Headlines lately have proclaimed a crisis of falling birth rates in the United States, but a closer look at the evidence recalls the famous phrase popularized by Mark Twain: “Lies, damned lies, and statistics.” At a Chan School of Public Health panel this week, a trio of Harvard professors made these key points:
- There likely is no emerging population crisis.
- Strong evidence demonstrates that globally, no single public policy would have more than a weak effect on raising birth rates.
The virtual discussion on August 19, moderated by doctoral student Veronica Adamson, featured Ana Langer, professor of the practice of public health emerita; Margaret McConnell, associate professor in the department of global health and population; and Henning Tiemeier, Feldberg professor of maternal and child health. They explained why the statistics are misleading but underscored the social realities that make raising children in the United States difficult for many families.
No crisis behind the numbers
While the Centers for Disease Control and Prevention reported a historic low U.S. birth rate of 1.6 children per woman in 2024, much of the decline, said McConnell, comes from teenagers and young women delaying childbearing.
“The population where the birth rate has been declining most rapidly is actually women 15 to 20 years old,” McConnell said. With better access to contraception and sex education, she explained, teen pregnancies have fallen dramatically—a trend Tiemeier called “a big societal success.”
McConnell also cautioned that the fertility rate, measured year by year, can obscure the bigger picture: completed family size over a woman’s lifetime has not fallen nearly as sharply. “If you look at numbers…that give you a sense of how many babies women have over their lifetimes—women between 40 and 44—the number of children they’ve had is actually not changing as much over time as the fertility rate,” suggesting that the supposed crisis reflects demographic shifts rather than collapse.
While much of the media has described the lower birth rates in alarming terms—“The Birth Rate Crisis Isn’t As Bad As You’ve Heard—It’s Worse,” read a recent headline in The Atlantic—Langer added that most people are not concerned about low fertility rates as a social problem. Surveys suggest Americans are more worried about overpopulation, climate change, and the cost of living than about too few babies being born.
Weak evidence for policy fixes
Concerns about lower birth rates around the globe tend to center on several issues: a shrinking labor force that leads to slower economic growth, paired with rising dependency of an aging population that strains pension and healthcare systems.
Even if there is no crisis now, can public policy nevertheless encourage more births to prevent the economic distress that might ensue if the population of young people shrinks too quickly in the future?
McConnell put it bluntly: “The evidence on paying people to have children is actually quite weak. Many countries have tried this and failed…even when they’ve put substantial resources into it.” From France to Hungary, baby bonuses and subsidies have yielded at best modest increases. Tiemeier concurred: “A $1,000 or $5,000 birth gift won’t change the needle at all. You would have to think in terms of $50,000.” The effect of every practical public policy intervention, in other words, would be small.
Even parental leave policies, often praised as pronatalist tools, show only limited effects. Tiemeier cited Scandinavian data suggesting modest boosts when fathers are strongly encouraged to take leave, but cautioned: “Any measure we take will have a modest effect only,” because there are so many factors contributing to fertility. “There are no big effects in this discussion.”
Still, the panelists said, there is a place for public policies that support families with children. But the professors suggested that such policies should be justified on their own merits—because they improve health, equity, and quality of life—rather than as a means of engineering a baby boom.
Langer argued that ensuring families can raise children in healthy, supportive conditions is a human right. McConnell pointed out that most American families experience the birth of a child as an “economic catastrophe”—one that pushes many families into poverty—yet U.S. social programs do little to buffer the expense of child-rearing, which sometimes leads one parent to leave the workforce. Expanding childcare access, postpartum care, and maternal health services, the panel argued, would improve outcomes regardless of their impact on fertility.
Beyond the birth rate: maternal health and inequality
The conversation repeatedly turned to maternal health—where the U.S. does face a crisis. The country’s maternal mortality rate is more than three times that of other wealthy nations, Adamson pointed out, and Black women are three to four times more likely to die from pregnancy-related causes than white women. Nearly 40 percent of Americans live in what Langer described as “maternal health deserts,” with little or no access to obstetric care.
“It’s quite unacceptable that the maternal mortality rates are so high in the United States,” she said. Universal healthcare and quality of care, she said, should be the real public policy priorities.
The panel also highlighted the postpartum period as a healthcare weak spot. “There’s an enormous amount of attention paid to women while they’re pregnant,” McConnell explained, “and then the health system kind of drops you.” Many maternal deaths occur not during birth but in the weeks and months afterward—a period one of McConnell’s colleagues calls a “postpartum cliff”—often due to untreated cardiovascular disease, mental health struggles, or substance use disorders.
The Supreme Court’s 2022 Dobbs v. Jackson Women’s Health Organization decision, which eliminated abortion rights on the federal level, was another point of discussion. Both McConnell and Langer noted that while state abortion bans may slightly increase births, the overall effect on fertility rates is marginal—and comes at the cost of deepened health inequities and worsened outcomes for the most vulnerable women.
In the end, the panelists suggested that the fertility debate has been framed the wrong way. Rather than panicking about a shrinking number of births, they said, policymakers should ask how to build a society where people can achieve their desired family size—whatever that may be—without facing preventable risks or financial ruin. As Tiemeier reiterated, the evidence shows only a weak effect of public policy interventions on the birth rate.
“But even a small effect,” he said, if achieved through better childcare, leave policies, and maternal healthcare, “would be welcome”—because those should be goals in their own right.
