The rate of twin births increased in recent decades, soaring by 76% from 1980 to 2011, according to the National Center for Health Statistics. Despite the near record high rate, twin births remain relatively rare, accounting for just 34 out of every 1,000 births in 2016.

There are two reasons for the rise in twin births. The first is that women are having babies at older ages, and the peak age for having twins is around 35. The second, more impactful, reason is that fertility treatments have become increasingly common, leading to multiple births.

The twin birth rate is different between states. 24/7 Wall St. reviewed government data and ranked states from the lowest to the highest birth rate of twins.

Click here to see the states where the most twins are born.

To identify the states where the most twins are are born, 24/7 Wall St. reviewed the Center for Disease Control and Prevention’s National Vital Statistics Reports. The twin birth rate is per every 1,000 live births. This rate, as well as the total number of twin births, were collected between 2014 and 2016. The data for total births in each state is for 2016. Fertility rates are calculated as births per 1,000 women aged 15–44 and are also for 2016. The rate of first births to older women aged 35 to 44 in each state came from the CDC and are for 2012, the latest period for which data is available.

50. New Mexico
> Twin birth rate: 23.9 per 1,000 live births
> Total twins born in 2016: 1,832
> First births to older women: 5.0 per 1,000 women aged 35-44 (21st lowest)
> Median income, all households: $46,748 (8th lowest)

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49. Arkansas
> Twin birth rate: 29.6 per 1,000 live births
> Total twins born in 2016: 3,426
> First births to older women: 3.3 per 1,000 women aged 35-44 (3rd lowest)
> Median income, all households: $44,334 (4th lowest)

48. Arizona
> Twin birth rate: 29.6 per 1,000 live births
> Total twins born in 2016: 7,606
> First births to older women: 5.5 per 1,000 women aged 35-44 (24th highest)
> Median income, all households: $53,558 (21st lowest)

47. Hawaii
> Twin birth rate: 29.9 per 1,000 live births
> Total twins born in 2016: 1,648
> First births to older women: 10.3 per 1,000 women aged 35-44 (3rd highest)
> Median income, all households: $. ()

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46. Delaware
> Twin birth rate: 30.0 per 1,000 live births
> Total twins born in 2016: 993
> First births to older women: 6.0 per 1,000 women aged 35-44 (20th highest)
> Median income, all households: $61,757 (14th highest)

45. Washington
> Twin birth rate: 30.3 per 1,000 live births
> Total twins born in 2016: 8,131
> First births to older women: 8.4 per 1,000 women aged 35-44 (7th highest)
> Median income, all households: $67,106 (9th highest)

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44. Kansas
> Twin birth rate: 30.3 per 1,000 live births
> Total twins born in 2016: 3,530
> First births to older women: 4.6 per 1,000 women aged 35-44 (15th lowest)
> Median income, all households: $54,935 (24th lowest)

43. West Virginia
> Twin birth rate: 30.6 per 1,000 live births
> Total twins born in 2016: 1,813
> First births to older women: 3.0 per 1,000 women aged 35-44 (2nd lowest)
> Median income, all households: $43,385 (3rd lowest)

42. Colorado
> Twin birth rate: 30.7 per 1,000 live births
> Total twins born in 2016: 6,102
> First births to older women: 8.3 per 1,000 women aged 35-44 (9th highest)
> Median income, all households: $65,685 (11th highest)

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41. Oklahoma
> Twin birth rate: 30.8 per 1,000 live births
> Total twins born in 2016: 4,905
> First births to older women: 3.4 per 1,000 women aged 35-44 (5th lowest)
> Median income, all households: $49,176 (10th lowest)

40. California
> Twin birth rate: 31.1 per 1,000 live births
> Total twins born in 2016: 46,150
> First births to older women: 9.0 per 1,000 women aged 35-44 (5th highest)
> Median income, all households: $67,739 (8th highest)

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39. Texas
> Twin birth rate: 31.3 per 1,000 live births
> Total twins born in 2016: 37,664
> First births to older women: 5.6 per 1,000 women aged 35-44 (23rd highest)
> Median income, all households: $56,565 (24th highest)

38. Idaho
> Twin birth rate: 31.3 per 1,000 live births
> Total twins born in 2016: 2,131
> First births to older women: 4.0 per 1,000 women aged 35-44 (11th lowest)
> Median income, all households: $51,807 (16th lowest)

37. Alaska
> Twin birth rate: 31.3 per 1,000 live births
> Total twins born in 2016: 1,060
> First births to older women: 6.2 per 1,000 women aged 35-44 (19th highest)
> Median income, all households: $76,440 (2nd highest)

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36. North Dakota
> Twin birth rate: 31.4 per 1,000 live births
> Total twins born in 2016: 1,069
> First births to older women: 4.7 per 1,000 women aged 35-44 (17th lowest)
> Median income, all households: $60,656 (16th highest)

35. Nevada
> Twin birth rate: 31.4 per 1,000 live births
> Total twins born in 2016: 3,401
> First births to older women: 5.9 per 1,000 women aged 35-44 (21st highest)
> Median income, all households: $55,180 (25th lowest)

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34. Maine
> Twin birth rate: 31.9 per 1,000 live births
> Total twins born in 2016: 1,212
> First births to older women: 5.5 per 1,000 women aged 35-44 (24th highest)
> Median income, all households: $53,079 (20th lowest)

33. Wyoming
> Twin birth rate: 32.0 per 1,000 live births
> Total twins born in 2016: 731
> First births to older women: 5.2 per 1,000 women aged 35-44 (22nd lowest)
> Median income, all households: $59,882 (18th highest)

32. South Dakota
> Twin birth rate: 32.3 per 1,000 live births
> Total twins born in 2016: 1,192
> First births to older women: 3.4 per 1,000 women aged 35-44 (5th lowest)
> Median income, all households: $54,467 (23rd lowest)

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31. Florida
> Twin birth rate: 32.5 per 1,000 live births
> Total twins born in 2016: 21,768
> First births to older women: 6.6 per 1,000 women aged 35-44 (17th highest)
> Median income, all households: $50,860 (14th lowest)

30. Tennessee
> Twin birth rate: 32.6 per 1,000 live births
> Total twins born in 2016: 7,947
> First births to older women: 4.3 per 1,000 women aged 35-44 (13th lowest)
> Median income, all households: $48,547 (9th lowest)

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29. Montana
> Twin birth rate: 33.0 per 1,000 live births
> Total twins born in 2016: 1,231
> First births to older women: 5.3 per 1,000 women aged 35-44 (24th lowest)
> Median income, all households: $50,027 (12th lowest)

28. Kentucky
> Twin birth rate: 33.2 per 1,000 live births
> Total twins born in 2016: 5,570
> First births to older women: 3.9 per 1,000 women aged 35-44 (8th lowest)
> Median income, all households: $46,659 (7th lowest)

27. Indiana
> Twin birth rate: 33.2 per 1,000 live births
> Total twins born in 2016: 8,335
> First births to older women: 3.6 per 1,000 women aged 35-44 (7th lowest)
> Median income, all households: $52,314 (17th lowest)

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26. Georgia
> Twin birth rate: 33.3 per 1,000 live births
> Total twins born in 2016: 13,073
> First births to older women: 5.8 per 1,000 women aged 35-44 (22nd highest)
> Median income, all households: $53,559 (22nd lowest)

25. Iowa
> Twin birth rate: 33.6 per 1,000 live births
> Total twins born in 2016: 3,982
> First births to older women: 4.1 per 1,000 women aged 35-44 (12th lowest)
> Median income, all households: $56,247 (25th highest)

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24. Oregon
> Twin birth rate: 33.7 per 1,000 live births
> Total twins born in 2016: 4,607
> First births to older women: 7.7 per 1,000 women aged 35-44 (12th highest)
> Median income, all households: $57,532 (20th highest)

23. Wisconsin
> Twin birth rate: 33.8 per 1,000 live births
> Total twins born in 2016: 6,784
> First births to older women: 5.3 per 1,000 women aged 35-44 (24th lowest)
> Median income, all households: $56,811 (23rd highest)

22. New Hampshire
> Twin birth rate: 33.8 per 1,000 live births
> Total twins born in 2016: 1,251
> First births to older women: 7.1 per 1,000 women aged 35-44 (15th highest)
> Median income, all households: $70,936 (6th highest)

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21. Mississippi
> Twin birth rate: 33.9 per 1,000 live births
> Total twins born in 2016: 3,900
> First births to older women: 3.0 per 1,000 women aged 35-44 (2nd lowest)
> Median income, all households: $41,754 (2nd lowest)

20. Louisiana
> Twin birth rate: 34.3 per 1,000 live births
> Total twins born in 2016: 6,601
> First births to older women: 4.0 per 1,000 women aged 35-44 (11th lowest)
> Median income, all households: $45,146 (5th lowest)

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19. North Carolina
> Twin birth rate: 34.4 per 1,000 live births
> Total twins born in 2016: 12,479
> First births to older women: 5.5 per 1,000 women aged 35-44 (24th highest)
> Median income, all households: $50,584 (13th lowest)

18. Virginia
> Twin birth rate: 34.7 per 1,000 live births
> Total twins born in 2016: 10,714
> First births to older women: 8.1 per 1,000 women aged 35-44 (10th highest)
> Median income, all households: $68,114 (7th highest)

17. Rhode Island
> Twin birth rate: 34.7 per 1,000 live births
> Total twins born in 2016: 1,133
> First births to older women: 7.4 per 1,000 women aged 35-44 (14th highest)
> Median income, all households: $60,596 (17th highest)

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16. Missouri
> Twin birth rate: 34.8 per 1,000 live births
> Total twins born in 2016: 7,838
> First births to older women: 4.6 per 1,000 women aged 35-44 (15th lowest)
> Median income, all households: $51,746 (15th lowest)

15. Nebraska
> Twin birth rate: 34.9 per 1,000 live births
> Total twins born in 2016: 2,794
> First births to older women: 4.7 per 1,000 women aged 35-44 (17th lowest)
> Median income, all households: $56,927 (21st highest)

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14. Minnesota
> Twin birth rate: 34.9 per 1,000 live births
> Total twins born in 2016: 7,315
> First births to older women: 7.6 per 1,000 women aged 35-44 (13th highest)
> Median income, all households: $65,599 (12th highest)

13. Pennsylvania
> Twin birth rate: 35.1 per 1,000 live births
> Total twins born in 2016: 14,856
> First births to older women: 6.3 per 1,000 women aged 35-44 (18th highest)
> Median income, all households: $56,907 (22nd highest)

12. Ohio
> Twin birth rate: 35.2 per 1,000 live births
> Total twins born in 2016: 14,669
> First births to older women: 4.8 per 1,000 women aged 35-44 (19th lowest)
> Median income, all households: $52,334 (18th lowest)

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11. Maryland
> Twin birth rate: 35.2 per 1,000 live births
> Total twins born in 2016: 7,776
> First births to older women: 8.9 per 1,000 women aged 35-44 (6th highest)
> Median income, all households: $78,945 (the highest)

10. Vermont
> Twin birth rate: 35.7 per 1,000 live births
> Total twins born in 2016: 635
> First births to older women: 8.0 per 1,000 women aged 35-44 (11th highest)
> Median income, all households: $57,677 (19th highest)

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9. Utah
> Twin birth rate: 35.7 per 1,000 live births
> Total twins born in 2016: 5,434
> First births to older women: 4.0 per 1,000 women aged 35-44 (11th lowest)
> Median income, all households: $65,977 (10th highest)

8. South Carolina
> Twin birth rate: 35.7 per 1,000 live births
> Total twins born in 2016: 6,178
> First births to older women: 4.8 per 1,000 women aged 35-44 (19th lowest)
> Median income, all households: $49,501 (11th lowest)

7. Alabama
> Twin birth rate: 35.7 per 1,000 live births
> Total twins born in 2016: 6,364
> First births to older women: 3.5 per 1,000 women aged 35-44 (6th lowest)
> Median income, all households: $46,257 (6th lowest)

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6. New York
> Twin birth rate: 36.4 per 1,000 live births
> Total twins born in 2016: 25,879
> First births to older women: 10.9 per 1,000 women aged 35-44 (2nd highest)
> Median income, all households: $62,909 (13th highest)

5. Michigan
> Twin birth rate: 36.4 per 1,000 live births
> Total twins born in 2016: 12,407
> First births to older women: 4.9 per 1,000 women aged 35-44 (20th lowest)
> Median income, all households: $52,492 (19th lowest)

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4. Illinois
> Twin birth rate: 37.9 per 1,000 live births
> Total twins born in 2016: 17,856
> First births to older women: 6.8 per 1,000 women aged 35-44 (16th highest)
> Median income, all households: $60,960 (15th highest)

3. Massachusetts
> Twin birth rate: 38.3 per 1,000 live births
> Total twins born in 2016: 8,228
> First births to older women: 11.4 per 1,000 women aged 35-44 (the highest)
> Median income, all households: $75,297 (4th highest)

2. New Jersey
> Twin birth rate: 40.1 per 1,000 live births
> Total twins born in 2016: 12,381
> First births to older women: 9.5 per 1,000 women aged 35-44 (4th highest)
> Median income, all households: $76,126 (3rd highest)

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1. Connecticut
> Twin birth rate: 41.3 per 1,000 live births
> Total twins born in 2016: 4,463
> First births to older women: 8.4 per 1,000 women aged 35-44 (7th highest)
> Median income, all households: $73,433 (5th highest)

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