What you probably already know: The U.S. birth rate continues to decline, driven by fewer women in their 20s becoming mothers, according to the latest report from the Centers for Disease Control and Prevention. The CDC said 3.6 million babies were born in 2025, marking a drop of less than 1% from 2024, while the general fertility rate also fell 1% to 53.2 births per 1,000 women ages 15 to 44 — though, notably, the rate for women ages 30 to 44 increased.
Why it matters: Falling fertility is often treated as a demographic puzzle, one that researchers and economists study through the lens of economic variables, social shifts and generational priorities. Amber Mest, a Formidable member and the founder of a new family building platform called Peony, sees a practical problem: For many people who want children, the path is hard to navigate and can be fraught with significant physical and emotional challenges including loss. “Through every path to parenthood,” Mest says, “they all carry this level of grief that nobody knows how to talk about, nobody knows how to acknowledge.”
What it means: Whether someone is trying to conceive, is pursuing fertility care, working with a surrogate or donor, or adopting, Mest says they must navigate six “deeply complicated” pillars: State and federal policies; legal issues; financial challenges; workplace benefits; emotional well-being; and logistics. State law alone is constantly changing, and verified information can be hard to find. Many people, Mest says, go without key information because professionals might be relying on outdated medical advice. Mest says these areas “really require a degree in program management to navigate … In today’s world, it doesn’t make sense that it’s that complicated anymore.”
We should be having these conversations out loud. The more we talk about it, the more information we have, the more it is normalized.
What comes next: The federal government is trying to boost birth rates with financial incentives and expanded fertility benefits. Earlier this year, the Trump administration proposed a new rule that would allow U.S. employers to offer standalone health insurance coverage for fertility benefits, similar to supplemental vision or dental insurance. Most health insurance plans don’t cover fertility care, which can include expensive treatments ranging from lab tests and medications to genetic testing and in-vitro fertilization.
Through Peony, Mest aims to help people understand their options and make informed decisions on the journey to becoming a parent — and beyond — with state-specific guidance, vetted provider recommendations, questions to ask at appointments and a benefits “decoder” that explains insurance coverage in plain language. She also says there’s work to be done eliminating persistent stigma relating to topics like miscarriage and fertility struggles. “These conversations are still happening in whispers,” Mest says. “We should be having these conversations out loud. The more we talk about it, the more information we have, the more it is normalized.” There shouldn’t be such a stigma, she says, and it’s not women’s fault that they don’t have all the information. “You don’t know what you don’t know and the people who were supposed to tell you to get the information,” Mest says, “didn’t tell you, because they’re operating off of outdated medical advice.”
