More than a year into President Trump’s second term—where he once declared himself the “fertilization president”—experts say that starting a family has not become any easier, and the desire to have children continues to decline.
During the 2024 campaign, Trump seized on in vitro fertilization (IVF) as a wedge issue, especially after then-Democratic vice presidential nominee Tim Walz claimed to have used the procedure, though he had actually undergone intrauterine insemination. Trump, in a Fox News town hall, dubbed himself the “father of IVF,” and later, in a Women’s History Month speech, quipped, “I’ll be known as the fertilization president.”
Since returning to office, Trump has taken several steps to back up that rhetoric. In October, he signed an executive order aimed at lowering the cost of fertility drugs like Gonal-F, which became one of the first prescriptions offered on his TrumpRx platform. The order also expanded fertility service coverage for employees at the Departments of Labor, Health and Human Services, and Treasury.
On Mother’s Day this month, Trump launched moms.gov, a website offering pregnancy support resources and links to “Trump Accounts” for children. White House spokesperson Kush Desai said, “They say it takes a village to raise a child, and it takes systemic change to turn America’s birth rates around. The Trump administration is leaving no stone unturned to address this challenge.”
These moves are part of the administration’s “pro-family” agenda, as outlined in the IVF executive order’s fact sheet, where Trump stated, “We want more babies, to put it very nicely.” Vice President Vance, who is expecting his fourth child, echoed that sentiment, saying, “I want more happy children in our country.”
But experts remain skeptical. Sean Tipton, chief advocacy officer for the American Society for Reproductive Medicine, noted that declining birth rates are a complex issue. “I think a solution to that is going to require a lot more than we have seen so far,” he said, calling it “a big sociological problem, cultural problem, as well as a biological problem.”
Healthcare analysts point to contradictions in Trump’s approach. Anthony Wright, executive director of Families USA, argued that “the rhetoric of honoring mothers and giving birth is hard to square with the reality of the massive cuts to Medicaid.” He highlighted the Big Beautiful Bill, which slashes over $900 billion from Medicaid—the primary payer for over 40% of U.S. births. Desai dismissed Wright’s concerns, calling him “an idiot” and asserting the bill’s Medicaid provisions don’t affect pregnant women or children.
The administration’s pronatalist push aligns with fears among elites, like Elon Musk, about population collapse. Musk, a Trump ally and former head of the Department of Government Efficiency, has long warned that “population collapse due to low birth rates is a much bigger risk to civilization than global warming.” He has over a dozen children and urges others to have more to prevent labor shortages.
Despite these efforts, the U.S. fertility rate hit a record low in 2025—53.1 births per 1,000 women, according to the CDC. The total fertility rate fell below 1.6 children per woman, well under the 2.1 needed for population stability. While infertility rates have risen—13.4% of women aged 15–49 reported impaired fertility in 2022—experts say that alone doesn’t explain the slowdown.
Economic realities, including housing costs and childcare expenses, remain major barriers. As Tipton noted, universally accessible fertility treatments might make a “dent,” but won’t solve the underlying issues. Wright concluded, “The biggest thing this administration has done is cut Medicaid, which has a dramatic effect on pregnancy care.”
