The United States saw a continued decline in birth rates in 2025, with a 1% drop to 3.6 million births and a fertility rate of 53.1 per 1,000 women aged 15 to 44. Despite efforts from the Trump administration to boost birth rates through policies promoting family formation, recent changes to the federal Title X family planning program signal a significant shift away from contraception accessibility and traditional reproductive health services.

Historically centered on providing low-income women with contraception, STI screening, and reproductive healthcare, Title X is now being redefined to emphasize fertility, family formation, and reproductive conditions, while explicitly de-emphasizing the prevention of unintended pregnancies. Critics argue this reorientation risks undermining core public health goals and potentially exacerbating maternal health disparities, especially in light of the high maternal mortality rate and restrictions on abortion access following the 2022 Supreme Court decision.

While some like conservative policymakers see these reforms as empowering women and addressing reproductive health conditions, reproductive health experts warn that limiting contraceptive access could lead to fewer options for women and increase maternal health risks. The move reflects broader political efforts to shift focus from contraception as a preventative health measure to a more pronatalist and lifestyle-oriented approach, raising concerns over long-term impacts on reproductive rights and health outcomes.