IntroductionThe US–Mexico border region has 15 million residents and 300,000 births annually. Reproductive health concerns have been identified on both sides of the border, but comparable information about reproductive health is not available. The objective of this study was to compare reproductive health indicators among populations in this region.MethodsWe used 2009 US Hispanic and Mexican birth certificate data to compare births inside the border region, elsewhere within the border states, and in the United States and Mexico overall. We examined trends in total fertility and birth rates using birth data from 2000 through 2009 and intercensal population estimates.ResultsAmong women in the border region, US women had more lifetime births than Mexican women in 2009 (2.69 births vs 2.15 births) and throughout the decade. Birth rates in the group aged 15 to 19 years were high in both the US (73.8/1,000) and Mexican (86.7/1,000) border regions. Late or no prenatal care was nearly twice as prevalent in the border regions as in the nonborder regions of border states. Low birth weight and preterm and early-term birth were more prevalent in the US border than in the Mexican border region; US border rates were higher and Mexican rates were lower than their corresponding nonborder and national rates. We found some variations within border states.ConclusionThese findings constitute the first population-based information on the reproductive health of the entire Hispanic US–Mexico border population. Evidence of disparities warrants exploration at state and local levels. Teen pregnancy and inadequate prenatal care are shared problems in US–Mexico border communities and suggest an area for binational cooperation.

Adolescent childbearing adversely affects both mothers and infants. The birth rate for US adolescent women of Hispanic origin is higher than that for US adolescents overall. Birth rates among US Hispanic adolescents in the border region are higher than rates among other US Hispanic adolescents, and rates among Mexican border adolescents are higher than rates among other Mexican adolescents. We used binational birth certificate data for US Hispanic and Mexican adolescent women living inside the border region, elsewhere within the border states, and in the US and Mexico overall to compare birth rates and other health indicators among these groups. From 2000 to 2009, birth rates for 15-19 year-olds declined 19-28 % among US Hispanic geographic subgroups and 8-13 % among Mexican geographic subgroups; rates in the border region in 2009 were 73.8/1,000 women ages 15-19 for US Hispanics and 87.2/1,000 for Mexicans and were higher than rates in other US and Mexican subgroups, respectively. Less than one in five US Hispanic and Mexican adolescent mothers in the border region was married. About one in three delivered by cesarean. Late or no prenatal care was more prevalent among US Hispanic (17.6 %) than Mexican (14.3 %) border adolescents. Birth weight and gestational age outcomes were generally poorest in Texas border counties compared with border counties in other US states and in municipios of Mexican states bordering Texas. High birth rates and low prenatal care utilization among adolescents are problems along the US-Mexico border.

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In the US and Mexico, women in border counties/municipios receive less timely prenatal care than their nonborder counterparts, but the magnitude of the disparity varies by state. Lack of a consistent, binational approach to birth data collection requires cautious interpretation of findings.

This paper offers two types of evidence in support of the idea that family planning services are most expediently provided as an integral part of the health and medical organization for maternity care. First, prenatal care and medical attention at delivery are found to be closely associated with postpartum contraceptive acceptance in a 1981 survey of family planning in rural Mexico. Second, interviews of a sample of doctors, nurses, and auxiliaries who provide maternal health services to the rural population reveal that these practitioners favor long birth intervals and small completed families, that they recommend the use of modern contraceptive methods including female sterilization, and that those in the employ of public institutions are motivated to recruit acceptors of these methods. The main impediment to contraceptive acceptance in this context is believed to be fear of side effects and permanent health consequences rather than the desire for additional children.