Birth rate decline driven by waiting longer to have children, cost of infertility treatment

May 21 2018

The U.S. fertility rate dropped to a record low for the second year in a row, federal officials announced Thursday. Dr. Eve Feinberg, assistant professor of reproductive endocrinology and infertility at Northwestern University Feinberg School of Medicine and a practicing OB-GYN at Northwestern Medicine, said she believes the decline in the birth rate is driven by a combination of people waiting longer to have children, the cost of infertility treatment and the economy.

"We see a huge increase in infertility when women wait a little longer to have children," Feinberg said. "It becomes much harder for a woman in her late 30s or early 40s to have kids, and there are barriers to accessing infertility care. Infertility treatment costs are more expensive and insurance doesn't always cover it."

Only 15 states have mandated infertility health care coverage, and insurance coverage in those states is not always comprehensive, Feinberg said.

"The cost of raising children has increased exponentially," Feinberg said. "I hear a lot of couples say they used to want to have, say, three kids but now with the cost of education, they only want to have two kids to maximize their resources and provide more for fewer children."

Feinberg also has heard patients say they're waiting to have children until they're older because they're either trying to advance their career or they need more time to feel more financially secure.