For the first time in U.S. history, more babies were born to women over 40 than to teenagers, according to a new report from the Centers for Disease Control and Prevention (CDC). The milestone comes amid a broader national trend: declining birth rates across nearly all age groups.
Between 2023 and 2024, birth rates fell among women under 35, continuing a steady two-decade decline. The one exception was women in their 40s, whose birth rate rose by 2%, according to CDC data. Experts say the shift reflects larger cultural and economic dynamics—including the rising cost of parenthood, greater access to contraception, and more women prioritizing education and career advancement in early adulthood.
Dr. Aua Smalls Monty, an emergency psychiatrist and lifestyle medicine specialist, told ABC News that one of the main reasons behind the change is the financial pressure that comes with having children. She said, “People are thinking about the resources required to raise a family. Access to contraception has allowed more intentional pregnancies. And many women are prioritizing their careers and financial stability.”
At the same time, the U.S. continues to face stark disparities in maternal and infant health outcomes. Another recent CDC report found that babies born to Black mothers, rural mothers, and teen mothers have the highest mortality rates in the country. The findings point to deeply rooted issues, including unequal access to prenatal care, the closure of labor and delivery units in rural areas, and systemic racism in medical treatment.
“We know more and more labor and delivery units are being closed around the country,” Dr. Monty said, particularly in areas already underserved by healthcare infrastructure. Long travel times to clinics, lack of specialist care, and limited transportation options all combine to make childcare a massive challenge. “This can delay critical treatment during pregnancy or childbirth,” she added.
For Black mothers, disparities persist even when accounting for education and income. Dr. Monty noted that racism in medicine contributes to poor outcomes. “There’s no reason why Black women should have higher maternal mortality. It’s about how they’re treated—how their pain is dismissed, how their concerns are overlooked.”
In light of these trends, maternal care deserts—regions with few or no birthing centers or obstetric providers—have drawn increased scrutiny from policymakers and public health officials. How do we fix these maternal care deserts? Specified investments in the infrastructure behind maternal healthcare, expanded insurance coverage, and a lack of bias in clinical settings.
As more women delay childbirth into their 40s, the shifting demographics may reshape how the nation approaches maternal health. But unless the racial and geographic inequities in care are resolved, experts warn that progress will remain uneven—and, for many families, out of reach.
