ObGyn Intelligence
Evidence Matters
Prepare
Evidence LibraryUnderstanding pregnancy, risk, and consentReading a number
Evidence Library · Reading a number

One complication, three different numbers

Per live births, per hospital deliveries and per pregnancies are not the same thing, and the gap between them is not small.

Three data systems produce almost all the numbers you will be quoted. They count different things.

SystemWhat it countsWhat it leaves out
Birth certificates (NCHS)Live births. 3,628,934 in 2024.Miscarriage, stillbirth, termination, ectopic pregnancy, anything that ended before delivery
Hospital discharge recordsHospital deliveries. 6,892,304 across 2018 and 2019 in the CDC study.Births outside a hospital (1.6% of 2024 US births were home births) and early losses managed as outpatients
PregnanciesEverything above added togetherNo current US figure exists at all

Here is why that matters at the level of a single sentence. Heavy bleeding after birth is recorded in 4.3% of hospital deliveries. Gestational diabetes is recorded in 8.5% of live births. Miscarriage happens in about 15 of every 100 recognised pregnancies, on a global pooled estimate. Those three numbers cannot be added together, subtracted from one another, or put on the same chart. They do not share a bottom.

The same procedure, two correct rates. Forceps and vacuum births were 2.7% of all live births in 2024. In a study that counted only deliveries where labor was actually attempted, the rate was 3.9%. Both are right. The second excludes scheduled cesareans, which cannot end in a forceps birth. Quoting one while implying the other is the error.

The other trap: a diagnosis defined by a percentileSpecialist guidance describes fetal growth restriction as occurring in up to 10% of pregnancies. The same document defines it as an estimated fetal weight or abdominal circumference below the 10th percentile for gestational age. A condition defined as the bottom tenth will, by construction, be found in close to a tenth of the babies measured. The figure is mostly a statement about where the line was drawn. The specialists say so themselves, noting the difficulty of telling apart a baby who is simply small from one who is not growing as it should.
Say this out loud

"Is that out of all births, or out of women in my situation?"

"Is that a diagnosis based on a threshold, or on something going wrong?"

Where this comes from:
271. Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP. Births: final data for 2024. Natl Vital Stat Rep. 2026;75(2):1-48.
492. National Center for Health Statistics. User guide to the 2024 natality public use file (revised 2026). Hyattsville (MD): National Center for Health Statistics; 2026.
490. Womack LS, DeSisto CL, Clark EA, Ford ND, Hollier LM, Menard MK, et al. Common complications and conditions at delivery hospitalization by race and ethnicity in the United States. Obstet Gynecol. 2026;147(4):540-9.
497. Corbetta-Rastelli CM, Friedman AM, Sobhani NC, Arditi B, Goffman D, Wen T. Postpartum hemorrhage trends and outcomes in the United States, 2000-2019. Obstet Gynecol. 2023;141(1):152-61.
507. Sarker MR, Teal EN, Wiley R, Emeruwa U, Kim J, Arida G, et al. Contemporary trends in operative vaginal delivery and obstetric anal sphincter injuries from 2016-2023. Pregnancy (Hoboken). 2025;1(4):e70063.
509. Society for Maternal-Fetal Medicine (SMFM); Martins JG, Biggio JR, Abuhamad A. Society for Maternal-Fetal Medicine Consult Series #52: diagnosis and management of fetal growth restriction. Am J Obstet Gynecol. 2020;223(4):B2-B17.
503. Quenby S, Gallos ID, Dhillon-Smith RK, Podesek M, Stephenson MD, Fisher J, et al. Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss. Lancet. 2021;397(10285):1658-67.

Covered in the essential classes

Continue

More from The perfect pregnancy

This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.