More than one year into President Trump's second term, the White House's push to boost U.S. birth rates has yet to produce measurable results in reversing a sustained decline in fertility, according to public health data and policy experts.
During the 2024 campaign, Trump declared himself the "father of IVF" after latching onto in vitro fertilization as a signature issue following comments by then-Democratic vice presidential nominee Tim Walz about his family's conception journey. In a Fox News town hall and later during Women's History Month remarks at the White House, Trump said he would be known as the "fertilization president."
The administration has taken several concrete steps to advance its stated goals. In October 2025, Trump signed an executive order aimed at lowering the cost of fertility drugs such as Gonal-F through his TrumpRx platform while expanding fertility service coverage for employees across the Departments of Labor, Health and Human Services, and Treasury. Earlier this month, the White House launched moms.gov on Mother's Day, a website offering resources on pregnancy support services including links to "Trump Accounts" for children.
What the Left Is Saying
Anthony Wright, executive director of Families USA, argued that the administration's actions contradict its messaging on supporting families. "The rhetoric of honoring mothers and giving birth is hard to square with the reality of the massive cuts to Medicaid and healthcare and caregiving in general," Wright told The Hill. He pointed specifically to the One Big Beautiful Bill's proposed $900 billion in Medicaid reductions, noting: "Medicaid is literally the primary payer for pregnancy and birth in this country. It covers over 40 percent of births and pregnancy care in the country."
Sean Tipton, chief advocacy and policy officer for the American Society for Reproductive Medicine, said he sees a fundamental mismatch between the scope of the problem and the solutions proposed so far. "It's clear that, like a lot of industrialized Western countries, the birth rate in the United States has been declining," Tipton said. "I think that it's a big sociological problem, cultural problem, as well as a biological problem." He added that while accessible fertility treatments could make a "dent" in falling rates, they would not constitute a comprehensive solution.
Progressives have also noted broader concerns about policy priorities. Pew Research Center data shows that among Americans who say they do not want children, the top reason cited is simply that they do not want them, suggesting structural policy changes alone may be insufficient to reverse demographic trends.
What the Right Is Saying
White House spokesperson Kush Desai defended the administration's record in a statement to The Hill. "They say it takes a village to raise a child, and it takes systemic change to turn America's birth rates around," Desai said. "The Trump administration is leaving no stone unturned to address this challenge, from researching long-ignored chronic health issues that affect fertility to pushing policies that will improve childcare, healthcare, and housing affordability."
Desai also pushed back on criticism from healthcare advocates regarding Medicaid cuts, calling such concerns misplaced: "Given that the Medicaid provisions in the One Big Beautiful Bill in no way affect pregnant mothers or children, this 'healthcare access advocate' is an idiot."
Vice President JD Vance, who is expecting his fourth child with second lady Usha Vance, has been a vocal proponent of pronatalist policies. Last year he said: "I want more happy children in our country, and I want beautiful young men and women who are eager to welcome them into the world and eager to raise them."
Tech billionaire Elon Musk, a close Trump ally who led the Department of Government Efficiency advisory effort, has long championed these concerns on social media. In 2022 he wrote: "Population collapse due to low birth rates is a much bigger risk to civilization than global warming." Musk has more than a dozen children and has publicly encouraged others to have larger families.
What the Numbers Show
The most recent data from the Centers for Disease Control and Prevention shows the national fertility rate fell to 53.1 births per 1,000 women in 2025, marking a record low. For a population to remain stable without immigration, the total fertility rate needs to reach approximately 2.1 children per woman. In 2024, that figure dropped below 1.6.
A Brigham Young University survey conducted last year found that roughly 7 in 10 Americans considered raising children unaffordable. Pew Research Center data shows 53 percent of Americans said fewer people choosing to have children would negatively impact the country in 2025, up from 47 percent just one year earlier—suggesting growing concern even as personal childbearing intentions decline.
The share of women aged 15-49 who reported impaired ability to reproduce stood at 13.4 percent in 2022, according to CDC data, but experts note this has not changed dramatically and does not explain the scale of fertility rate declines, pointing instead to economic and cultural factors as primary drivers.
Federal spending on fertility-related services remains a small fraction of overall healthcare expenditure, and no major legislation specifically targeting assisted reproductive technology access has passed Congress during Trump's second term.
The Bottom Line
The disconnect between White House rhetoric on family formation and broader policy choices—particularly proposed Medicaid cuts that would affect coverage for pregnancy-related care—has drawn criticism from advocates who say the administration is not addressing the underlying economic barriers to parenthood. Supporters counter that executive actions on drug costs and new federal resources represent meaningful steps toward reversing demographic decline.
Experts broadly agree that no single policy, including expanded IVF access, is likely to substantially move birth rate numbers in the near term. The trend reflects a confluence of economic anxiety, shifting cultural attitudes, and evolving preferences about family size that extends across industrialized nations. What happens next will likely depend on whether Congress advances broader legislation addressing childcare costs, housing affordability, and healthcare access—all factors cited by Americans who say they are delaying or forgoing parenthood.