Where births and legal capacity are furthest apart
The median U.S. county with 500 or more annual births has 34.3 births per Offices-of-Lawyers establishment. The thinnest counties run to roughly six times that. Separately, 853 counties recorded births in 2024 and contain no lawyer establishment of any kind, covering 74,339 births. This is a market map, not a merit map: establishment counts do not distinguish practice areas and say nothing about where claims exist.
The join
Two federal sources, one key. Births by county come from the Census Bureau's Vintage 2024 population estimates, which publish births as a component of population change for every county with no suppression. Legal establishments come from County Business Patterns 2023, filtered to NAICS 541110 exactly — not the 5411 parent, which also contains title abstract and settlement offices.
- Births, 2024
- 3,605,563all counties, no suppression
- Offices of Lawyers
- 164,561establishments, all practice areas
- Median births per office, 500+ birth counties
- 34.3across 1,036 counties
- Counties with births and no lawyer office
- 85374,339 births
The four limits, stated before the findings are used
1. The classification does not distinguish practice areas. A fourteen-attorney medical malpractice practice and a solo doing closings count identically. A county with forty offices may contain nobody equipped to fund a multi-year matter.
2. An establishment is a location, not a firm. Multi-office firms are counted once per office and are concentrated in metropolitan counties, which overstates urban density relative to rural.
3. Employment is noise-infused at this level. County Business Patterns applies noise to employment values to protect confidentiality. We therefore use establishment counts, which are not noise-infused, and publish no county employment figure at all rather than one with an undisclosed error band.
4. Zero means zero establishments reported. Not zero legal services available. Residents of a county with no lawyer office are served from elsewhere, exactly as residents of a county with no hospital deliver elsewhere.
Where the gap is widest by state
| State | Births 2024 | Lawyer offices | Births per office | Counties with no lawyer office |
|---|---|---|---|---|
| Tennessee | 83,223 | 2,231 | 37.3 | 20 |
| Indiana | 79,422 | 2,219 | 35.8 | 13 |
| South Dakota | 11,311 | 322 | 35.1 | 42 |
| Wisconsin | 59,445 | 1,697 | 35.0 | 12 |
| North Dakota | 9,592 | 275 | 34.9 | 38 |
| Kansas | 33,963 | 1,067 | 31.8 | 58 |
| Utah | 45,695 | 1,439 | 31.8 | 12 |
| Nebraska | 24,443 | 773 | 31.6 | 52 |
| Ohio | 126,575 | 4,062 | 31.2 | 2 |
| Alaska | 9,014 | 291 | 31.0 | 23 |
| Iowa | 36,301 | 1,181 | 30.7 | 19 |
| Minnesota | 61,438 | 2,020 | 30.4 | 24 |
| North Carolina | 121,281 | 4,011 | 30.2 | 10 |
| Kentucky | 52,248 | 1,774 | 29.5 | 30 |
| Texas | 388,115 | 13,751 | 28.2 | 108 |
What it is legitimately useful for
| Valid | Invalid |
|---|---|
| Geographic media planning — where to weight paid spend | Inferring that claims are more likely in thin-capacity counties |
| Referral network development — where an originating relationship has fewer competitors | Inferring anything about care quality in those counties |
| Access-to-justice reporting, with the limits attached | Ranking counties by "legal need", which this does not measure |
| County | State | Births 2024 | Lawyer offices | Births per office | Delivering hospitals |
|---|---|---|---|---|---|
| Webster County | MO | 614 | 3 | 204.7 | 0 |
| Franklin County | WA | 1,417 | 7 | 202.4 | 0 |
| Waller County | TX | 776 | 4 | 194.0 | 0 |
| Frederick County | VA | 959 | 5 | 191.8 | 0 |
| Loudon County | TN | 562 | 3 | 187.3 | 0 |
| Mississippi County | AR | 516 | 3 | 172.0 | 1 (+1 unknown) |
| LaGrange County | IN | 687 | 4 | 171.8 | 0 |
| Douglas County | WA | 506 | 3 | 168.7 | 0 |
| Coryell County | TX | 995 | 6 | 165.8 | 0 |
| Pinal County | AZ | 5,128 | 32 | 160.2 | 3 (+1 unknown) |
| Madera County | CA | 2,070 | 13 | 159.2 | 0 (+2 unknown) |
| Van Buren County | MI | 807 | 6 | 134.5 | 0 |
We use it for the first two. Our own state pages apply it to media planning, and the co-counsel playbook applies it to the second.
A limit we will not cross. Nothing on this page links a clinical outcome rate to a legal claim. Adverse-event rates measure medicine. Litigation measures a legal process. They are different quantities, they are collected by different agencies for different reasons, and correlating them would be the fastest way to publish something false. Where we present clinical data and legal data together, it is to describe a market — never to imply that one causes, predicts, or justifies the other.
Sources
- U.S. Census Bureau — County Population Totals and Components of Change, Vintage 2024 — births by county, 2021–2024
- U.S. Census Bureau — County Business Patterns, 2023 — NAICS 541110, Offices of Lawyers; establishment counts by county
- U.S. Census Bureau — Cartographic Boundary Files, 2023 (1:20,000,000) — county and state polygons; projected to Albers equal-area at build time
Cite this analysis
Free to reproduce with attribution, including commercially. Charts may be embedded as published.
Birth Injury Marketing. “Where births and legal capacity are furthest apart.” 24 August 2026. https://birthinjurymarketing.com/insights/births-per-lawyer-office-county-analysis/
Journalists and researchers: we will cut this data to your specification — by state, by county, by hospital, by year — and send the underlying CSV, free and without conditions. Ask for a custom cut. We will also tell you what the data cannot support.
More
CMS published no obstetric outcome scores for 2024
Across all 4,426 reporting hospitals, CMS Care Compare published zero scores for cesarean birth and both severe obstetric complications measures in the 2024 period.
EconomicsCost per lead can fall while cost per signed case rises
In birth injury both movements are real at the same time, and only one of them matters. Here is the mechanism, and how to tell whether it is happening to you.
OperationsWhy more spend stops producing more birth injury cases
Signed case volume is limited by how many inquiries a firm can competently review, not by how many it receives. Above that ceiling, additional spend buys a queue.
All articles → · The data behind them → · The publications →
Authorship & review
- Author
- Kevin Schwaner, Founder; Chief Marketing Officer. Credentials.
- Last reviewed
- Corrections
- Found an error? Tell us and it goes in the dated corrections log, whether or not it flatters us.