women.
===============================================================================================

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Table_2
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TABLE 2. Pregnancy rates * for 15-19-year-olds * , by
race + and state -- United States, 1991-1992
=======================================================
                      1991                1992
                 ----------------   -------------------
State             White    Black      White   Black
-------------------------------------------------------
Alabama            77.2    139.1      73.4    134.7
Alaska              @        @         @        @
Arizona             &        &       102.3    150.6
Arkansas           83.4    153.3      76.7    142.6
California          @        @         @        @
Colorado            &        &         &        &
Connecticut         @        @         @        @
Delaware            @        @         @        @
District
 of Columbia        @        @         @        @
Florida             @        @         @        @
Georgia            82.2    165.1      79.6    162.9
Hawaii             70.3     **        64.7     **
Idaho              63.9     **        59.4     **
Illinois            @        @         @        @
Indiana            66.3    161.2      62.9    156.7
Iowa                @        @         @        @
Kansas             73.1    177.2      77.8    211.9
Kentucky           82.2    155.0      75.5    149.9
Louisiana          66.3    131.4 ++   65.3    133.7 ++
Maine              64.4     **        54.9     **
Maryland           55.6    136.3      51.0    137.1
Massachusetts       @        @         @        @
Michigan            @        @         @        @
Minnesota           &        &        47.3    218.1
Mississippi         &        &        71.9    135.1
Missouri           65.1    193.0      60.9    186.0
Montana            68.9     **        61.8     **
Nebraska            @        @         @        @
Nevada            106.0    168.6     101.9    171.2
New Hampshire       @        @         @        @
New Jersey         52.4    178.1      41.2    179.7
New Mexico        101.4    132.7     102.2    100.8
New York           76.1    173.2      77.3    175.9
North Carolina     86.5    163.2      83.3    155.3
North Dakota       47.5     **        47.8     **
Ohio                &        &         &        &
Oklahoma            @        @         @        @
Oregon             88.5    200.9      79.4    181.7
Pennsylvania       58.0    214.9      53.5    211.5
Rhode Island       80.7    214.5      78.0    211.8
South Carolina     74.2    129.5      68.6    119.6
South Dakota       46.4     **        46.5     **
Tennessee          85.6    168.4      77.4    162.4
Texas              98.2    152.3      98.2    148.8
Utah               58.4     **        54.2     **
Vermont            77.9     **        68.4     **
Virginia           69.2    143.8      62.9    139.4
Washington          &        &         &        &
West Virginia      62.9    100.3      64.6    116.5
Wisconsin          49.7    241.3      45.3    226.9
Wyoming             @        @         @        @
-------------------------------------------------------
*  Per 1000 women.
+  Pregnancy rates for women of races other than white
   or black are not presented because the composition
   of this category varied widely by state, and
   abortion information was not available on the race
   breakdown of "others" for each state.
@  Pregnancy rate could not be calculated because the
   state did not provide abortion data by age or race.
&  Pregnancy rate was not calculated because age or
   race information was missing for >15% of women who
   had abortions.
** Pregnancy rate is not shown for groups with <20
   pregnancies or <1000 women.
++ Rate is for all races other than white.
=======================================================

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Table_3
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TABLE 3. Birth rates for 15-19-year-olds, * by race, + Hispanic ethnicity, @ and state
-- United States, 1991-1992
============================================================================================

                             1991                                   1992
             ------------------------------------   -----------------------------------------
                Race         Ethnicity                  Race         Ethnicity
             ----------- ----------------- ------   ----------- ----------------- -----------
                                    Non-                                   Non-
State        White Black Hispanic Hispanic Total &  White Black Hispanic Hispanic Total &
---------------------------------------------------------------------------------------------
Alabama       56.4 110.9   45.5     74.1    73.9    55.2  108.9    65.6    72.6    72.5
Alaska        53.2  **     **       64.9    65.4    49.9   **      **      63.7    63.9
Arizona       77.1 131.1  131.4     62.6    80.7    79.9  112.0   135.4    62.0    81.7
Arkansas      66.8 127.5   **       79.8    79.8    62.8  122.0    **      75.3    75.5
California    79.3 100.1  122.3     48.8    74.7    79.3   94.6   123.5    46.6    74.0
Colorado      55.2 120.7  117.3     45.5    58.2    55.9  108.4   121.3    44.8    58.4
Connecticut   32.9  98.2  143.2     29.4    40.4    32.4   94.5   139.4    28.2    39.4
Delaware      40.5 137.1   **       59.2    61.1    41.4  122.9    **      57.2    59.6
District
  of Columbia  9.2 149.5  106.6    114.8   114.4    26.4  130.8    **     115.1   116.1
Florida       52.4 134.8   60.7     70.2    68.8    50.7  126.5    57.9    67.8    66.3
Georgia       55.8 119.0   88.3     76.1    76.3    54.9  115.2    97.0    74.1    74.5
Hawaii        40.7  **    118.8     52.2    58.7    32.8   **      99.0    48.4    53.5
Idaho         53.9  **    122.1     49.1    53.9    51.3   **     127.7    46.3    51.7
Illinois      46.0 145.1  103.4     60.2    64.8    45.2  144.6   106.6    58.4    63.6
Indiana       53.4 128.1   64.8     60.3    60.5    51.4  125.9    70.0    58.4    58.7
Iowa          40.3 135.9   86.3     41.9    42.6    38.4  137.7    89.1    39.9    40.8
Kansas        50.0 127.0   94.5     53.3    55.4    49.7  137.4    97.0    53.5    55.7
Kentucky      64.9 114.4   **       69.1    68.9    60.7  112.1    **      64.8    64.7
Louisiana     51.7 117.1   24.3     77.3    76.1    51.3  118.4    22.5    77.8    76.5
Maine         43.4  **     **       43.6    43.5    39.9   **      **      39.8    39.8
Maryland      36.4  97.4   46.9     54.5    54.3    32.0   95.5    59.1    50.4    50.7
Massachusetts 33.2  97.7  134.6     30.4    37.8    33.1   97.0   128.1    30.5    38.0
Michigan      43.1 129.2   95.1     57.8    59.0    41.6  124.6    90.3    55.5    56.5
Minnesota     30.6 160.9  108.4     36.0    37.3    29.5  162.6   110.0    34.6    36.0
Mississippi   58.8 117.9   **       86.0    85.6    57.2  116.1    **      84.6    84.2
Missouri      51.7 145.7   64.5     64.5    64.5    50.5  143.9    62.9    63.2    63.2
Montana       39.5  **     **       46.1    46.7    38.0   **      **      45.7    46.2
Nebraska      37.0 129.9  103.7     40.3    42.4    35.8  125.6    99.8    38.9    41.1
Nevada        69.9 138.4  114.0     69.0    75.3    65.6  137.2   122.8    62.7    71.4
New Hampshire 33.6  **     ++       ++      33.3    31.1   **      ++      ++      31.3
New Jersey    28.9 101.5   84.4     35.3    41.6    26.1  103.2    78.1    33.3    39.2
New Mexico    77.8 103.2   99.5     62.8    79.8    79.5   75.6   102.5    61.2    80.3
New York      39.0  77.6   87.5     38.3    46.0    39.0   73.8    85.0    37.6    45.3
North Carolina53.5 111.3   97.2     70.2    70.5    53.4  107.7   132.1    68.8    69.5
North Dakota  28.8  **     **       35.5    35.6    30.6   **      **      36.5    37.3
Ohio          49.8 133.4   83.2     60.1    60.5    47.2  132.4    74.9    57.7    58.0
Oklahoma      63.4 127.8   92.7     71.3    72.1    63.1  116.4    91.2    69.1    69.9
Oregon        54.2 117.3  129.3     50.6    54.9    52.2  113.6   134.1    48.6    53.2
Pennsylvania  36.3 131.1  129.8     44.5    46.9    34.6  127.3   131.9    42.6    45.2
Rhode Island  39.1 129.6  119.7     40.3    45.4    40.1  131.1   128.0    41.2    47.5
South Carolina54.6 104.3   62.7     73.0    72.9    52.2   99.7    66.2    70.3    70.3
South Dakota  35.5  **     **       47.5    47.5    34.9   **      **      48.1    48.3
Tennessee     62.1 127.7   45.4     75.4    75.2    58.5  124.1    70.5    71.4    71.4
Texas         74.5 115.5  110.5     62.9    78.9    75.1  113.4   112.2    61.5    78.9
Utah          47.8  **    100.9     45.1    48.2    45.4   **     107.4    42.8    46.3
Vermont       39.4  **     **       39.5    39.2    35.6   **      **      35.8    35.6
Virginia      41.5  98.3   61.2     53.2    53.5    39.5   97.6    63.2    51.4    51.8
Washington    52.6  96.2  127.9     48.6    53.7    49.3   91.6   136.4    45.1    50.9
West Virginia 57.3  80.1   **       58.0    57.8    55.5   77.4    **      56.1    56.0
Wisconsin     31.8 178.1   94.6     42.3    43.7    29.8  167.1    94.7    40.5    42.1
Wyoming       52.0  **     75.3     52.4    54.2    47.5   **      79.1    47.1    49.6
--------------------------------------------------------------------------------------------
*  Per 1000 women.
+  Birth  rates for women of races other than white or black are not presented because the
   composition of this category varied widely by state.
@  Hispanic ethnicity is independent of race; Hispanics and non-Hispanics may be of any race.
&  Total includes all women aged 15-19 years.
** Birth rate is not shown for groups with <20 births or <1000 women.
++ Birth rate could not be calculated because the state did not provide birth data by
   ethnicity.
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