The national fertility rate — calculated as the total number of live births per 1,000 women of reproductive age — has been declining steadily in the United States over the past decade, from 62.5 in 2013 to 54.5 in 2023, according to the Centers for Disease Control and Prevention. (Photo by Oscar Wong/Getty Images)
Clare Barkley of Ohio always pictured having a second baby. But watching the erosion of reproductive rights and fights over public education and health care, she said the world feels like it’s in upheaval and isn’t sure she wants to roll the dice.
Kristen Witkowski, a North Carolina mom of two, has had several life-threatening complications related to her pregnancies. She might have considered having a third child but is now so terrified of getting pregnant again, she said she wishes she’d had her fallopian tubes tied during her second Cesarean section.
And Brenna Craven Dumas, a mother of two in Arizona who had high-risk pregnancies, wanted to be so sure she didn’t have another, she got her tubes tied and asked her husband to get a vasectomy.
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These women live in states that currently or previously had abortion bans, and cited those policies as part of or the primary reason for their fertility decisions.
The national fertility rate — calculated as the total number of live births per 1,000 women of reproductive age — has declined steadily in the United States over the past decade, from 62.5 in 2013 to 54.5 in 2023, according to the Centers for Disease Control and Prevention. The data shows the decline is present in every state to varying degrees. During the same time frame, rates have fallen steeply in states with abortion bans, including Idaho, where the rate dropped from 71.8 to 57.5, and Arizona, which fell from 66.3 to 54.1.
Those falls in fertility have been top of mind for elected politicians tied to President Donald Trump’s second-term administration. It is a central piece of Project 2025, the blueprint for Trump’s presidency as written by the conservative Heritage Foundation and several anti-abortion organizations.
In a memo issued on Jan. 29 by new U.S. Department of Transportation Secretary Sean Duffy, programs supported or assisted by transportation funds have been directed to give preference to communities with marriage and birth rates higher than the national average. As a congressman for Wisconsin, Duffy supported and co-sponsored many anti-abortion bills, including a bill to defund Planned Parenthood.
Vice President JD Vance has expressed concern over declining fertility rates for several years, and repeatedly drew attention during the 2024 presidential election for negative comments he made about women without children and society as a whole becoming too detached from the ideal of becoming a parent. He has argued that policies limiting or prohibiting abortion access, which he supports, are not contributing to the rates, and advocates for higher taxes for those who don’t have children and for expanding the child tax credit to help families.
“Our society has failed to recognize the obligation that one generation has to another is a core part of living in a society to begin with,” Vance said at the annual anti-abortion March for Life event in January. “So, let me say very simply: I want more babies in the United States of America.”
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Why fertility rates are lower across the U.S.
Phillip Cohen, a sociology professor at the University of Maryland who specializes in population science, said birth rates have been declining for centuries as modern culture shifted away from using children as a source of labor.
“So that gets you down from eight children per woman to three or four, and then the question is, what makes you continue to go all the way down to very low numbers?” Cohen said.
In the past two decades, he attributes the decline to positive and negative factors. People have more opportunities to spend their time in other ways, especially women, along with more career and life goals that previously were more difficult or impossible to pursue. Although some women manage a career and a family, there is often pressure to choose one for financial, societal or individual reasons.
The negative factors that are driving down rates, Cohen said, are the expenses of having children, uncertainty and risk.
“(There is) concern about being able to raise children who are competitive in an increasingly unequal world and who can succeed in a society where the penalty for not succeeding seems to be growing,” Cohen said. “If you’re worried about how your kids are going to turn out, and Americans really are … then you can increase your chances of your children succeeding by having fewer of them.”
That rings true for Katie T. in Alabama. Growing up in Alabama as one of four children, she always thought that she would have a big family — probably five kids.
But with the past few years of political developments, including Trump’s re-election, the economy and five months of being a first-time mom, she has decided one baby is enough.
She and her husband are “one and done” after their son, who was born in August. Throughout her pregnancy, Katie said she was already stressed about living in a state with a near-total abortion ban in case anything went wrong, especially as a pregnant woman close to 35, the age when pregnancies are medically considered higher risk. The closest state with broad abortion access is Virginia, which is about 10 hours away by car.
“After I had my baby, I went in for my first checkup to talk about birth control options, and I talked with my husband at length about how I just don’t think (more kids are) in our future anymore,” said Katie T., who asked not to use her last name out of fear of retaliation in her community for her political beliefs.
Not only that, but finances also weighed heavily.
“We are realizing now that day care is a literal second mortgage payment, and we just can’t afford that,” she said.
Not having a sibling for her son is a disappointment, she said. Her siblings are all older than her, and she describes growing up essentially as an only child, so it was important to her for a long time to have more than one child. But facing a reality of political fights over vaccines and the education system, along with more potential restrictions to reproductive health care, Katie said she had an eight-year birth control implant placed right after the election.
“I hope he will forgive us one day for that,” she said.
‘If something happens, where do we go from there?’
Kiley DeVor, 28, moved from California to Idaho to obtain a degree in physical therapy, and she specializes now in pelvic floor therapy. She and her husband bought a house, thinking they could stay in Idaho for a while, until the U.S. Supreme Court issued the Dobbs decision in June 2022 and Idaho implemented its near-total abortion ban. The state has been at the center of several abortion-related lawsuits in the past two years, including a Supreme Court case in June about whether abortions that are performed during a medical emergency are subject to prosecution under the state law. That matter is still pending in the 9th Circuit U.S. Court of Appeals.
During that time, DeVor said she’s discovered other health issues in addition to endometriosis she’s had for many years that may make conceiving a child more challenging.
“I’m just like, man, it is going to be incredibly difficult for us to get pregnant, so that’s one hurdle, and then if something happens, where do we go from there?” she said. “If we have to use IVF or IUI, if I have to travel out of state and spend another 10 or 20 grand to get the care I need, that’s just not feasible.”
DeVor’s husband started a general contracting business in Idaho that has done well, but she said he doesn’t want to risk starting a family in the state either and would rather wait until they can move somewhere she knows her health care will be protected.
“It’s been an interesting experience of moving to a state where people say, ‘We don’t want big government,’ but at the same time telling people, this is what you can and can’t do,” DeVor said.
Idaho economist doesn’t see worrying trends so far in population movement
Though one recent study from the National Bureau of Economic Research said the 13 states with total abortion bans are collectively losing 36,000 residents per quarter based on change of address data from the U.S. Postal Service, it’s unclear how many of those departures are related to politics. According to data from the American Community Survey, nearly 82,000 people moved to Idaho in 2023, while nearly 65,000 moved away, for a net increase of about 16,700 residents.
Jan Roeser, a regional economist at the Idaho Department of Labor, said the state’s population growth has slowed over the past two years, but it had accelerated greatly during the COVID-19 pandemic between 2020 and 2022.
It’s possible that more young people are leaving the state, Roeser said, as seven districts announced or considered school closures in the first half of 2023 because of declining enrollment, according to Idaho Education News. But Idaho is among the eight youngest states in the nation, she said, and one of the leading states for job growth.
“We’d all like to be able to jump up and move just based on our beliefs, but the reality hits that most of us need a job,” Roeser said. “So really, economic opportunity is what I believe allows people to be able to make that final decision, because it’s expensive, and it’s disorienting.”
Until she starts seeing indicators like a spike in layoffs or a decline in enrollment at state universities, Roeser isn’t too concerned about outmigration. But she does worry about the steady decline of fertility rates.
“There’s not much you can do about it, of course, and it takes a long time to reverse once it starts,” she said. “It’s not something you can solve by coming up with public policy.”
Cohen said abortion bans may lead to a small increase in births initially since access is harder to reach, but in the long run, he expects it to contribute more to decreases because it creates uncertainty and fear about pregnancy.
Economically, increasing fertility rates would be a financial drain and potentially hamper growth, he said. That doesn’t mean policies that make it easier to have more children aren’t worth having, but they shouldn’t be done in the interest of increasing births.
“It’s one of the great victories of human development that we allowed people to lower their birth rates,” he said.
‘I’m not going to let them get me down’
For some people, having more children is almost an act of resistance.
Rachel West, a 34-year-old resident of central Texas, had a baby five months ago after a three-year struggle to conceive. She wants at least one more, but knows it might be a stressful experience again because of where she lives. Texas has a near-total abortion ban, along with an attorney general who has attempted to prosecute women who left the state to have an abortion. Cities in Texas have also tried to institute travel bans to prevent women from crossing state lines for abortions.
At the beginning of her pregnancy, West said there were concerns that her embryo was ectopic, when a baby grows in the fallopian tube rather than the uterus. Ectopic pregnancies are not viable and require termination to prevent infection and loss of fertility.
“We did have to think through what that would look like, if we would have to terminate, if we would have trouble finding somebody,” she said. “It was scary, we were just kind of spiraling at home trying to figure out what we would do.”
As someone who struggled to get pregnant the first time, West has also been concerned about efforts to restrict or ban IVF, just in case it becomes an option she has to utilize. But all of the news developments haven’t deterred her from the idea of having another.
“We’ve always wanted to have at least two, maybe three kids, and I would be very frustrated if because of laws in Texas, I had to change my personal life that dramatically,” West said. “It’s almost a prideful thing, where I’m like, I’m not going to let them get me down.”
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