US fertility rate drops to record low, CDC says – here’s what that means

FILE - A woman holds her four-month pregnant belly in a file image dated Aug. 10, 2018. (Photo: ULISES RUIZ/AF

The number of babies born last year fell in the United States, resuming a trend that was observed before the pandemic, experts say. Meanwhile, the U.S. fertility rate – or the average number of children a woman would have during her child-bearing years – has fallen to the lowest number on record.

A little under 3.6 million babies were born in 2023, according to provisional data shared on Thursday by the U.S. Centers for Disease Control and Prevention. That’s about a 2% decline from the year before, and the lowest one-year tally since 1979.

Births in the U.S. were declining for more than a decade prior to the pandemic, then dropped 4% from 2019 to 2020. There was an uptick in births for two straight years after that, an increase experts attributed, in part, to pregnancies that couples had put off amid the pandemic’s early days. 

Some even called it a small, pandemic "baby bopm," with some economists suggesting that both the increasing ability to work from home and the federal COVID-19 stimulus likely contributing.

However, "the 2023 numbers seem to indicate that (the) bump is over and we’re back to the trends we were in before," Nicholas Mark, a University of Wisconsin researcher who studies how social policy and other factors influence health and fertility, told the Associated Press.

Data: Women having babies later, if at all

Birth rates have long been falling for teenagers and younger women, but rising for women in their 30s and 40s — a reflection of women pursuing education and careers before trying to start families, experts say. 

But last year, birth rates fell for all women younger than 40, and were flat for women in their 40s.

Mark called that development surprising and said "there’s some evidence that not just postponement is going on."

Rates fell across almost all racial and ethnic groups.

US fertility rate falls to record low

The U.S. was once among only a few developed countries with a fertility rate that ensured each generation had enough children to replace itself — about 2.1 children per woman. But it’s been sliding, and in 2023, it dropped to about 1.6, the lowest rate on record.

The total fertility rate was 1,616.5 births per 1,000 women in 2023, a decline of 2% from 2022, according to the CDC data. The general fertility rate was 54.4 births per 1,000 females between the ages of 15 and 44, down 3% from 2022. 

Surveys suggest many U.S. couples would prefer to have two or more kids but see housing, job security and the cost of child care as significant obstacles to having more children.

"There’s something getting in the way of them being able to achieve those goals," Mark said.

Teen birth rates flatten after years of decline

The U.S. teen birth rate has been falling for decades, but the decline has been less dramatic in recent years, and the steep drop seems to have stopped for teen girls ages 15 to 17, according to the CDC data.

"That could be Dobbs," said Dr. John Santelli, a Columbia University professor of population and family health and pediatrics, referring to the June 2022 U.S. Supreme Court decision that allowed states to ban or restrict abortion. 

Or it could be related to changes in sex education or access to contraception, he added.

Whatever the case, the flattening of birth rates for high school students is worrisome and indicates that "whatever we’re doing for kids in middle and high school is faltering," Santelli said.

C-section birth rates rise again

The cesarean section birth rate rose again, to 32.4% of births in 2023, according to CDC data.

It added that the low-risk cesarean delivery rate also increased to 26.6% from 26.3% the year prior.

It was the fourth increase in a row after the rate generally declined from 2009 (32.9%) through 2019 (31.7%), and it was the highest rate since 2013 (32.7%), the agency said.

Some experts worry that C-sections are done more often than medically necessary.

Meanwhile, the percentage of babies born preterm held about steady.

This story was reported from Cincinnati. The Associated Press contributed.