NCHS - U.S. National Center for Health Statistics

06/10/2026 | Press release | Distributed by Public on 06/09/2026 22:24

A Decade of Decline in Twin Childbearing in the United States, 2014–2024

NCHS Health E-Stat 117, June 2026

by Joyce A. Martin, M.P.H., and Michelle J.K. Osterman, M.H.S.

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The twin birth rate (twin births per 1,000 total births) rose 79% from 1980 (18.9) to 2014 (33.9), then began to decline (1-4). Trends in twin childbearing are of public health interest because of the increased maternal and neonatal risk compared with singleton pregnancies (5-7). This report describes trends in the number and rate of twins born in the United States from the most recent high in 2014 through 2024. It also describes changes in the twin birth rate by maternal age and race and Hispanic origin from 2014 to 2024.

The twin birth rate declined an average 1% per year from 2014 (33.9 twins per 1,000 births) to 2024 (30.1) for a total decline of 11% (Table, Figure 1). The number of births in twin deliveries declined an average 2% per year from 2014 (135,336) to 2024 (109,195) for a total decline of 19%. In comparison, the number of births in singleton deliveries declined 9% (from 3,848,214 to 3,517,151) over the same decade (Table). The largest single-year decline in both the number (7%) and rate (3%) of twin births during 2014-2024 occurred in 2020.

By maternal age, the largest declines in twinning rates from 2014 to 2024 were for mothers age 30 and older. Those rates were down 18% for mothers ages 30-34 (40.3 to 33.2 per 1,000 births), 27% for mothers 35-39 (48.6 to 35.4), and 46% for mothers 40 and older (66.0 to 35.6) (Figure 2). The rate for mothers ages 25-29 declined 5% (30.5 to 28.9), while changes in rates for mothers 20-24 (23.0 to 22.7) and younger than 20 (16.0 to 16.1) were not significant.

Among the three largest race and Hispanic-origin groups, twin birth rates declined 15% for White non-Hispanic (36.7 to 31.3) and 3% for Hispanic (24.1 to 23.4) mothers, and rose 5% for Black non-Hispanic mothers (40.0 to 42.0) (Figure 3).

Data source and methods

This report is based on birth certificate data from the National Vital Statistics System (NVSS) data files (8).

Twin birth is defined as two fetuses delivered alive or dead at any time in the pregnancy regardless of gestational age, or delivered at different times during the pregnancy. Data for American Indian and Alaska Native non-Hispanic, Asian non-Hispanic, and Native Hawaiian and Other Pacific Islander non-Hispanic are not shown because of revisions to the 1997 Office of Management and Budget standards on classification of race and ethnicity, which resulted in noncomparable data for these groups over the study period (9). References to differences in birth rates indicate that the change is statistically significant at the 0.05 level based on a two-tailed z test. Trends in the number and rate of twin births for Figure 1 were evaluated using the Joinpoint Regression Program (10).

References

  1. Martin JA, Hamilton BE, Osterman MJK. Three decades of twin births in the United States, 1980-2009. NCHS Data Brief. 2012 Jan;(80):1-8. PMID: 22617378.
  2. Martin JA, Osterman MJK. Is twin childbearing on the decline? Twin births in the United States, 2014-2018. NCHS Data Brief. 2019 Oct;(351):1-8. PMID: 31751205.
  3. Horon I, Martin JA. Changes in twin births in the United States, 2019-2021. Natl Vital Stat Rep. 2022 Dec;71(9):1-11. DOI: https://dx.doi.org/10.15620/cdc:121829.
  4. Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP. Births: Final data for 2023. Natl Vital Stat Rep. 2025 Mar;74(1):1-87. DOI: https://dx.doi.org/10.15620/cdc/175204.
  5. Multifetal gestations: Twin, triplet, and higher-order multifetal pregnancies. ACOG practice bulletin summary, no 231. Obstet Gynecol. 2021 Jun;137(6):1140-3. DOI: https://dx.doi.org/10.1097/AOG.0000000000004398. PMID: 34011883.
  6. Madar H, Goffinet F, Seco A, Rozenberg P, Dupont C, Deneux-Tharaux C, EPIMOMS (Epidémiologie de la Morbidité Maternelle Sévère) Study Group. Severe acute maternal morbidity in twin compared with singleton pregnancies. Obstet Gynecol. 2019 Jun;133(6):1141-50. DOI: https://dx.doi.org/10.1097/AOG.0000000000003261.
  7. Ely DM, Driscoll AK. Infant mortality in the United States, 2023: Data from the period linked birth/infant death file. Natl Vital Stat Rep. 2025 Jun;74(7):1-20. DOI: https://dx.doi.org/10.15620/cdc/174592.
  8. National Center for Health Statistics. Vital statistics online data portal. Birth data files. Available from: https://www.cdc.gov/nchs/data_access/VitalStatsOnline.htm.
  9. Office of Management and Budget. Revisions to the standards for classification of federal data on race and ethnicity. Fed Regist. 1997;62(210):58782-90.
  10. National Cancer Institute. Joinpoint regression program (version 4.8.0.1) [computer software]. 2020.

Suggested citation

Martin JA, Osterman MJK. A decade of decline in twin childbearing in the United States, 2014-2024. NCHS Health E-Stats. 2026 Jun;(117):1-6. DOI: https://dx.doi.org/10.15620/cdc/252449.

Table

Table. Number of singleton births and number and rate of twin births: United States, 2014-2024
Year Number of singleton births1 Number of twin births2 Twin birth rate2,3
2014 3,848,214 135,336 33.9
2015 3,841,219 133,155 33.5
2016 3,810,149 131,723 33.4
2017 3,723,273 128,310 33.3
2018 3,664,651 123,536 32.6
2019 3,623,963 120,291 32.1
2020 3,498,335 112,437 31.1
2021 3,547,198 114,161 31.2
2022 3,550,380 114,483 31.2
2023 3,482,971 110,393 30.7
2024 3,517,151 109,195 30.1

1Significant decreasing trend for 2014 to 2020, p < 0.05.
2Significant decreasing trend for 2014 to 2024, p < 0.05.
3Twin births per 1,000 total births.
SOURCE: National Center for Health Statistics, National Vital Statistics System, natality data file

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