A woman lies in bed and looks at a pregnancy test.
More women are planning their families in terms of when they have children and how many they want to have. (For Spectrum Health Beat)

American women are having fewer children, and they’re having them later in life, a new government report shows.

“Overall, we saw continuing decreasing trends in total fertility,” said report author Danielle Ely, a health statistician at the National Center for Health Statistics, which is part of the U.S. Centers for Disease Control and Prevention.

Dr. Jennifer Wu, an obstetrician-gynecologist at Lenox Hill Hospital in New York City, said the trends reflect shifting cultural norms.

First, fewer teens are getting pregnant, which raises the average age at which women are having children. “This is a good thing because most teens do not have adequate economic or emotional means to take care of a child,” Wu said.

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Our Take

Samantha Kauffman, RNC, perinatal education coordinator at Spectrum Health Gerber Memorial.

In addition to women having fewer children and having them later in life, studies also show that 10 to 15 percent of couples are infertile. If you are trying to get pregnant, this time of trying is easy for some, but can be difficult for others, notes Samantha Kauffman, RNC,  perinatal education coordinator at Spectrum Health Gerber Memorial. If you’ve been trying for a while, you should see your doctor.

These lifestyle changes can help:

  • Improve your diet. This starts with the basic things we probably all know. Eat lots of fresh fruits and vegetables. Some current literature has more specifics about what to eat and not eat. This would include eating healthy fats, supplementing with vitamin C, eat folate, and include zinc, which has been linked to fertility. Foods with folate include dark leafy greens, citrus fruits, broccoli, lentils and asparagus. Foods with zinc include oysters, wheat germ, spinach, beans, mushrooms and nuts.
  • Maintain a healthy weight. We know that obesity can affect reproduction. Exercise can also be important to your health. Excessive exercise can cause issues for both male and female reproduction.
  • Avoid chemicals. This includes pollution, heavy metal exposure, smoking and drugs.
  • Check your medications. Certain medications, such as some used to treat ulcers, can have an effect on the sperm count.
  • Other suggestions include avoiding hot tubs, wearing boxers to avoid constricting underwear, and avoiding sitting for long periods of time.
  • Consider herbal supplements. You want to contact an herbalist to find out what is best for you. New sperm formation takes almost three months, so these changes will take a little bit of time. Always remember to check with your doctor first.

Learn more.

Women waiting to have children until they have financial security and health insurance tends to lead to healthier infants, she added.

Birth rates are declining in industrialized countries around the world, Wu said. “Families are realizing that they have limited resources,” she explained.

Wu also believes that more women are planning their families in terms of when they have children and how many they want to have.

“I’m glad more women are considering that,” she said. “They have a lot of choices to make when they are very young about college and career, and sometimes having a baby very young can derail all that.”

In addition, more women are using contraception to prevent pregnancy and opting to terminate a pregnancy rather than seeing it through and putting the child up for adoption, Wu noted.

While there were declines in births across the United States, those drops were greater in metropolitan counties than in rural counties, the researchers noted.

Between 2007 and 2017, birth rates dropped 12 percent in rural areas, 16 percent in small and medium cities, and 18 percent in large metro counties.

Compared with cities, rural areas had higher birth rates throughout the entire period, the findings showed.

The birth rate in rural areas declined 9 percent from 2007 through 2011, and it did not change significantly from 2011 through 2017.

At the same time, birth rates in small or medium-sized urban areas dropped 16 percent while they declined 18 percent in large urban areas, according to the report.

Ely said, “Another finding was the age when mothers first give birth in rural counties is lower than mothers who are having their first birth in metro counties.”

From 2007 through 2017, the average age when a woman had her first child in rural areas rose from 23 to nearly 25. In small or medium cities, the average age went from 24 to 26, while it went from 26 to 28 in large cities.

Birth rates did decline as maternal age increased among all groups, the researchers noted.

The findings were published in the CDC’s NCHS Data Brief.