Funding for To The Contrary provided by: This week on To The Contrary: There are ways that this country is behind other places with the same level of development, if you will.

Or even countries with lower levels of development.

We also need to make sure that current policies are supporting these people when they are ready to start a family.

Hello, I'm Bonnie Erbé.

Welcome to To The Contrary, a discussion of news and social trend from a variety of perspectives.

The number of Americans is up do largely to immigration, but the number of babies born in the US has reached a low.

New data show birth rates fell again last year, continuing a downward tren that has lasted nearly 20 years.

Many younger women are focusing on their careers and their personal lives, starting families not so much.

Older US women are having more children, but not enough to make up for the sharp drop among younger parents.

Joining me this week are Dr.

Letícia Marteleto, professor of sociology a the University of Pennsylvania, and Dr.

Jamila K. Taylor, president and CEO of the Institute for Women's Policy Research.

Welcome to you both.

To start out, let's talk about what is the primary reason that birth rates in the US are falling?

Starting with you, Dr.

Marteleto.

Yeah.

Bonnie, it's a pleasure to be here with you and with Dr.Taylor.

There's no single factor.

What we have is a multitude of factors, but they cull less around economic pressure, the need for women to have higher educational levels, to study more and for longer and to really start well in employment.

And so those pressures are making women, couples, families decide to not have children or to postpone childbearing.

First off, just want to sa thank you so much for having me, and it's great to be here with you all and fully agree with everything that has already said.

I'll just add to this.

I mean, I think also too, that with th economic impacts we're seeing, you know, high costs in term of housing, weaker job prospects and higher child rearing costs like unaffordable childcare.

And so these all come together, you know, almost like a perfect storm when it comes to parents or aspiring parents thinking through, you know, whether or not they want to build their families.

Another thing I also think we need to bring into the conversation is the increased availability of contraception, coupled with more women being ambitious and wanting to get into the job fields sooner rather than later, as there's no one primary factor.

There's so many different pieces here.

Women lead multi issue lives, and so it's important to sort of draw all of those connections.

Studies show that it is really women who, if they do not have the right educational credentials or the correct employment credentials, they are the ones that are penalized by, you know, childbearing.

Right.

By birth.

So it does make sense to delay, to postpone childbearing or even to have fewer children because you don't have the correct conditions.

Right.

And Dr.

Taylor mentioned something very important, which is the availability of contraception, and in the sense that it is very important for women and for society to really provide, you know, women with the right tools for them to be abl to have reproductive autonomy.

Right, and to really plan a family.

Now, what about—we can talk for a second about this.

The Supreme Court first reversed and then reinstated, at least temporarily, the right to mifepristone, which is a very widely used drug.

I think it's responsible for something like 60 or 70% of all abortions in this country.

And then, of course, it reversed itself and said, okay, you can use it.

So how are these factors like availability of this— this kind of birth control in particular, affecting women's decisions about whether to work or whether to start families or both?

It is important for women to have comprehensive reproductive health care, no matter where they sort of are in the lifespan.

And so as we have this conversation about fertility rates and women's ability to move and navigate the job market, the abilit to have access to affordability in terms of their lives and greater good.

We want to center bodil autonomy in this conversation.

And so when women have access to comprehensive reproductive health care, including access to safe abortion care, including contraception, including treatment and prevention of STIs if they need them, it allows them to not only b more productive in our society and our economy, but also to lead healthier lives.

And so this decision by the Supreme Court is certainly linked to this conversation that we're having toda when it comes to fertilty rates and women's ability to have bodily autonomy, which they all deserve.

But in addition to mifepristone, are there other factors about availability of birth control that are impacting the rate a which women are having children?

Yeah, the availability of birth control is extremely important for reproductive autonomy and for, I mean, of all ages, no only women at reproductive ages.

Right, but the availability.

And we know if studies have shown that they are not readily available to all women equally, right, there's a gap there that needs to be met.

So we think the scope of a conversation about low fertility or lower population growth rate, it is really productive to center it on women and people who can have children i n general, in the sense that it is extremely important for them to have the right tool to exert their bodily autonomy.

Right.

And the US is lacking, its beh other countries with, you know, same levels of economic growth in that regard.

And we do know that there are— we think the US society extreme inequalities that make minoritized women, they are in even worse conditions in terms of lack of access to contraception and therefore lack of providing them with the conditions to have children if they want, when they want and as many as they would like to.

So this is an important conversation to be had.

Now I'm old enoug to remember the 1970s, at a time when lots of teenage girls were becoming pregnant and having babies, and that was a problem.

What has changed in the last 50 years that now we have the opposite problem?

I think this has changed because one, you know, and I feel like contraception will continue to be a theme in this conversation.

I want to credit, you know, the the better availability of contraceptio through the Affordable Care Act and other health insurance coverage.

You know, the fact that contraception was basically available at no cost through the ACA was major for women and people with the ability to get pregnant across the lifespan.

And so I credit that as as a part of the conversation, especially when we talk about young people and teenagers.

So not only having access to the contraception, but also having access to information about how to lead healthy sexual lives.

And so I think that's very important here.

I think also too, again, linking this back to, you know, the rates that we're seeing in terms of women later in life deciding to start families.

I think also, too, we're seeing women being more ambitious.

They want to get into the job market.

They want to finish school.

They want to do all these things before they start families.

And that is a good thing.

Now, what's being witnessed in Asia and parts of Europe is being called population collapse.

How is what we're going through differen from what they're going through, and why are they calling it a collapse over there, and we're not yet calling it that here?

The US has much higher fertility rates still, even though it's been declining, but still much higher than, you know, some countries in East Asia like Japan or South Korea.

Japan, it's around 1.2.

As of Korea, 0.8—extremely low.

And parts of Europe like Spain and Italy is another country that it's 1.2.

The US, we have a total fertility rate today of 1.6.

So we are you know, even though it is low, lower than what demographers call the replacement level of 2.1, which means that a population would replace itsel if it continues at that level.

Right.

So we are not quite there yet.

So what's being called the population collapse in this place is the fact that the age structure of these societies, right, has been shifting towards having like fewer, younger and more older people, relatively speaking.

This can be a concern because we can imagine a lower proportion of people in the workforce and thinking about sustaining the population in the long run.

Right.

At the same time, we do know that from a global perspective, in the 60s and 70s, we had the fear of population explosion.

And it did not quite happen the way that, you know, the way that it was discussed at the time.

But because of those concerns we have seen at the time, we saw at the time, especially in countries in the global South, several types of human rights violations, in terms of forced sterilizations and a series of issues and with minoritized people in the global North as well.

So I'd like to add, you know, that in this conversation centering the conversation on autonomy and providing reproductive autonomy seems to be the productive way to think about this, giving— providing women with autonomy to make decisions over their bodies.

Tell me about the differences between white women and women of color in terms of having children.

Well, we continue to see disparities, racial disparities, particularly when it comes to access to comprehensive health care, which does mean that, you know, we do see highe rates of unintended pregnancy, you know, particularly among women of color in this country.

And I think that, you know, at the same time, particularly in this moment where we're grappling with, you know, shifts in the economy, issues around the lack of affordability, you know, it's incredibly expensive to have children.

I mean, it always has been.

Right?

And so as we see these pressures on families overall when it comes to just making basic needs, you know, we're going to se that stretch across the board, but particularl among marginalized communities, low income people, young people, people with disabilities.

You know we are going to see, you know, more challenges for those populations when it comes to being able to have the bodily autonomy to control their reproduction, and then also with the economic piece as well.

And so the disparities have tightened in some areas, but at the same time, we continue to see them.

Theyre vast enough for us to continue to have concern.

And the root of that has a lo to do with systemic inequality, which includes access to comprehensive health care, including reproductive health care as well.

And so that's where we see those changes when it comes to, you know, black women and white women and other women of color as well, because that should be a part of the conversation.

Let me just jump in with a question.

Does either of you know what it costs for a woman to have a child now?

And is that why the— and of course, the woman is the one who goes through the pregnancy and has the child literally.

Is that why it's maybe more of a woman's decision than it is a man's decision?

Or am I wrong about that?

I don't have an exact number.

I don't know if the professor does, but it is still, you know— the United State spends more per capita on health care than any other country, and so it is still very expensive to have a child in a hospital setting, including the costs that are attached to raising that child.

And so I think when it comes to— we would like for for issues around child rearing to be shared equally acros both partners in a relationship.

But the burden does heavily fall on women.

You know, women are more likely to take on the unpaid labor that is associated with, you know, being the CEO of their household and their families, raising the children, ensuring that they get to activities, finding access to affordabl childcare, all of those pieces.

And at the same time, women are also trying to navigate the economy.

You know, those that would like to work.

You know, so it's really— it really is an issue that centers wome because they are making the bulk of these particular decisions for their households.

Do women are they the predominant gender?

Who decides they want to have children, or is it a joint decision between men and women or do men dominate that decision?

Studies that have looked at women's versus men's or, you know, decisions?

And I'm here talking about ci couples or heterosexual couples in this case, that these decisions are oftentimes very different, right.

They differ particularly regarding the timing for that childbearing.

So we do know that there are differences, that usually postponing is something that women prefer to do, particularly to be able to establish a career, to finish educational trajectories.

In addition to the costs of a pregnancy and the cost of children, there's also the cost that women bear in terms of the promotions that they would have expected that don't materialize or there's the gap, right.

We need to talk about the salary gap or th compensation gap, that we do kno that it's much higher for women when they are mothers than for men when they are fathers.

Right.

So that does happen.

And that gap is even larger for disadvantaged women in that sense as well.

Right.

So you asked also about the teenage adolescence childbearing.

We do know that some o the recent declines infertility in the US come from declines in adolescent fertility.

And that is a welcome— I mean, it can b a beneficial trend in the end.

If these teenagers did not want to get pregnant at that time, it can be beneficial.

And the group, the two group that the decline comes, you know it's starker is really Latin teenagers and black teenagers.

And so that can be extremely beneficial.

So again, we cannot have these conversations without seeing the benefits of delaying childbearing, particularly for those groups.

You know, as people are, you know, sort of navigating whether or not they want to have children and when, we also need to make sure that current policies are supporting these people when they are ready to start a family.

So that means, you know, ensuring access to affordable, high quality childcare, you know, having access to paid leave, addressing some of the challenges around unpaid care burdens and also increasing education costs.

We know that more and more women are going to colleg and pursuing higher education.

And also, you know, bein strapped with student loan debt.

And so that is something that, you know, is going to be burdening, you know, these individuals when they do start a family as well that additional cost on top of, you know, the costs associated with raising a family.

So policy also has a role to play here, when we think about, you know what are the upstream solutions that need to be in place in order to support families when they do decide, you know, to expand, to make sure that they have the support that they need.

And what policies is the Trump administration supporting that may be influencing fewer women to have children?

There are a lot that we can talk about.

You know, definitely we already talked about the, you know, mifepristone challenge right now, I think— I think that is also central to this conversation.

We can also go back furthe and look at the Dobbs decision and how that has really blown up the availability of abortion access, abortion care across the country.

You know, particularly when I look at, you know, concentrated in like the South is, you know, abortion is unavailable.

It's not accessible there.

And so due to the Dobbs decision, mifepristone— you know, this administration is also making it harder for people to access affordable health care.

We know that due to the One Big Beautiful Bill that was passed and signed into law last year, that we are going to see extreme cuts to health care, particularly, you know, take a step back.

Think about the Medicaid program.

You know, some of the advancements that were made under the Affordable Care Act.

So these changes ar really going to be concentrated among low income and middl income families in this country.

And so that alone is going to have a grave impact and make it increasingly hard for people to take a step bac and plan their families in ways that make sense for them in their broader communities.

And those are just a few.

And are there other way that it's easier for white women to have children than women of color, and largely because they are lower income, generally speaking, due to racial prejudices.

Absolutely.

Due to systemic inequality, you know, we do see that particularly, you know, women of color are more likely to, you know, work in low wag jobs, not have access to health care associated with the jobs that they are in, and making really low hourly wages.

And even when we take a step back and think about something like access to fertilty treatment, for example, we've already had a conversation about how we're seeing women, you know, in older ages, you know, having children.

And so we know that there are vast racial disparities and who gets access to treatment, which is very expensive in this country, it could cost upwards of $100,000, you know, for treatment of fertility challenges.

And so oftentimes women of color are going without the care and support that they need, even when they do want to have children, when they are ready to start a family.

And so those are als some key pieces to think about.

And then one thing that I also want to bring up as well is the maternal mortality crisis in this country, which we haven't been able to get to so far.

And just to say, you know, since we're focusing on racial disparities, black women are about three time more likely to die of pregnancy related causes when compared to white women.

The root of that is you know, racism and inequality.

But it can also be linked t who has access to quality health care in this country, who has access to livable wages and the jobs that they need, who has access to bette social support in our society?

So that is also something that we have to grapple with as a country.

The United States has the worst maternal mortality rate when compared to othe similarly developed countries.

So it really is a proble for all women in this country.

We don't have very good maternity care, but it is particularly challenging for black women and indigenous women to access the care that they need, particularly pregnancy related care.

Dr.

Marteleto, what are your thoughts?

Do you agree?

I'll let you have the final comment on this.

Yes, absolutely.

This is incredibly important to think about the high rates of black maternal mortality in this country.

And that has been only increasing.

So when we think about policies, right, policies that would ameliorate that situation would be extremely welcome.

Unfortunately, it is not what we are seeing.

And then but weve been getting policies over the last 50 years that that have made it somewhat easier anyway.

Maybe they're too small, maybe they make it easier in ways that only a very small percentage of American women can take advantage of.

But we have seen, you know, more job sharing, more higher minimum wage.

We just had a huge round o increasing minimum state wages.

And they're all at the— except for the federal wage, but they're mainly at the state level.

And I mean, if you say we need— women need more help, and they're already gettin a lot of help from the policies.

And we're in an er that is cutting federal support for everything, not just women's health, but everything.

Yes.

What does that likely to do to the birth rate?

Yeah.

So 2 comments here.

One is: in the big picture, we can claim that there are some policies; in terms of health care, for example, there are countries that have a much lower GDP, like for example Brazil, the country that I studied the most that does have universal health care and this country does not offer that to— I mean, just to think like, you know, comparing in a globa perspective.

European countries do have a social safety net as well that we do not— that we do not offer in the US as well.

So there are ways that this country is behind other places that with the same level of development if you will, or even countries with lower levels of development, even though I don't necessaril like that word development, but in the global South.

So there is more that could be done.

In terms of other policies, just to add.

If I think about low growth rates, right.

Population growth rate reall is made up of three components.

Fertility is one of them, mortality is the othe and migration is the third one.

Right.

So one other way to counteract these lower population growth rates would be through migration.

Right.

So and—that we—so again just to exemplify, something that this government is doing the exact opposite.

If there is a—what we would— what we would expect if the concern is low population growth rates, right, we would in fact have a more welcoming immigration policy or migration policy, because that is the third way that could ameliorate the low populatio growth rates that we are seeing in this country.

It's the elephant in the room.

But I had to mention it as a demographer.

No, that's fine, and thank you for that.

And we're about out of time.

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