05/13/2026 | Press release | Distributed by Public on 05/13/2026 13:21
May 13, 2026
Highlighting an important but mostly overlooked factor in declining US birth rates, this working paper examines the growing medical difficulties of childbearing alongside shifting generational preferences, discussing policies addressing both fertility desire and biological constraints.
View PaperWorking Paper 2026-5
Abstract: Using the National Survey of Family Growth, this paper explores reasons behind the falling birth rate in the United States. The analysis confirms that newer generations of women are less likely to have any children than generations that came before. Comparing outcomes among women at the same age, two sources for this decline are identified: (1) a dramatic decrease in the desire to have children, but only among the youngest generation in the sample (Gen Z) and (2) an increase in the medical difficulty of having children among all generations of women since the Boomer generation. Various policies addressing both desire and difficulties are discussed in the context of a goal to arrest or reverse declining birth rates. The primary contribution of this paper is consideration of increasing medical difficulty in conceiving and bearing children (impaired fecundity) alongside the current dominant theory of shifting priorities and preferences of recent cohorts of women.
JEL classification: J13, I19, Q58
Key words: birth rates, total fertility rates, infertility, impaired fecundity, microplastic, IVF, family formation, Gen Z, cohorts
https://doi.org/10.29338/wp2026-05
Allen Bradley is with Bradley Arant Boult Cummings LLP. Lila Newberry Bradley is with Claiborne Fox Bradley LLC. Julie Hotchkiss, corresponding author, is with the Federal Reserve Bank of Atlanta and Georgia State University. Clare Ostle is with the Marine Biological Association. Deborah Partey is with the Federal Reserve Bank of Atlanta. Comments from Lindsey Isaf, Alexander Monge-Naranjo, Nathaniel Moore, Robert Moore, Roberta Moore, M. Melinda Pitts, and David Ribar are greatly appreciated, as well as comments received from other colleagues at the Federal Reserve Bank of Atlanta. Any views expressed here are those of the authors and not necessarily those of the Federal Reserve Bank of Atlanta or the Federal Reserve System. No funding was received for the completion of this project and the authors have no known competing financial interests or personal relationships that have influenced the work in this paper. No part of this paper was produced using AI tools. Authors are listed in alphabetical order.
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