In 2023, fertility rates in the United States were at an all time low. They had decreased by 3% since 2022, which was the second consecutive year of decline (CDC). Fertility rates are measured by the number of births per 1,000 women 15-44 years old by U.S. county. This trend reflects significant cultural and socioeconomic changes that are reshaping American families. One notable shift is the growing trend of Americans delaying or forgoing marriage completely, which directly impacts fertility decisions. Factors like financial instability and career prioritization play a significant role in whether families choose to have children.

Factors Influencing Fertility Rates

Raising children in the U.S. can be financially challenging due to rising costs in housing, education, and healthcare. The Pew Research Center also points to high childcare costs as a reason many couples are choosing not to have children, as it can be a major financial burden for some parents. Additionally, rising home values have a negative impact on birth rates because they, on average, represent the highest cost related to raising children compared to costs of food, childcare, or education (NBER). These findings suggest that as the price of housing continues to increase, so does the price of having children. As a result, many couples delay childbearing or choose to have fewer children.

Research also indicates that economic downturns are associated with declines in fertility rates in developed nations, such as the United States. Over the past decade, birth rate trends have roughly mirrored the nation’s economic fluctuations (Pew Research). Additionally, a study found that in very expensive housing markets, the age at which married couples have their first child is significantly older compared to married couples in less expensive housing markets (NIH). Expensive housing markets tend to have a higher proportion of college-educated individuals, many of whom are women, which is associated with a later age for having their first child. This delay is likely due to a decrease in wages when college-educated women take a leave from work to have children. For college-educated women, an 18-month break from work is associated with a roughly 41% decrease in earnings for individuals with an MBA, 29% for those with a JD or Ph.D., and 15% for those with an MD (US Treasury). Over the past decade, the four-year college completion rate for women has increased by 10%, and women who complete four years of college are less likely to have children during their early adult years (Wharton).

Furthermore, the lack of access to affordable childcare is a significant constraint on labor force participation, as the cost of childcare has increased by over 30% in the last decade and more than 200% over the past 30 years (White House). The Pew Research Center also cites high childcare costs as a key reason why couples are choosing not to have children. Affordable, high-quality childcare is often linked to higher fertility rates (IZA). In addition to rising childcare costs, many individuals are also struggling with increasing healthcare expenses due to higher inflation and insurance plans with higher deductibles and less comprehensive coverage (CBS News). These rising healthcare costs contribute to financial insecurity, which can make individuals more cautious about expanding their families.

Broader Impacts of Declining Fertility Rates

While a decline in fertility may result in a temporary reduction in national and state-level education as well as pediatric healthcare costs, there are concerning long-term effects, and the most profound effects of low fertility may not be felt for several decades. A shrinking population can lead to a smaller workforce and slower economic growth. Although low fertility can increase labor force participation among women and boost income tax collections (Pew), fewer children could eventually result in a smaller pool of workers to contribute to income tax revenue. Declining fertility rates mean that there will be fewer workers contributing to programs like Social Security and Medicare, which would place a significant strain on these systems (Wharton). Additionally, with fewer young people, it will be harder to fill jobs in the military or construction that require individuals who are younger and more physically fit (Wharton). A shrinking labor workforce may also stifle innovation. Overall, continued declines in fertility present long-term challenges, including workforce shortages and economic stagnation.

The fertility rate calculator and heat map below can be valuable tools in shaping healthcare initiatives and employment policies, particularly in regard to paid time off and parental leave. These tools can also be useful for insurance agencies and healthcare providers to make informed decisions. Most importantly these tools can serve as a resource for prospective parents that are navigating the complex decision of having children. This link provides a heat map of the residuals for the predicted fertility rates in each county. The fertility rate calculator below allows users to input various input parameters to predict fertility rate for the selected county.