According to new CDC data, there were 3.6 million births in the United States in 2025, a 1% decline from 2024, with the fertility rate dropping to 53.1 births per 1,000 women ages 15 to 44, down 23% since 2007. The Trump administration has said it wants to reverse this trend by proposing to reshape Title X, the federal government’s only dedicated family planning program.
Title X Transformation
In early April, the Department of Health and Human Services invited nonprofit organizations to apply for Title X grants for fiscal year 2027. The 67-page Notice of Funding Opportunity included only one mention of contraception, describing it as overprescribed, associated with negative side effects, and part of a broader “overreliance on pharmaceutical and surgical treatments.”
The grant notification reshapes the program from its traditional public health intervention efforts to focus on fertility, family formation, and reproductive health conditions such as polycystic ovary syndrome, endometriosis, low testosterone, and erectile dysfunction. While Title X will continue to help women achieve healthy pregnancies, the document does not explicitly reference preventing unintended pregnancies, a long-standing goal of the program.
For more than five decades, Title X has been geared with bipartisan support toward giving low-income women access to contraception, STI screening, and reproductive health care regardless of ability to pay. At its peak, it served more than 5 million patients per year, with six in 10 Title X clients reporting the program as their sole source of health care.
Expert Response
Jessica Marcella, who oversaw the Title X program as a senior official in the Biden administration, said the new funding notice amounts to a wholesale redefinition of family planning. Researchers studying fertility trends say the decline is driven by forces that have little to do with contraception access and that restricting it is unlikely to produce more births. Eight in 10 women of childbearing age surveyed by KFF in 2024 reported having used some form of contraception in the previous 12 months.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://us.headtopics.com/news/as-u-s-birth-rate-falls-trump-officials-downplay-82289334