The Commonwealth of Massachusetts
Executive Office of Health and Human Services
Department of Public Health
Registry of Vital Records and Statistics
150 Mt. Vernon Street, 1st Floor
Dorchester, MA 02125
KATHLEEN E. WALSH
Secretary
MAURA T. HEALEY
Governor ROBERT GOLDSTEIN, MD, PhD
Commissioner
KIMBERLEY DRISCOLL
Lieutenant Governor Tel: 617-740-2600
www.mass.gov/dph/rvrs
December 19th, 2024
Steven T. James
House Clerk
State House Room 145
Boston, MA 02133
Michael D. Hurley
Senate Clerk
State House Room 335
Boston, MA 02133
Dear Mr. Clerk,
Pursuant to Section 2 of Chapter 111 of the Massachusetts General Laws, please find enclosed a report from the
Department of Public Health entitled Massachusetts Births 2022.
Sincerely,
Robert Goldstein, MD, PhD
Commissioner
Massachusetts Department of Public Health
Massachusetts Births
2022
November 2024
 Article I. Legislative Mandate
The following report is hereby issued pursuant to Section 2 of Chapter 111 of the Massachusetts General
Laws as follows:
Chapter 111: Section 2. Annual report (specific text bolded below)
The commissioner shall administer the laws relative to health and sanitation and the regulations of the
department, and shall prepare rules and regulations for the consideration of the council. The secretary of
elder affairs and the commissioner shall jointly develop and submit to the council rules and regulations
governing the licensure and operation of convalescent or nursing homes, rest homes, infirmaries
maintained in a town and charitable homes for the aged. He may direct any executive officer or employee
of the department to assist in the study, suppression or prevention of disease in any part of the
commonwealth. He shall submit annually to the council a report containing recommendations in regard to
health legislation.
The commissioner shall prepare from the birth, marriage and death records received by him under
the provisions of chapter forty-six, and from the divorce returns received by him under the provisions
of section forty-six of chapter two hundred and eight, such statistical tables as he deems useful, and
shall make annual report thereof to the general court. The commissioner may transmit such
information to the appropriate agency of the federal government to participate in the development of a
cooperative system for producing uniform statistical information at the federal, state and local level. The
commissioner may make further use of such records as he deems useful for administrative and research
purposes connected with health programs and population studies. He shall, as soon as is reasonably
practicable, cause the birth, marriage and death records to be bound with indexes thereto and shall retain
their custody. He shall prepare an alphabetical index of such divorce returns showing the names of the
parties, year and number of the judgment and the county in which the divorce occurred.
Prior to undertaking any activity or implementing any policy which would affect expenditures for medical
assistance under chapter one hundred and eighteen E, including but not limited to the certification and
licensure of providers of services under said chapter, the commissioner shall assure that such activity is
reviewed by the commissioner of medical assistance.
The commissioner shall consult with the commissioner of mental health prior to taking an action
substantially affecting the design and implementation of behavioral health services for children under
guidelines established by the secretary of health and human services under section 16S of chapter 6A.
The commissioner, subject to the approval of the governor, may make such rules and regulations
governing the conduct of written and oral examinations by the several boards of registration and
examination under the department as shall be necessary to standardize procedures and protect the
commonwealth and applicants for registration against fraud. Nothing in this section shall prevent a board
from adopting, under authority of other provisions of law, specific rules and regulations that are not in
conflict with the rules and regulations authorized by this section.
 Massachusetts Births 2022
Maura T. Healey, Governor
Kathleen E. Walsh, Secretary of Health and Human Services
Robert Goldstein, MD, Ph.D., Commissioner of Public Health
Sai Cherala, MD, MPH, Assistant Commissioner
Karin Barrett, Registrar
Registry of Vital Records and Statistics
Massachusetts Department of Public Health
November 2024
 Acknowledgments
Special thanks go to: Karin Barrett, Registrar, Registry of Vital Records and Statistics; Dean
DiMartino, Deputy Registrar, Registry of Vital Records and Statistics; Sharon Pagnano, Director
of Statistics, Registry of Vital Records and Statistics; Maria Vu, Registry of Vital Records and
Statistics; Darien Mather, and Registry of Vital Records and Statistics; Ollie Nusbaum.
The data in this report were collected by the Registry of Vital Records and Statistics staff,
including Tara Andrews, Helen Ba, Alex Forman, Adahma Lucas-Conley, and Marta Mercado.
To obtain additional copies of this report, contact:
Massachusetts Department of Public Health
Registry of Vital Records and Statistics
150 Mt. Vernon Street, 1st Floor
Dorchester, MA 02125
(617) 740-2670
To obtain more information on births in Massachusetts and other
Department of Public Health data, please visit the Department’s free, Internet-based public
health information reports at: http://www.mass.gov/dph/phit or email DPH.PHIT@state.ma.us
 TABLE OF CONTENTS
Article I. Legislative Mandate ................................................................................................ 3
Note to Readers ......................................................................................................................... 7
Executive Summary .................................................................................................................... 8
Selected Takeaways................................................................................................................... 9
Table 1. Trends in Birth Characteristics, Massachusetts: 1970, 1980, 1990, 2000, 2010-2022. 10
Table 2. Birth Characteristics by Race/Hispanic Ethnicity and Birthplace of Birthing Person,
Massachusetts: 2022 ................................................................................................................ 11
Table 3. Birth Characteristics by Ancestry of Birthing Person, Massachusetts: 2022 ................ 12
Figure 1. Trends in the Number of Births by Birthing Person’s Age Group, Massachusetts: 1970-2022
................................................................................................................................................. 13
Table 4. Trends in Number and Percent Distribution of Births by Plurality Age of Birthing Person,
Massachusetts: 2012-2022 ....................................................................................................... 14
Table 5. Summary of Selected Teen Birth Characteristics, Massachusetts: 2022 ..................... 15
Table 6. Number and Teen Birth Rates by Race/Hispanic Ethnicity for Selected Communities,
Massachusetts: 2022 ................................................................................................................ 16
Table 7. Trends in Teen Birth Rates for Selected Communities, Ranked by 2022 Teen Birth Rate,
Massachusetts: 2013, 2020, and 2022 ..................................................................................... 17
Figure 2. Teen Birth Rates among Birthing People Ages 15-19 Years by Race/Hispanic Ethnicity of
Birthing Person, Massachusetts: 2013 and 2022 ...................................................................... 18
Table 8. Births by Birthweight, Race/Hispanic Ethnicity, Massachusetts: 2022 ......................... 19
Table 9. Low Birthweight by Plurality and Age of Birthing Person, Massachusetts: 2012-2022 . 20
Table 10. Births by Gestational Age, Race/Hispanic Ethnicity, Massachusetts: 2022 ............... 21
Table 11. Percent Preterm and Term Births by Gestational Age Category, Massachusetts: 1980,
1990, 2000, 2010-2022............................................................................................................. 22
Figure 3. Trends in Adequacy of Prenatal Care2,3 by Race/Hispanic Ethnicity, Massachusetts: 2000-
2022 ......................................................................................................................................... 23
Figure 4. Adequacy of Prenatal Care by Selected Characteristics of Birthing People, Massachusetts:
2022 ......................................................................................................................................... 24
Figure 5. Distribution of Prenatal Care Payment Source, Massachusetts: 2022....................... 25
Table 12. Resident Birth Characteristics, 30 Largest Municipalities, Massachusetts: 2022 ....... 26
Table 13. Birth Characteristics by Facility/Location, Massachusetts: 2022................................ 28
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Table 14. Resident Teen Birth Characteristics, 30 Largest Municipalities, Massachusetts: 2022.29
Table 15. Adequacy of Prenatal Care Utilization: Summary and Component Indices, Massachusetts:
2022 ......................................................................................................................................... 31
Table 16. Birth Characteristics by Race/Hispanic Ethnicity and Source of Prenatal Care Payment,
Massachusetts: 2022 ................................................................................................................ 32
Table 17. Birth Characteristics: Occurrence and Resident Births, Massachusetts Municipalities: 2022
................................................................................................................................................. 34
Table 18. Birth Characteristics: Occurrence and Resident Births by County, Massachusetts: 2022.41
Table 19. Birth Characteristics: Occurrence and Resident Births, Massachusetts Community Health
Network Areas (CHNAs), Massachusetts: 2022........................................................................ 42
Figure 6. Reported Smoking During Pregnancy, Percent of All Infants, Massachusetts: 1990 - 2022
................................................................................................................................................. 43
Table 20. Cesarean Deliveries and Vaginal Births after Cesarean (VBACs) by Licensed Maternity
Facility, All Birthing People, Massachusetts: 2022 .................................................................... 44
Figure 7. Body Mass Index (BMI) Prior to Pregnancy, All Birthing People, Massachusetts: 2022.45
Figure 8. Obesity Prior to Pregnancy by Race/Hispanic Ethnicity, All Birthing People, Massachusetts:
2022 ......................................................................................................................................... 45
Figure 9. Birthing People Who Reported Having Their Teeth Cleaned During Pregnancy by
Race/Hispanic Ethnicity, All Birthing People, Massachusetts: 2022 .......................................... 46
Figure 10. Birthing People Who Reported Having Received WIC Food During Pregnancy by
Race/Hispanic Ethnicity, All Birthing People, Massachusetts: 2022 .......................................... 46
Figure 11. Birthing People Who Reported Smoking During Pregnancy by Race/Hispanic Ethnicity, All
Birthing People, Massachusetts: 2022 ...................................................................................... 47
Table 21. Birthing People Who Used Infertility Treatments, Massachusetts: 2022 .................... 48
Technical Notes ........................................................................................................................ 49
Data Cautions ........................................................................................................................... 49
Changes in the Collection of Race/Ethnicity Information ........................................................... 49
Table A1. 2020 Massachusetts Population Estimates by Age Group, Gender, Race/Hispanic Ethnicity
(mutually exclusive) .................................................................................................................. 51
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 Note to Readers
As required by Chapter 111, Section 2 of the General Laws, this report satisfies the requirement of the annual
report of statistics on births for calendar year 2021 (Annual Report Vital Statistics of Massachusetts-Births,
Public Document #1 2021). Public Document #1 information on 2021 deaths, marriages, and divorces is
covered in separate reports.
1. Population Sources. We have used two population files based upon the 2010 Census for
denominators in rate calculations:
• Population estimates from 2000-2009 were created using straight line interpolation of data from
the U.S. Census.
• Population estimates from 2011-present were created by the UMASS Donahue Institute
(UMDI). The same categorizations were applied to the 2010 census data to make a consistent
dataset from 2010-present. Data are updated annually with summary census files that
incorporate lagging birth data. These more accurate and up-to-date rates may differ somewhat
from previously released rates. UMDI estimates were created by a team of expert
demographers using novel modifications of an existing and well-accepted methodology. UMDI
created estimates by sex, age, race, and ethnicity at the census tract and community levels.
These estimates are controlled to the annual county level Census estimates 1 on a yearly basis,
so they become more accurate over time. To read the full methodology, please refer to the
report created by UMDI: Strate, S., Renski, H., Peake, T., Murphy, J.J., Zaldonis, P. (2016).
Small area population estimates for 2011 through 2020. [White Paper]. Population Estimates
Program, Economic and Public Policy Research, University of Massachusetts Donahue
Institute.
2. Resident births. All data in this publication are resident data unless otherwise stated. Resident data
include all events that occur to residents of the Commonwealth, including resident births that occur in
other U.S. States and territories.
3. Race and Ethnicity. In the text, the race categories, White, Black, American Indian/Alaska Native, Asian/
Pacific Islander, and Hispanic are mutually exclusive. See “Technical Notes” for detailed information on
the multiple-race reporting area and methods used to bridge responses for those who report more than
one race to a single race. These methods may have a disproportionate impact on some race groups,
making it difficult to compare data over time. Please use caution in interpreting these numbers.
4. Breastfeeding. Beginning in 2016, statistics on breastfeeding indicate whether the infant was being
breastfed during the hospital stay. In earlier birth reports, statistics on breastfeeding were reported at the
time of discharge. Please use caution when comparing breastfeeding data before and after 2016.
5. Tables/Figures Based on Birthing People. Please note that Tables 20-21 and 7-11 are based on
birthing people, not births.
Suggested Citation
Massachusetts Births 2022 Boston, MA: Registry of Vital Records and Statistics, Massachusetts Department of
Public Health. June 2024.
7
 Executive Summary
This report summarizes trends in births to Massachusetts residents for 2022. It is important to note that births in
2022 were conceived during the ongoing COVID-19 pandemic; all birthing people represented in this report
experienced the pandemic during their pregnancy. This report describes trends in prenatal care and birth
outcomes in Massachusetts in 2022 and does not aim to analyze or explain the impact of the pandemic on
these trends. Future studies will be needed to understand the impact of the pandemic on short- and long-term
parental and child health.
The overall birth rate decreased for Massachusetts between 2021 and 2022 but remained higher than the birth
rate for 2020. It is too early to quantify or determine the significance of the slight increase in birth rate between
2020 and 2021, followed by this year’s decline, so this trend must continue to be monitored. White non-Hispanic
and Hispanic birthing people also remained the most prevalent racial/ethnic groups contributing to the birthrate.
Recent social and work policies, such as Massachusetts’ Paid Family and Medical Leave, rise in remote work
and hybrid setting work, and access to healthcare during the COVID-19 pandemic, must be considered along
with the unique circumstances of 2022: a national 30% increase in medication shortages and infant formula
shortages.1,2 Further investigation is warranted to examine if there are any long-term health impacts of both th