Why Fewer Americans Are Having Kids: The Soaring Cost Of Parenthood
Deciding to have a kid is one of the most personal choices someone can make—it's also one of the most expensive. Between hospital bills, child care and the everyday cost of living, many Americans are finding that starting a family will put a stretch on their finances.
According to the CDC, the general fertility rate in the U.S. dropped 3% from 2022 to 2023, reaching a historic low. Between 2014 and 2020, the rate had declined by about 2% yearly, with a brief 1% increase from 2020 to 2021. The recent drop is part of a steady pattern of low or declining birth rates across the country—a trend that has people wondering what it means for the future.
The U.S. birth rate has been dropping for years, hitting record lows we haven't seen in decades. There are plenty of reasons for that, from shifting priorities or changing lifestyles, but for many people, it comes down to something simple: having a baby in America just costs too much.
A 2024 Pew Research survey found that 41% of adults ages 18 to 39 who don't want children say the high cost of raising a child is a major reason. The U.S. ranks among the most expensive places in the world to give birth, and even with insurance, families often face hefty bills.
On average, insured patients pay about $2,854 out of pocket for pregnancy, childbirth and postpartum care costs, according to the Peterson-KFF Health System Tracker .
Without insurance, the price of giving birth can soar past $26,000, depending on the hospital, delivery method and any complications that may arise from giving birth. For many families, that kind of bill is devastating. A 2021 study published in JAMA Network Open found that nearly a quarter of pregnant and postpartum women reported unmet health care needs due to cost underscoring just how tough it is to navigate the financial side of early parenthood in the U.S. health system.
The bills start piling up long before the baby arrives. Prenatal care—including OB-GYN visits, ultrasounds, and routine tests—can cost $2,000 to $3,000 without insurance. With coverage, it's usually closer to $250 to $500.
Then comes everything else: diapers, wipes, a crib, a car seat, a stroller—the list goes on. The USDA estimated in 2015, the most recent data available, that parents are expected to spend between $12,350 and $13,900 for a child per year—and that was before inflation spiked in recent years.
Caring for a newborn is a full-time job—but in the U.S., most parents don't get paid for it. Unlike many other countries, there's no federal guarantee of paid family leave. The Family and Medical Leave Act gives eligible workers take up to 12 weeks off, but it's unpaid.
That means many families face a tough choice: take unpaid time off and lose weeks—or months—of income, or return to work sooner than they'd like. Some states like California, New Jersey, New York, and Rhode Island offer paid leave programs with some wage support. But in most of the country parents must rely on savings or employer policies, if they're lucky to have them. For many, it's an added cost they can't afford at all.
If you're planning to have children, choosing the right health insurance plan matters more than ever. Forbes Advisor highlights a handful of strong options worth comparing on coverage, cost and reputation:
Health insurance is a big help when it comes to managing the skyrocketing costs of having a baby. Childbirth can easily cost tens of thousands of dollars, but fortunately, insurance companies work out discounted rates with hospitals and doctors, so people with coverage usually pay much less than the full price.
Most plans cover essential things like prenatal checkups, ultrasounds, the hospital stay for labor and delivery, and care after birth. While you'll likely still have some out-of-pocket costs like deductibles or copays, those are generally much smaller than the total bill without insurance.
Having a baby in the U.S. is expensive—not just financially but emotionally and physically, too. Even when people try to plan, the cost can make parenthood seem out of reach.
Still, having the right health insurance can help cover many of those costs—from checkups to delivery and aftercare—making things a bit easier when starting a family.
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