America is hurtling towards a demographic disaster.
Our birth rates have been declining for decades. In 2023, they hit an all-time record low.
President Trump ran on a "new baby boom." This week, the New York Times covered the plan to help deliver it.
A few takeaways. 🧵
In 2023, our fertility rate fell to just 1.62 births per woman—well below the 2.1 replacement rate needed to maintain our population.
If nothing changes, America faces a future of shrinking families and communities, economic and cultural stagnation, and national decline.
This isn't just an abstract demographic problem. It's a civilizational crisis. It touches every aspect of American life.
President Trump ran on launching a new baby boom as part of his pro-family agenda. This administration is a historic opportunity to reverse the birth decline.
The solution isn't just more babies. It's more FAMILIES.
Birthrates for married couples have actually been mostly stable since the 1990s. (Save for a modest decrease from 2016-2020).
The birthrate collapse is driven not just by fewer kids per marriage, but by fewer marriages.
As I wrote for @firstthingsmag last year: The U.S. marriage rate has dropped an astounding 60% since 1970.
Roughly one-third of Generation Z is on track to never marry.
We need policies that reward marriage and family formation—not just giving birth in isolation.
Thankfully, we have an administration that wants to do just that.
This week, NYT published a long report highlighting how the Trump administration is building an ambitious plan to boost marriage and birthrates. That includes many of the ideas we've been working on at @Heritage.
There are many parts of this plan: Financial incentives for childbearing and marriage, pro-marriage preferences in government programs, etc.
But one of the major issues to confront—something I've worked on at length—is tackling the crisis of infertility.
Financial incentives aren't enough, on their own, if American couples physically can't have babies.
As many as 1 in 7 American couples struggle with infertility—and it's been steadily climbing for years. We treat it like a niche issue. In reality, it's a public health crisis.
The problem is, in many cases, we don't even know why. 15%-30% of individuals with infertility receive a diagnosis of "unexplained infertility," with few meaningful treatment options available.
One obvious, easy fix: Fund research and education.
Endometriosis affects as many as 1 in 10 U.S. women—but it takes an average of 10 years to be diagnosed. 30-50% of women with endometriosis are diagnosed with infertility. NIH spent just $2 per patient for endometriosis research in 2022.
We spend more on researching hair loss 🤯
This gets to the deeper challenge: We need a total overhaul of the way we treat infertility. Most infertility "cures" just bypass the problem. We should be treating the root causes—like endometriosis and hormone imbalances—rather than papering over them with treatments like IVF.
That requires a comprehensive approach—one that's in line with the Make America Healthy Again mandate: Restorative Reproductive Medicine (RRM). It means treating the root causes—rather than just the symptoms—of infertility.
RRM solves the infertility crisis at the source.
RRM ensures that people are not only able to have the children they desire—but also live longer, healthier lives. (Because the reproductive health conditions that lead to infertility often have other negative health effects, too). It's a pro-human flourishing solution.
This isn't an abstract, fringe set of ideas. It's gaining momentum every day. Just last week, Arkansas passed a state-level RESTORE Act on RRM.
With @RobertKennedyJr calling for research on the root causes of illness, we should rethink infertility care, too.
A new women’s health movement is emerging—rooted in science, powered by innovation, and guided by respect for the female body. It seeks not just to manage symptoms, but to heal. And it's going to be one of the keys to solving our birthrate crisis—and reversing American decline.
Read the full NYT piece here: nytimes.com/2025/04/21/us/…
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