How a declining birthrate could impact every American

Michelle Budge, Deseret News
Michelle Budge, Deseret News

Births to teenagers hit a new low in 2022, following a decades-old trend that began in 1991, despite brief increases in 2006 and 2007. And the birthrate for young women, ages 20-24, also reached a record low.

But not all birth declines are being hailed as good news. Demographic experts say reports on fertility rates are not just an interesting look at numbers. Fertility is a roadmap to aspects of the future that have great bearing on most people’s lives in one way or another, though they may not recognize it.

Population change impacts schools, economies and social programs, they say. It can impact whether you can cash out the equity in your house or how many holes the social safety net might have as you grow old.

Births overall, in fact, are down — though by an insignificant less than 1%, according to 2022 provisional data that includes nearly all the birth certificates filed that year, according to a report just released by the National Center for Health Statistics within the Centers for Disease Control and Prevention.

“Fertility has been declining basically since the Great Recession,” Emily Harris, senior demographer at the Kem C. Gardner Policy Institute at the University of Utah, told the Deseret News. She said when economic times are hard, it’s “normal” for both births and immigration to decline. “People kind of stop what they’re doing when times are uncertain. What’s interesting is that even after we exited recession and went into more boom time, rather than seeing a rebound in fertility, we actually saw a decline.”

“The babies that are born today are the future schoolchildren, the future adults, the future seniors. A lot of the work I do is around helping governments plan for population change,” said Beth Jarosz, program director in U.S. programs and director for KidsData at the Population Reference Bureau.

Ask why the fertility trend is down and experts say they have theories, not proof. But there are compelling ideas about why people are delaying or not having children.

“There are a ton of issues going on,” Harris said. “Things people are talking about as societal, institutional issues and problems, such as the inability to find housing, the inability to find affordable housing, the increasing cost of day care or even trying to find a day care. There are inflation concerns. Things are becoming more expensive.”

When you think about fertility, you must think about the societal context of what’s going on. “People are going to make very real decisions on that, year to year, day to day,” she added.

One factor in drooping fertility, which is happening in most of the world, is clear, experts say. Many people are waiting longer to have their first child, which also limits the number of children they can have.

3.6 million-plus new Americans

In 2022, 3,661,220 births were recorded in the United States, according to the provisional data, which is unlikely to change significantly when finalized in a few months. The center said the report includes the 99.91% of births in 2022 that had been registered by Feb. 14, 2023. Data for American Samoa, Guam and the U.S. Virgin Islands were not yet available.

The general fertility rate was 56.1 births per 1,000 women of what’s considered prime childbearing ages, 15-44. That rate had fallen about 2% every year between 2014 and 2020, before climbing 1% in 2021 and then falling very slightly in 2022.

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But the U.S. population is shrinking over time, demographers say: The total fertility replacement rate is 2.1 births per 1,000 women. The rate in 2022 was 1.665 births per 1,000 women, well below that replacement rate. According to the report, “The total fertility rate estimates the number of births that a hypothetical group of 1,000 women would have over their lifetimes, based on the age-specific birth rate in a given year.”

Since the pandemic, Harris said demographers are noticing some moderation of the fertility decline in some states and even some slight increases.

“From general trends, it seems like at the moment we’ve hit that trough and are now moderating — plateauing. Maybe we’ll see an increase. We don’t know that yet,” she said.

Why falling fertility is bad news

If you want a stable population size — and experts say not having one portends economic and other challenges — you have to have babies or count on immigration to raise the numbers.

America’s total fertility has “generally been below replacement since 1971 and consistently below replacement since 2007,” the report said.

Changes are coming — though not right away, experts told the Deseret News.

“You don’t feel the effects immediately,” said Harris, “but in 30 to 40 years, you start to feel age structure shifts that impact society and institutions and programs that were built on the assumption you will have the same age structure. A lot of our national policies are built on the assumption that we will have a lot of young people and fewer older people — a large workforce to support those who are older.”

Instead, America is beginning to see a shrinking workforce and a larger number of those retirement age and older.

“In 50 years, what does that mean for how our economy operates with employment and jobs? We’ve kind of always been in this growth, growth, growth phase for the last 50 years — not that we’re not still growing, but we’re not growing as fast. And part of that is because we have less children, less internal growth,” Harris said.

“The first place you see the impact (of falling fertility) is changing demand for schools,” Jarosz said. “There may be hard decisions about if schools need to close — or if births raise, if schools need to open. Then what do you do with those resources?”

She notes an interesting model where schools may be paired with senior facilities — “Dual use at the site is one way of dealing with that challenge of the changing population,” she said.

Over the longer term, workforce issues arise, from having enough workers to fill jobs to entrepreneurship, which increases with a robust young workforce. And it is typically through younger workers that funding is available so older people get some government support.

Harris said that many policies and structures now in place “are not modernized to what is going on.”

Even traffic and transportation patterns change alongside population, per Jarosz. “Everyone thinks about the commute to work as the primary reason people get in their cars or get on a bus or train,” she said. “But think about school trips and after-school activities. The timing of travel patterns and the types of transportation we need” changes along with the population, she noted.

Maternal age and race

The decrease in the number of births to teens age 15-19 represents a new low. And it’s worth noting that since 1991, which was the most recent peak for teen births, the rate has declined by 78%. In 2022, 143,442 babies were born to females in that age group.

“I have been saying births to teens are at an all-time low for way more than a decade now,” said Jarosz. “I think that’s a good thing: We know the younger someone has a birth, the higher the risk of complications, the higher the chance they may end up in poverty.”

Why teen births are down probably involves a number of factors, Jarosz said, including access to contraceptives. While some reports say teens are less sexually active, she noted that sexually transmitted disease among teens has risen, which makes that seem somewhat less likely.

The number of births to women in most age categories was down slightly between 2021 and 2022, but not all of them, though changes were generally quite small. The provisional birthrate for women 35-39 rose 2%, to 54.9 births per 1,000 women. And the rate for women ages 40-44 rose by 4% to 12.5 per 1,000.

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“The rate for this age group has risen almost continuously from 1985 through 2021,” the report says, while the number of births to women in that age group rose 6% between 2021 and 2022.

Harris points out that while a birth is a major event at ground level, on the national or global scale, pregnancies when one is older or a teen don’t make much difference to the overall fertility rate because the numbers are relatively small compared to those in the peak childbearing ages.

The increase in births to women in older age groups doesn’t surprise Jarosz — and it’s not really new, either, she added. “One of the things to keep in mind is births to women in their early, mid, even late 40s is not a surprise historically.” She said that when baby boomers were born between 1946 and 1964, many of their mothers were in their 40s — at numbers “at least comparable, if not higher than what we’re seeing today.”

The provisional birthrate for women 45 and older is low, at 1.1 births per 1,000 women, but the number of births to women in this age category increased by 12%, per the report.

Jarosz said the slight decline in births in the age 30-34 category was “a little more unexpected in part because there was some optimism that maybe people were just delaying childbirth in 2021.

It could reflect some structural issues in the country and not adequate supportive policy for people to feel confident in choosing to have children, she noted. Her list of challenges includes lack of paid leave, difficulty affording high-quality child care and housing costs that are “extremely expensive,” she said. “The fact births are going down for that age group implies those forces are at work.”

The report said the numbers represent a 3% decrease in births to American Indian, Alaska Native and white women and a 1% decline among Black women. Births to Asian women rose by 2%, while they rose by 6% for Native Hawaiian or other Pacific Islander women and Hispanic women.

The report also notes that the rate at which babies are delivered by cesarean increased slightly again for the third year to 32.2% in 2022, while the C-section rate for women with low-risk pregnancies remained unchanged at 26.3%. Low-risk pregnancies are singelton babies who are considered full-term (at least 37 weeks gestation) and are in proper head-first delivery position.

The preterm birthrate dropped 1% to 10.38%.