US birth rate decline driven by desire and medical difficulty
A Federal Reserve Bank of Atlanta working paper identifies two primary drivers behind the falling U.S. birth rate: decreased desire for children among Gen Z and increased medical difficulty in conceiving across generations since the Boomers.
Desire wanes, difficulty grows
Using the National Survey of Family Growth, a Federal Reserve Bank of Atlanta working paper explores the reasons behind the falling U.S. birth rate.
The analysis confirms that newer generations of women are less likely to have children than previous ones.
Two key sources for this decline are identified: a significant decrease in the desire to have children, particularly among the youngest generation (Gen Z), and a persistent increase in the medical difficulty of having children across all generations since the Boomer era.
The study employs a trivariate probit model to jointly determine childbearing, desire for children, and impaired fecundity, distinguishing between preference-driven and biologically driven fertility decline.
Economic ripples of fewer births
Existing explanations for declining birth rates often emphasize shifting preferences and priorities among younger cohorts, a narrative dominant in policy and academia.
This paper's central contribution is to integrate this perspective with the simultaneous rise in medical impediments to childbearing, including infertility and impaired fecundity.
Understanding both conscious choices and physical constraints is crucial for effective policy.
The study also briefly reviews the economic mechanisms through which fertility shapes growth, noting arguments from Malthus to recent simulations by Weil (2026) and Huang (2024) on long-term economic impacts.
Beyond the obvious
This working paper offers a crucial, dual perspective on declining U.S. birth rates, moving beyond the prevailing focus on preferences alone.
By rigorously quantifying the role of increasing medical difficulties alongside generational shifts in desire, it provides a more comprehensive foundation for policy discussions.
However, translating these complex findings into actionable and effective interventions remains a significant challenge for policymakers.
Source: What's Behind Declining Birth Rates in the U.S.?
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