By MIKE MAGEE
Last week, policy wonks from the right and the left, finally found a topic they could agree on – Kids are no longer having (as many) kids.
Specifically, teen pregnancies dropped an additional 10% in the US in 2025. This is an acceleration of a trend which began two decades ago. Teen births peaked in America in 1991 with 62 births per 1000 girls/women age 15 to 19. In 2025, the rate was below 12 per 1000, a drop of 80%, with the majority of that (72%) occurring since the 2008 Great Recession.
Obviously, this is “good news” for these young women according to Congressional reports. And most agree the causes are multifactorial, and include gains in health education, declines in sexual activity in youth, access to contraception and the Plan B pill, and expanded economic and professional opportunities for women in society.
But for societies worldwide, leaders look on with angst as the birth rates in their nations have broken through the replacement line, with deaths exceeding births. This “replacement rate” is roughly 2.1 births per woman. The CDC recently reported that without immigration, the 2023 total fertility rate was only 1.6 births per woman (1,616 per 1000 women over a lifetime).
Since 2007, trend lines have pointed decidedly downward. In that year, there were 4,316,233 births in the U.S. In 2025, American women gave birth to only 3,606,400 newborns (a 23%) decline.
Demographers generally agree that the trend initially was most pronounced in young, college-bound girls/women. But it is now evident across all demographics, with concerns about jobs, housing, costs of child care, political instability and more causing prospective parents to wonder whether having children is a wise choice and economically attainable, segregating society into “fertility haves and have nots” according to UNC Sociologist Karen Benjamin Guzzo.
Culture warriors, like Katie Miller, texted away on X from the air conditioned comfort of her DC office, a safe distance from her own children.“Our biological destiny is to have babies — not slave behind desks chasing careers while our civilization dies.” But she’s fighting a downward trend.
About half of the nation’s 30-year-old women are now childless. In the immediate post-WWII era, total fertility rate was a remarkable 3.5. With the introduction of the Birth Control Pill, that number plummeted to 1.7 by 1976, and then slowly recovered. But by 2007, it had crossed the replacement figure of 2.1, and has moved steadily downward since then.
One countervailing trend is “delayed motherhood.” While birth rates under age 30 have collapsed, women over 30 are having more children, but not enough to make up the difference. Over the past three decades, birth rates in women 35-39 rose 71%, and doubled for women 40-44. But numbers remain small, and inadequate to cover the “postponement.”
As an expert report pointed out, education is having a dual impact. “The key insight: women aren’t just delaying childbearing—they’re having fewer children overall… American women with advanced degrees averaged 1.8 children, compared to 2.25 for women with high school diplomas and 2.7 for women without high school education.”
We’ve clearly entered an era where women think twice before becoming pregnant. The nation as a whole, compared to others, have done little to signal appreciation for the sacrifices required to select parenthood. In a country with problematic health coverage and services, a housing crisis, no subsidized child care, and a AI-shaken job market, why take the risk?
The “opportunity cost of child-rearing” has risen dramatically with women’s educational and career gains. Sociologists label this the success penalty. Interrupting a career is a derailment of opportunity growth including promotions, raises, and advances. And that’s without considering the direct costs associated with the care of a child, let alone the pressures of debt associated with housing and student loans. Not surprisingly, fertility rates have declined as housing costs and student debt have risen.
Economist Martha Bailey, who directs the California Center for Population Research at the UC, Los Angeles, doesn’t place the blame on women for protecting themselves. She summed up her feelings this way, “People are having the number of children they want and that they can afford at a time that makes the most sense for them. What I don’t think anyone is in favor of is a Handmaid’s Tale type policy regime, where we’re trying to talk families into having children they don’t want.”
Mike Magee MD is a Medical Historian and regular contributor to THCB. He is the author of CODE BLUE: Inside America’s Medical Industrial Complex. (Grove/2020)
