America faces a challenge with declining fertility rates.
News Analysis
As governments’ fears shift from a world with too many people to a world with too few, four analysts gathered at the Cato Institute last week to strategize about how the United States can reverse its trend of falling fertility rates.
In introducing the panel, Vanessa Brown Calder, Cato’s director of Family Policy Studies, said, “I think I can say for all of us, the issue of fertility and family policy is not merely a theoretical one.
“In fact, everyone contributing to the conversation is either a mom or will be one soon,” Ms. Calder said. “Three of the four of us are pregnant and all three trimesters are represented.”
The discussion took place amid reports that hospitals across America, particularly in rural areas, are closing maternity wards because of a shortage of babies.
The Wall Street Journal reported last week that this trend of shuttering maternity wards has led to a situation in which “roughly 2.2 million women of childbearing age lived in so-called maternity deserts in 2020, according to March of Dimes, which it defined as counties without a hospital, a birth center, and doctors and nurse midwives with experience delivering babies.”
“There’s just not enough babies to be had,” said Dr. Michael Cruz, chief operating officer of OSF HealthCare in Pontiac, Illinois.
This has led to rising maternal death rates in the United States, which are currently at the highest rate since 1965, and are now higher in America than in any other high-income country. And it only adds to a seemingly irreversible trend of a graying population with fewer and fewer children.
Too Many People or Too Few?
“For the vast majority of human history, the world’s population was more or less stable; it was growing but very, very slowly,” said Chelsea Follett, policy analyst at HumanProgress.org. Fertility rates were higher, she said, but until the industrial revolution “many children did not live to adulthood, many did not even live through their first year.”
As medicine and living standards improved, mortality rates fell and populations increased dramatically. Around the year 1804, the world’s population reached a billion people. It took another 123 years for the population to reach 2 billion, but it increased rapidly from there, hitting 8 billion in 2022.
As early as 1798, historians like Thomas Malthus predicted that the earth would be unable to sustain increasing populations, and that mass starvation and environmental catastrophe was in our future. But he failed to take our ability to adapt and innovate into account.
“Even as the population continues to reach new highs every year, poverty and hunger are reaching new lows, the exact opposite of what the population panic had predicted,” Ms. Follett said. “Another reason why their concerns were ultimately unfounded was the fertility transition and the fall in birth rates, because as more and more children were reaching adulthood many people realized that to have two children surviving, they didn’t need to give birth six times.”
The U.N. estimates that the population will grow to 10 billion by 2060, and issued a “code red for humanity” in 2021, arguing that so many people would cause irreparable harm to the planet.
“The alarm bells are deafening, and the evidence is irrefutable: greenhouse gas emissions from fossil fuel burning and deforestation are choking our planet and putting billions of people at immediate risk,” U.N. Secretary-General António Guterres Guterres said.
But many demographers dispute the U.N. predictions and see a significant slowing in population growth. They believe the world’s population will peak sooner, and then begin to shrink. Countries like South Korea, Japan, Italy, Portugal, Poland, and Greece are already beginning to see their populations collapse.
In 1960, the average woman worldwide had 5.2 children. Today that number has fallen to 2.4, barely at replacement level, across the globe. Currently, Ms. Follett said, two-thirds of the world’s population resides in countries with fertility rates below the 2.1 replacement level, including countries like India, Mexico, Brazil, China, and virtually every country in Europe.
A demographic study in the Lancet, conducted by researchers at the University of Washington, predicts that by the year 2100 global fertility will fall to 1.66. They attribute this decline to current global trends of urbanization, women’s education and workforce participation, and accessibility to birth control.
This decline in birth rates leads to what is called the “fertility trap.” For a country to sustain its population, women must have an average birth rate of 2.1 children over their lifetime. Historically, once the fertility rate falls below 2.1, it never comes back.
The U.S. fertility rate fell to 1.6 in 2020, the lowest rate in America’s history and a sharp decline from 3.7 in 1960. Europe’s average fertility rate is 1.5; Japan’s is 1.3; and China’s ranges from 1.3 to 1.5, depending on the source, though some estimates put it as low as 1.15.
The Lancet study predicts that by the end of this century, China, the world’s most populous country, will have shrunk by 668 million people, losing nearly half of its current population, and India, the second-most populous, will lose 290 million. China and India together represent about one-third of Earth’s population, such that trends within these two countries are pivotal for the remainder of the world’s population.
Despite China’s efforts to reverse the decline, including eliminating the one-child policy and providing incentives for child-rearing, it experienced its fifth consecutive record-low birth rate in 2021.
In May 2022, Tesla/SpaceX CEO Elon Musk stated that “civilization is going to crumble” from the loss of so many people. Mr. Musk had previously declared that “the biggest problem the world will face in 20 years is population collapse.”
Countries Try, Fail to Boost Birth Rates
Many countries now recognize declining birth rates as a significant problem, but solutions are proving elusive.
“By 2015, 55 countries had declared an explicit policy objective of raising birth rates,” Ms. Follett said. “And yet, despite many different initiatives to try to alter these trends, there has never been a single case in the modern era of a wealthy country raising its birth rates back to replacement level and sustaining it there.”
“Probably the best, although kind of depressing place to start is Singapore,” said Elizabeth Nolan Brown, senior editor at Reason and a frequent writer on the subject.
Starting in 2001, she said Singapore began giving citizens cash bonuses for having children. They now start at $8,000 for first and second children, and $10,000 for every child after that. The country offered tax rebates, paid maternity leave, and other subsidies and incentives, but the fertility rate continued to fall, from 1.83 in 1990 to its current rate of 1.05.
South Korea made a similar attempt, Ms. Brown said, offering an allowance equal to $540 per month to parents. The country spent an estimated $200 billion subsidizing childcare and parental leave over the past 16 years, only to see its fertility rate fall from 1.1. to 0.78.
“What I found really interesting when researching this subject was how paltry the fertility rate returns are for any of these types of social welfare spending,” she said.
“Japan has spent massively on family policies like these between 1990 and 2015,” she said. “It expanded childcare subsidies, paid family leave policies, parental tax credits, and more.
“Meanwhile, its fertility rate went from 1.5 in 1990 to 1.3 in the early 2000s,” Ms. Brown said. “It hit 1.2 in 2022.”
The lesson may be that women cannot be bribed into having children, or perhaps the bribes are simply too small. According to the Brookings Institution, raising a child in the United States today costs on average more than $300,000.
“We have suggested a different path in our ‘Freeing American Families’ report,” Ms. Calder said. “These reforms have the advantage of reducing the obstacles that parents face in a variety of different ways, not solely financial.”
She suggests reforming government policies to reduce the cost of parenting and create more flexible work policies.
“Policymakers have really been focused on band-aid policies to boost the amount of money or resources that families have,” she said. “But they haven’t been as interested in the underlying cost drivers and what is causing these increases in childcare prices.”
Relaxing regulatory restrictions on staffing and zoning for daycare centers could help, she said, together with reforming the au pair program to allow au pairs to stay beyond a year or two. Hospital policies that push women to have C-sections instead of natural births should also be reconsidered, she said.
‘Mothering Harder’
Among the largest expenses and time commitments for parents come in the area of education. The cost of college has become prohibitive for many families, and government-sponsored student loan programs only green-light more spending by universities, driving costs up further.
In addition, many parents have become uncomfortable with grade school curricula that they believe is pushing progressive racial and gender ideologies on children. As a result, many are opting to pay for private schools o
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