The number of babies born in the United States fell again last year, with 3.6 million births in 2025, a 1% decline from 2024. The fertility rate dropped to 53.1 births per 1,000 women ages 15 to 44, down 23% since 2007. In response, the Trump administration is proposing to reshape Title X, the federal government’s only dedicated family planning program.
Redefining Family Planning
For more than five decades, Title X has been geared toward giving low-income women access to contraception, screening for sexually transmitted infections, and reproductive health care regardless of ability to pay. At its peak, the safety net program served more than 5 million patients a year. The Department of Health and Human Services invited nonprofit organizations to apply for Title X grants for fiscal year 2027, with a 67-page Notice of Funding Opportunity including only one mention of contraception—describing it as overprescribed and associated with negative side effects. The grant notification reshapes the program from traditional public health efforts to focus on fertility, family formation, and reproductive health conditions such as polycystic ovary syndrome, endometriosis, low testosterone, and erectile dysfunction.
Demographic Realities
Researchers studying fertility trends say the decline is driven by forces that have little to do with contraception access. Demographer Alison Gemmill of UCLA noted that childbearing is increasingly delayed as part of a broader shift toward later adult milestones, including stable employment, leaving the parental home, and marriage. Most American women still complete their childbearing years with an average of two children, suggesting a shift toward smaller families rather than an increase in childlessness.
Maternal Mortality Concerns
The United States already has one of the highest maternal mortality rates among wealthy nations at 17.9 deaths per 100,000 live births as of 2024, with 4 in 5 pregnancy-related deaths potentially preventable. Medical research shows that pregnancy carries substantially higher risks of blood clots, stroke, and cardiovascular complications than hormonal contraception. Since the Supreme Court’s Dobbs decision in 2022, access to abortion has been significantly curtailed across much of the country, though national abortion numbers have risen through telehealth and interstate access.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.arcamax.com/newsheadlines/s-4077263