
The fertility rate was stable in 2024, but it's still near record lows
As the Trump administration renews its focus on declining birth rates in the U.S., new data from the Centers for Disease Control and Prevention suggests that births were fairly stable in 2024, rising 1% over the year prior.
There were 3,622,673 births in the U.S. last year, according to a CDC report released Wednesday. Overall, the number of births declined by 2% per year, on average, from 2015 through 2020 and fluctuated in the years since, according to the report.
The report also estimated the birth rate among women ages 15 to 44, referred to more specifically as the fertility rate. The rate declined from 2014 to 2020, then fluctuated through 2024. The fertility rate last year was 54.6 births per 1,000 women, the report found — a 0.2% uptick compared with 2023.
Brady Hamilton, the report's main author and a CDC statistician, said the data marks 'a continuation of the general downward trend in births to teenagers and upward trend in births to older women seen for the last three or so decades.' However, he said the CDC could not speak to the reasons behind the trend.
Sociologists who examined the CDC data said it largely reflects women who delayed having children in their 20s finally choosing to do so in their 30s and 40s. Birth rates increased last year among women ages 25 to 44, but declined among teenagers and those under 25.
'It's not that people are deciding against having kids at all,' said Karen Benjamin Guzzo, director of the Carolina Population Center at the University of North Carolina at Chapel Hill.
Rather, she said, people are asking themselves: 'Do I have the right partner? If I have another baby in child care, what would that do to my expenses? Does my job feel stable?'
Those same concerns might also compel parents to have fewer children, Guzzo said. The average woman in 2024 had one to two biological children, according to the CDC report, compared with more than three in 1960.
The overall fertility rate in the U.S. has declined since 2007 — a pattern sociologists expect to continue, despite the nominal uptick last year.
While the economy has generally improved since the 'Great Recession,' many people still don't feel like their financial position has gotten better, said Sarah Hayford, director of the Institute for Population Research at Ohio State University.
'In a lot of places, the housing market is really challenging, and that's something that a lot of people want to have kind of in place before they have children,' she said.
Guzzo said the Trump administration's tariffs on imported goods and gutting of federal programs that support women and children could add to a climate of women delaying having kids or deciding not to altogether.
The Trump administration, for its part, has lamented the decline in birth rates.
Vice President JD Vance called for 'more babies in the United States of America' at an anti-abortion rally in January. And Transportation Secretary Sean Duffy said that same month that communities with higher-than-average marriage and birth rates should be prioritized for federal transportation funds.
President Donald Trump dubbed himself 'the fertilization president' at a White House event in March. His executive order to expand access to in vitro fertilization emphasizes 'the importance of family formation' and calls for making it easier 'for loving and longing mothers and fathers to have children.'
Tech billionaire Elon Musk, a senior Trump adviser, has also referred to declining birth rates as a danger to humanity's survival. According to the CDC report, the birth rate in the U.S. is far below what's known as the 'replacement level,' where enough babies are being born that a population can keep its size from one generation to the next.
The New York Times reported Monday that the White House is weighing proposals to incentivize childbirth, including a $5,000 cash bonus to mothers after delivery. But sociologists said those efforts aren't likely to reverse declining birth rates. A 2021 study of 'baby bonuses' in South Korea found that most of the money went to women who would have had a child regardless of the incentive.
'You can't just flip a switch and change the birth rate,' said Julia Strasser, an assistant research professor at the George Washington University Fitzhugh Mullan Institute for Health Workforce Equity.
'The economic requirements — not just for having babies, but for raising babies — last a very long time, and $5,000 doesn't really go a long way towards supporting that,' she added.
Sociologists generally agreed that low fertility or birth rates aren't an inherent problem. In fact, they said, the decline in teen birth rates is a positive trend.
'It's good news when people can avoid having kids at periods of their life where they themselves would say, 'This is not the right time,'' Guzzo said.
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NBC News
an hour ago
- NBC News
How CDC cuts affect women with chronic diseases like sickle cell
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'Over the years, it's like the period actually started getting heavier, and that's when it started affecting my sickle cell.' At times, she's ended up in the hospital needing iron infusions due to loss of blood. Doctors don't know how to manage her symptoms. Sickle cell has no cure and treatment options are variable. 'The lack of education on sickle cell is very frustrating,' she said. 'I go into hospital stays having to educate doctors and nurses.' Now, women like Jackson are worried that lack of knowledge, particularly about how contraception affects their conditions, could get worse. In April, a small team that compiled information into what some consider the country's 'contraception bible,' a set of guidelines used by physicians to assess which types of birth control are safe for their patients, was fired from the Centers for Disease Control and Prevention as part of mass layoffs from the agency. The eight-person team was responsible for evaluating research and recommending birth control methods for patients with various conditions, from sickle cell disease, kidney disease and lupus to those at risk for HIV. The guidelines, called the U.S. Medical Eligibility Criteria for Contraceptive Use, provided the latest research for doctors, including an app that recommended which contraceptive methods were safe. The app has been downloaded more than 440,000 times, according to the CDC. Now, the work of that team has been halted as part of the reduction of the Women's Health and Fertility Branch of the Division of Reproductive Health. 'These are the only federal guidelines that focus on the safety of contraception for women with certain medical conditions,' said Lee Warner, the former chief of the Women's Health and Fertility Branch. 'This work exists nowhere else, and these individuals specialize in this area. Without their presence, the work stops.' Warner retired from the agency in April just after learning his team was being eliminated. 'While most women are able to use most methods, we looked at 60 conditions and over 1,800 evidence-based recommendations across an array of contraceptive methods,' he said. 'For some women, it is very dangerous for them to become pregnant at a certain point. So having contraception available to them that they can choose can help protect them.' At least 90% of people in the United States with sickle cell disease are Black. The maternal mortality rate for Black sickle cell patients has been found to be 26 times higher than for non-Black people. 'The CDC's decision to cut the team responsible for contraceptive guidelines is especially troubling for the sickle cell community, where pregnancy can carry severe health risks,' said Teonna Woolford, who founded the nonprofit Sickle Cell Reproductive Health Education Directive to advocate for patients and expand knowledge about the often-misunderstood disease. 'Eliminating this resource will disproportionately impact a community already facing significant barriers to care, further deepening health disparities.' In response to a request for comment, an official for the Department of Health and Human Services did not explain why the team was cut. In May, Health Secretary Robert F. Kennedy Jr. defended the cuts in a hearing before the Senate Health, Education, Labor and Pensions Committee. ' Right now we have 42 divisions that do maternal health,' Kennedy testified. 'They're not cuts. They're consolidations. It's ridiculous to have 42 divisions that are all supposed to be doing the same thing.' Warner disagreed with Kennedy's testimony. 'Especially with this branch,' he said, 'the expertise is not redundant of that elsewhere in the federal government.' 'Once this expertise is gone, it is permanently gone from the agency. It is going to be very hard to resume and re-create,' he said. 'The HHS restructuring consolidates maternal and child health programs into the new Administration for a Healthy America (AHA) to improve efficiency and better address public health needs,' an HHS official said in a statement to NBC News. 'The reorganization aims to streamline operations, maximize resources, and support key priorities like maternal mental health and data collection. We remain committed to improving health outcomes for American families.' Representatives for HHS did not specify if work on the contraception guidelines would continue. The Trump administration did not respond to questions about why the team was cut or if its work would continue. The CDC's most recent update to the contraception guidelines was published in August. The updates included new recommendations for people with sickle cell disease, finding that combined hormonal contraception presents an 'unacceptable health risk' due to patients' risk of life-threatening blood clots. In previous versions of the guidelines, the CDC found the advantages of combined hormonal birth control, which contains estrogen and progestin, outweighed potential risks such as blood clots or stroke. The newest guidelines also increased the risk category for the Depo-Provera shot, while ranking methods like progestin-only pills and IUDs as generally safe. Jackson was unaware of the updated guidance until her interview with NBC News. She said she is using an IUD as well as combined hormonal contraception in the form of a pill to try to manage her bleeding. 'I didn't know that,' she said. 'I kind of just hope that my doctor knows a lot and kind of just steers me in the right direction.' Warner said the CDC team should be publicizing the updated guidance now to make physicians aware of the changes and adjust how they treat patients. 'We actually planned to do a road show of the guidelines in the late fall and throughout the spring in which we would disseminate the guidelines and go speak to provider groups,' he said. 'It's not happening.' The severe pain associated with her periods has driven Jackson to seek a hysterectomy for relief. 'I have been asking for a hysterectomy for years. I've seen five different OBs, and no one will do it,' she said. While the current guidelines are still accessible, the August update could be the last, leaving Jackson with little hope that she'll find a method of birth control that works for her.


NBC News
an hour ago
- NBC News
Democratic governors seek to roll back state-funded health care for undocumented immigrants
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The plans, which would scale back health care coverage for undocumented immigrants in the three Democratic-led states just years after it was expanded, have angered progressives and immigrant advocacy groups, who warn the party risks alienating its base — particularly as protests against Trump's deportation plans break out around the country. The latest development came in Minnesota on Tuesday, after both chambers of the Legislature passed a bill to end state-funded health care for undocumented adults. The bipartisan effort advanced through the Republican-controlled House and the Democratic-controlled Senate as part of attempts to balance the state budget. It now goes to Walz, who has said he'll sign it. The bill would end undocumented adults' eligibility for MinnesotaCare — the state-funded health insurance program for low-income residents — effectively reversing one of the signature policy wins Walz secured during a landmark legislative session in 2023, when Democrats were in full control of state government. Undocumented children would remain eligible to enroll in the program under the legislation. In California, Newsom unveiled a budget plan last month that would cut back on health care benefits for undocumented immigrants — a stark reversal from his promises of universal health care for all the state's residents, regardless of their immigration status. Newsom's plan in his 2025-26 budget has called for freezing enrollment for undocumented adults to receive the full scope of the state's Medicaid program, known as Medi-Cal. Newsom's office has said the changes would apply only to new applicants over age 19, that existing enrollees wouldn't be kicked off their plans and that the freeze, which would begin next year, wouldn't apply to people enrolled in limited plans. Newsom's proposed changes also included a new $100 monthly premium for adults 19 and older with 'unsatisfactory immigration status' beginning in 2027. His expansion of Medi-Cal has cost far more than his administration anticipated. Newsom has said the changes will help to balance the state's budget, which has run a multibillion-dollar shortfall that he has blamed on Trump's tariffs, as well as growing costs from higher enrollment in Medi-Cal. Meanwhile, Illinois remains on track by the end of the month to end a program — called Health Benefits for Immigrant Adults — that provides state-funded health care coverage for more than 30,000 low-income adults who are living in the state without documentation. Similarly, the program in Illinois was more expensive than expected when it was created in 2021. Pritzker's latest budget, which the Democratic-led Legislature passed last month, proposed eliminating it by July 1. While the moves would help those states recalibrate their budgets, a sweeping Trump-backed domestic policy bill moving through Congress proposes slashing Medicaid funding for states that provide health care coverage to undocumented immigrants. Trump also signed an executive order this year targeting undocumented immigrants' access to government assistance programs. In response to questions from NBC News, Newsom spokesperson Elana Ross reiterated his statement in his initial announcement of the changes last month that 'instead of rolling back the program — meaning cutting people off for basic care — we're capping it.' Pritzker's office said in an email that 'this year, passing a balanced budget required the difficult decision that reflects the reality of Trump and Republicans tanking our national economy and attempting to strip away healthcare.' A Walz spokesperson didn't respond to questions about Minnesota's plan, which was the result of a compromise after Republican lawmakers had pushed to end the entire MinnesotaCare program. 'No one got everything they wanted,' Walz said last month after he reached a tentative deal with Republicans on the budget, which was finalized in a special session this week. 'There were very difficult conversations about issues that were very dear to each of these caucuses. But at the end of the day, we were able to come to this agreement.' Blowback from the left Immigrant advocacy groups have panned the moves, saying they risk further imperiling the broader health care system, and blasted Democrats for succumbing to Trump's attacks. 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Some progressives questioned whether the moves were part of a broader strategy by the three governors to move to the right on the broader issue of immigration, which polling has shown still remains one of Trump's strongest issues. They said they could face a backlash from their base by departing from positions on supporting immigrant communities and expanding health care. 'It really feeds into the conservative narrative that undocumented immigrants are a drain on our communities,' said Jennifer Driver, a senior director at the State Innovation Exchange, a progressive legislative policy group. 'This assumption that by moving more to the middle or to the right that you're going to recruit some people back — I think it's a miscalculation. 'The frustration that you're seeing in the Democratic base is due to this kind of this waffling, this kind of idea that 'OK, yes, we are progressive — but only in some moments,'' Driver added. Other strategists suggested it remained too early to gauge whether a broader shift was in play as governors and other lawmakers positioned themselves for potential 2028 White House bids, and they emphasized that the threats blue states face from Trump are serious. 'The Trump administration is squeezing the hell out of states,' said Jeff Blodgett, a Minnesota-based Democratic strategist who was a campaign manager for the late Sen. Paul Wellstone and the state director for both of Barack Obama's presidential campaigns. 'There's just a lot of concern about current and future budgets given what the federal government is doing to states.'


The Herald Scotland
4 hours ago
- The Herald Scotland
RFK fires CDC's ACIP members: What does that mean for Americans?
Noel Brewer, a professor at the University of North Carolina Gillings School of Global Public Health, had been on the panel, called the Advisory Committee on Immunization Practices (ACIP), since July 2024 before the firings blindsided him. "It's surprising... shocking," he said. "None of us had any idea that this was coming, so it came out of the blue and it was not something that's ever been done before with ACIP." Kennedy plans to replace the fired members with new people "currently under consideration," according to a statement by the U.S. Department of Health and Human Services. Kennedy's decision marks a reversal from what a key Republican senator said the Trump Cabinet member had promised during his confirmation hearings earlier this year. Sen. Bill Cassidy, R-Louisiana, chair of the Senate Committee on Health, Education, Labor and Pensions, said Kennedy had promised to maintain the advisory committee's current composition. "If confirmed, he will maintain the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices without changes," Cassidy said. In a June 9 post on X, Cassidy said he's in contact with Kennedy to ensure that ACIP won't "be filled up with people who know nothing about vaccines." Kennedy says "a clean sweep" will "reestablish public confidence in vaccine science," and some who follow the Make America Healthy Again movement praise his decision, but former health officials and medical experts worry the firings will sow more distrust in the public health system and impede access to vaccines. "An important part of our social contract is trust and introducing unnecessary chaos and disruption violates that trust," said Cathy Bradley, dean of the Colorado School of Public Health. Vaccine guidance: RFK Jr. fires entire 17-member CDC vaccine board. Here are the vaccines they recommended What does ACIP do? After the Food and Drug Administration approves a vaccine, ACIP reviews the scientific evidence to create guidance on who should receive it based on age, preexisting medical conditions and other factors. The CDC director approves these recommendations, which shape guidance from other medical organizations and insurance coverage. In an op-ed published by the Wall Street Journal, Kennedy said the committee has been "plagued with persistent conflicts of interest," citing evidence from 25 years ago. Brewer said the committee has since strengthened its vetting process, which typically takes a year from nomination to member status. "All ACIP members go through a vetting for conflicts of interest," he said. "We're not allowed to have them during our time, we're not allowed to accept money from drug companies for consulting or grants, we're not allowed to sue them." Members are required to disclose any conflicts of interest, which are published on the CDC website. Meetings are also open to the public, typically livestreamed on the CDC website, and are open for public comment. "It's a very open and transparent process which leads to a body of individuals with different types of expertise," said Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation and former acting director of the CDC. "Pulling information from decades ago to disparage the ACIP was ludicrous." Can Americans still get vaccinated? Vaccine guidance regarding all the shots recommended for adults and children remains in place, for now, which means eligible patients should have access to these vaccines. But Dr. Tina Tan, a pediatric infectious disease physician and president of the Infectious Diseases Society of America, said that may change as Kennedy appoints new members to the advisory committee. She fears the administration could walk back certain vaccine recommendations, similar to how Kennedy dropped COVID-19 vaccine recommendations for healthy children and pregnant women on May 27. Changing vaccine recommendations could impact how private insurance companies cover certain vaccines, Tan said, which could deter Americans from getting vaccinated and fuel outbreaks of vaccine-preventable diseases. ACIP also determines which vaccines are included in the Vaccines for Children program, which provides vaccines to children whose parents or guardians may not be able to afford them. Changes made to the program would be a "great concern for public health," Brewer said. It's also unclear if COVID-19 vaccines will be available in the fall, he said. The committee met in April to discuss the COVID-19 shot, among other vaccines, but Kennedy canceled the vote that would have made recommendations for the fall. ACIP is scheduled to meet again between June 25 and June 27 with its new committee members, according to the HHS statement. More details: RFK Jr. fires entire CDC vaccine advisory panel What parents should know Doctors and public health experts urge parents to continue discussing vaccine options with their pediatricians and primary care providers. Tan also said professional organizations such as the American Academy of Pediatrics, the American Academy of Family Physicians and the American Medical Association are working together to ensure that children have access to vaccines despite possible changes to the recommendations. She encourages parents to look to these national organizations for guidance and support, and to vaccinate their children if they're not up to date with their shots. "They need to get up to date now, given the fact that access to vaccines at this moment shouldn't be an issue," she said. "The American public needs to understand that the federal agencies that were in place before... they're not going to be the same now." Adrianna Rodriguez can be reached at adrodriguez@