US Birth Rate Drops Again: How Federal Family Planning Changes Could Impact Pregnancy Care

The number of babies born in the United States fell again last year, according to new data from the Centers for Disease Control and Prevention (CDC). In 2025, there were 3.6 million births, a 1% decline from 2024. The fertility rate dropped to 53.1 births per 1,000 women ages 15 to 44, a 23% decrease since 2007.

The Trump administration has expressed a desire to reverse this trend. President Donald Trump has called for “a new baby boom,” and aides have solicited proposals from outside advocates and policy groups, including ideas like baby bonuses and expanded fertility planning. The administration is also proposing significant changes to Title X, the federal government’s only dedicated family planning program.

What Is Title X?

For more than five decades, Title X has operated with bipartisan support to provide low-income women with access to contraception, sexually transmitted infection (STI) screening, and reproductive health care, regardless of their ability to pay. At its peak, the program served more than 5 million patients annually. According to surveys, six in 10 Title X clients reported that the program was their sole source of health care in a given year.

Proposed Changes to Title X

In early April, the Department of Health and Human Services (HHS) invited nonprofit organizations to apply for Title X grants for fiscal year 2027, which begins in October. 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 shifts the program’s focus from traditional public health interventions to fertility, family formation, and reproductive health conditions such as polycystic ovary syndrome, endometriosis, low testosterone, and erectile dysfunction. While Title X will continue to support women “achieving healthy pregnancies,” the document does not explicitly reference preventing unintended pregnancies—a long-standing goal of the program.

Expert Reaction to the Proposed Changes

“What we’re seeing is trying to use our nation’s family planning as a Trojan horse for an entirely different agenda.”

Jessica Marcella, who oversaw the Title X program as a senior official in the Biden administration, criticized the proposed changes. She also noted that President Trump has proposed eliminating Title X altogether.

Why Are Birth Rates Declining?

The administration’s overhaul of Title X coincides with declining birth rates. However, researchers studying fertility trends argue that the decline is driven by factors unrelated to contraception access. Restricting access to contraception, they say, is unlikely to reverse the trend.

According to Alison Gemmill, a demographer at UCLA, the most significant factors are timing-related. “Childbearing is increasingly delayed as part of a broader shift toward later adult milestones, including stable employment, leaving the parental home, and marriage,” she said. Gemmill added that most American women still complete their childbearing years with an average of two children, indicating a shift toward smaller families rather than an increase in childlessness. “Having children has become more contingent and more planned,” she explained.