Family building in the U.S. has an interesting paradox. On the one hand, we have seen an ongoing decline in the U.S. birth rate driven by a combination of social and economic trends, leading many women to delay, limit or even forgo having children. Yet, despite birth rates hitting an all-time low, a recent Pew Research Center survey found that 51 percent of young adults who are not yet parents actually do want children one day. Only 18 percent of the young adults surveyed said they don’t want children at all. A recent Gallup poll revealed that Americans believe the ideal family includes three or more children, a viewpoint that has been rising steadily in recent years and is currently at its most widespread rate of agreement since 1971. Is America about to see a second baby boom?
The baby boom between 1946 and 1964 has been attributed to many factors: soldiers returning home with a desire to settle down, economic optimism in a post-World War II economy and lower labor force participation rates for women following the mass mobilization of the war years. Another contributor was the 1944 bipartisan G.I. Bill, which stimulated jobs and home ownership. The resulting baby boom reversed a century of fertility decline. We live in a different economic and political era today. Several new factors are emerging that may lead to an impending baby boom—distinct from the first. These relate to unlocking the pent-up demand from people who want children but are on pause for two top-cited reasons: timing and affordability. Even in our divided nation, boosting the U.S. fertility rate is a clear bipartisan issue as both political parties rush to propose solutions in the upcoming 2024 presidential election.
Timing as a reason for delaying parenthood
Many women delay childbearing as they pursue higher education, career advancement and other personal and professional goals. Correspondingly, rates of fertility preservation have been rising with a 30 percent year-over-year increase in egg-freezing cycles. One day soon, these “egg banks” will be put to use. Relatedly, IVF treatments have also seen a sharp rise as women build families later in life. Until now, these options have been available to few people—those with progressive employer benefits and those able to access fertility financing solutions. But California Gov. Gavin Newsom just passed a law requiring insurers to cover IVF treatments, meaning our nation’s most populous state may be getting bigger. Significant backlash erupted over an Alabama Supreme Court ruling in February that declared embryos created through IVF should be considered children. Alabama Gov. Kay Ivey signed a bill weeks later granting IVF service providers and receivers both civil and criminal immunity. As political winds shift in favor of women’s health, even the Trump campaign is lining up behind this idea at the national level.
Beyond the upcoming government aid, reproductive technology investments have also been growing. VCs have poured money into fertility startups for some years, investing a whopping $874 million in 2023 alone. These venture-backed startups include fertility clinic chain Kindbody, egg freezing and third-party reproduction platform Cofertility, and fertility financing benefits like Future Family and Progyny. Never before have Americans had this much choice, support or financial assistance to support their family-building timelines. And as the high growth rates of these companies show, they are using it.
Affordability as a reason for delaying parenthood
Today’s parents spend about $240,000 on each child from birth to age 18, putting, on average, a fifth of annual income towards child-related expenses. Childcare costs are especially prohibitive before elementary school begins, causing some parents to drop out of the workforce. The U.S. is the only wealthy country without federal paid parental leave. Having children can be expensive, time-consuming and physically exhausting—enough to discourage potential parents from growing their families. The U.S. Surgeon General even issued an advisory on the mental health and well-being of parents this year.
Democrats and Republicans alike can agree that family building must become, once again, attractive to young Americans, and not just for demographic reasons but for economic stability as well. The 2024 Presidential election is the first time family-friendly programs like newborn tax credits, paid family leave and affordable childcare are taking center stage with bipartisan support—we have finally reached the tipping point. As the Federal Reserve begins to cut interest rates to stimulate the labor market and investment activity, we are once again entering a period of economic expansion. Paired with the pent-up desire for family building and a full slate of fertility solutions and incentives with the potential to unlock it, we may be once again standing on the cusp of a unique set of conditions that parallel those that created the baby boom of 1946 to 1964.
While there have been significant advances in the medical field, one area has remained unchanged—the U.S. approach to maternal healthcare. Unlike peer nations, America is in the midst of a maternal health crisis due to a broken, outdated system where women often receive incomplete, one-size-fits-all, reactive care. Our maternal mortality rates surpass those of peer nations, with over 50,000 additional near misses a year. Outcomes are much worse for mothers of color, with mortality rates three to four times their white counterparts. The U.S. also has high rates of preterm births, NICU stays and maternal depression. These statistics sit against the backdrop of severe OB-GYN shortages nationally and hospitals closing their maternity units due to unviable economics, with 36 percent of U.S. counties designated as “maternity care deserts.”
There is an urgent need to rebuild the maternal health system. Our existing infrastructure is ill-equipped to support an influx of pregnancies and births. We must work together—policymakers, healthcare providers, investors, families and communities—to enhance maternity care and to make it more accessible and affordable for all families. We are progressing, with many states expanding programs to increase access to midwives, doulas and postpartum care. We are on the cusp of a new era of family building in America. But it will take a village to get there.