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Despite the breadth of the data included in its January 2019 vital statistics update, the CDC statistic generating the biggest headlines is the one that calculates the birth rate in the U.S. to be 16 percent below the amount needed to replace our population over time.
Most of the stories dominating the news cycle have sensational, clickbait headlines: "Women in the U.S. Are Having Fewer Babies" (Time); "U.S. Fertility Rates Have Plummeted Into Uncharted Territory, and Nobody Knows Why" (Science Alert); "The U.S. Is in the Danger Zone for a 'Demographic Time Bomb'" (Insider); and "Florida, U.S. Have a Baby Problem" (Orlando Sentinel). Among my personal favorites are the headlines where women are blamed as if it's all immaculate conception - "Women Aren't Having Enough Babies to Replace Ourselves" (Moms).
But all of the news noise is missing the glaringly obvious facts that every millennial I know recognizes immediately. Here are seven real reasons behind the declining birth rate:
1. The U.S. has the highest maternal mortality rate of all developed countries.
When NPR and ProPublica investigated maternal mortality in the U.S., their findings were clear: "More American women are dying of pregnancy-related complications than any other developed country. Only in the U.S. has the rate of women who die been rising."
Here, around 26 out of every 100,000 pregnant women die each year, and while some European and Eurasian countries have rates in the teens, the U.S. maternal mortality rate is rising while most other countries are seeing their rates decline. The U.K., for example, has a rate of around nine in every 100,000 women dying, but the Lancet noted that country's efforts to reduce maternal mortality has meant "being pregnant in the U.K. has never been safer." Not to mention that our rate remains three times greater and is increasing.
The lowest rates around the globe are three deaths per 100,000. Which means that compared with women in places like Finland, Iceland, and Greece, mothers in the U.S. are dying at a rate that's nine times greater. That's not even taking race into account. The CDC reports that black women in the U.S. are three to four times more likely to die from pregnancy-related causes as their white counterparts.
But it's not just a higher risk of death here in the U.S. that makes birth difficult, it's also a matter of cost.
2. Giving birth in the U.S. is exceedingly expensive.
The United States is the most expensive place in the world to give birth. In the Guardian's analysis, it costs around $32,000 to give birth vaginally in the U.S. if you don't have insurance. If you require a C-section, those costs increase to around $51,000.
Think about that: Without insurance, it's the financial equivalent of an extremely nice car or multiple years of tuition at a state university merely to have a baby. And that's if everything goes well. If there are complications - either for the child or the mother - those costs can quickly escalate to six figures or more.
Say you're lucky enough to have great insurance, though - despite the best efforts of Republicans in the House and Senate to repeal Obamacare and get rid of protections for pre-existing conditions, of which pregnancy is one - even then, insurers only negotiate the cost down to around $10,000 for a vaginal birth. In Spain (which has the supposedly dreadful socialized medicine), it costs insurance companies a mere average $1,950 for women to give birth vaginally.
That's not a matter of lower cost for less quality; Spain's maternal mortality rate is five times lower than the U.S. So while pregnant women in the U.S. with insurance might be paying less out of pocket, the costs paid by their insurance companies are still astronomically high and are no doubt reclaimed by charging higher insurance rates.
What we have in the U.S. then, is - on top of a high mortality rate - the added burden of giving birth made to be ridiculously expensive. And once you have the baby, we've created a system that fails to take care of U.S. mothers further.
3. The U.S. has no national mandate for paid parental leave.
In another disappointing distinction, the United States remains just about the only industrialized country, and the only OECD member country, not to require paid parental leave. It's up to the discretion of individual employers to decide whether or not to offer paid maternal or parental leave.
Governments in other countries provide weeks or even years with varying amounts of assured income to moms and, increasingly, dads. It's a simple argument - as Christopher Ingram writes in the Washington Post:
Not only is it more dangerous and more expensive to have a child in the United States, but even after that, we're not going to provide parents with the financial security to ensure they can take time to be with their newborn. With these facts, is it really that shocking that we have a declining birth rate?At the risk of stating the obvious, having kids is a necessary condition for our biological and economic survival. The species must perpetuate itself, and at the country level, if economic growth is to continue, it behooves couples to churn out as many future employees and taxpayers as possible.
Even if you manage to get past all of this, there's an additional financial burden that becomes a major factor in keeping people from having kids.
4. Child care can cost as much as rent.
Care.com's latest annual survey, which factors in parents who use nannies as well as those who opt for daycare, put the national average of child care expenses at $1,500 per month, or $18,000 per year. That's equivalent to a national-average rent payment, which Rent Cafe put at $1,405.
The U.S. Department of Health and Human Services says that child care is considered "affordable" if it costs no more than 10 percent of a family's income. Using Care.com's average of $18,000, that'd require a combined household income of $180,000. But the latest figures from the Census put the median household income at $61,372, meaning child care for the average family is likely closer to nearly 30 percent.
Contributing almost 30 percent of your household income to child care is untenable for many multi-income families, much less single-parent households. Especially considering the state of most people's personal finances.
5. Wages have remained nearly stagnant for 40 years.
Pew Research found that "today's real average wage (that is, the wage after accounting for inflation) has about the same purchasing power it did 40 years ago. And what wage gains there have been have mostly flowed to the highest-paid tier of workers."
This means that as the cost of living continues to skyrocket, wages aren't keeping pace for most of us. This makes it all that much harder to afford both quality health care and quality child care. Plus, while wages have barely budged, our debt is crushing us.
6. We are struggling to make ends meet even before having children.
Our level of debt - which for many young people today is student loan debt - drastically outpaces any other generation before us, according to the Federal Reserve. Its most recent study flat out states that "millennials are less financially well-off than members of earlier generations when they were the same ages, with 'lower earnings, fewer assets and less wealth.'"
If high maternal mortality rates, the high cost of having a baby plus the lack of guaranteed income after having that baby, and child care that costs a significant percentage of already stagnant wages for a generation that's openly worse off financially than previous ones isn't enough to evidence as to why the birth rate is decreasing, there's one more factor to bring it home.
7. We're disillusioned and burned out.
If you haven't read Anne Helen Peterson's brilliant piece on how millennials are the burnout generation, you really should. She explains how our parents raised us in relatively stable economic and political times and reared us with an eye to our hard-working futures with the belief we'd be even better off than they were. From purposeful play time to post-graduate school expectations, we have, as Peterson writes, "internalized the idea that [we] should be working all the time." But we very rarely reach the dangling carrot. Saddled with the nation's financial crisis on top of our own mountains of debt and the idea that we are failures if we stop, we are - quite simply - exhausted.
Now, I'm not saying that no one should have children. I have many friends who have amazing kids, and I love them. But if you're going to act shocked at why the birth rate is decreasing, or worse, try to analyze it while ignoring all of the above realities, then you're doing everyone a disservice.
Entrepreneur, Activist, Podcast Fan, and Proud Millennial. I freelance, write, and run my own career coaching business at thecolorcodedlife.com.
We've already got far more than ever needed. Eh R.C.?