It certainly may not seem like it, but people are having fewer children. We’ve been hearing that the population is declining, and many of us have laughed it off. But turns out, it’s actually true: the population is declining. According to new CDC data, fertility rates declined from 60.3 per 1,000 women between ages 15-44 in 2017 to 59.1 in 2018. Though it may seem small, a decline in birth rate is something to take notice of.
The decline in birth rate likely comes from a host of factors. Having children isn’t necessarily for everyone. And even for those of us who do have children, we may realize that we’re better parents to one child than we would be to multiple children. We’re also living in a world that’s making it increasingly more difficult for parents to be able to support their children, and not just financially. Some people are admitting to having fewer kids (or no kids) for environmental reasons too.
Some people may want to have children, but infertility issues may stand in their way to do so. Those facing infertility may choose not to have children at all, or may stop at one because they don’t have the means to have more. Receiving treatment for infertility can take a toll on the body, but also on the wallet. For those who may have gone through treatments the first time, a second or third time may not be financially feasible or smart.
For a little more insight on infertility’s affect on the birth rate, Scary Mommy consulted with Dr. Rachel A. McConnell, MD, a Fertility Specialist at Columbia University Fertility Center. She explains that infertility affects about 15% of cisgender couples who are reproductive age (20-45.) In one third of those couples, infertility will relate to the woman, and in another third it will relate to the man. The final third is that infertility issues can relate to both the man and woman.
For women, the leading cause for infertility is age. “The chances of a female conceiving in her 20s are about 25-30% per month,” Dr. McConnell tells Scary Mommy. “However, as a female enters her 30s, infertility will begin to decrease. By age 40, the chances of conceiving per month will decrease to about 10%.” Other factors for women include polycystic ovarian syndrome (PCOS), thyroid problems, endometriosis, or other conditions that affect ovulation.
For men, infertility is often affected by abnormal sperm production, but also ejaculation problems. Additionally, a genetic disease like cystic fibrosis can affect sperm production, as well as a disease like diabetes. Men with a “low sperm count, decreased sperm motility and/or low normal sperm morphology (shape) will have infertility issues which could be caused many different factors and in many cases the cause is unknown,” Dr. McConnell adds.
Since some people trying to conceive may not think of infertility as the reason they’re not getting pregnant, Dr. McConnell also gave some warning signs. They include “irregular menstrual cycles, which may be a result of PCOS. Pelvic pain during intercourse or painful periods may be a result of endometriosis. Women with heavy periods may have uterine fibroids.”
Plus, women with “abnormal facial hair, unexplained weight gain, acne, cold hands or feet may have a hormonal problem that can be associated with infertility.” Women over the age of 35 and women who have had sexually transmitted infections are also at risk for infertility.
But when should people get tested for infertility? Again, that depends on different factors. Dr. McConnell advises that people having unprotected sex for a year without conceiving should reach out to a doctor for testing. But if the woman is over the age of 35, they should be getting tested after six months of unprotected sex with no conception. And if anyone has any of the above medical conditions, they should be tested immediately.
Another interesting thing the CDC data shows is the shift in gestational age at birth. The number of births at less than full-term (before 39 weeks) increased between 2017 and 2018. Preterm births rose from 9.93% to 10.2%. Early-term births also have a slight raise from 26% to 26.53%. Not surprisingly, the rise in births before full-term corresponded to a decrease in the number of full-term births. Between 2017 and 2018, full-term births went from 57.49% to 57.24%. Late-term births went from 6.58% to 6.20%.
Racially, the increase in preterm and early-term births affected all three of the groups in the data, though black mothers were more likely to have a preterm birth. 14.13% of black mothers had a preterm birth, versus 9.08% of white mothers and 9.73% of Hispanic mothers. Black mothers also have a higher percentage of early-term births at 29.64% compared to 24.68 % for white mothers and 28.05% for Hispanic mothers. In recent years, maternal healthcare for black mothers has become a talking point, and these numbers support the claims that doctors aren’t giving black expecting mothers the same level of care.
Unfortunately, the CDC data only focuses on medical and racial factors for the decline. So there’s no way of knowing how socioeconomics affect the drop in birth rate. As the cost of living grows, parents must plan accordingly. Even the parents who want to have more children may not be able to afford it. When you’re already paying the equivalent of a month’s pay on childcare, having another child could financially cripple you. And as the “working poor” continues to grow, the birth rate could continue to drop.
“It’s a national problem,” Dowell Myers, a demographer at the University of Southern California, told NPR. “The birthrate is a barometer of despair.”
However you frame it, one thing is clear: the birth rate impacts us all. It’s time we all start paying attention to and supporting families.