Government figures released in April 2026 show that US lifetime fertility fell to 1.57 children per woman in 2025, below the replacement rate of 2.1 children per woman needed to maintain a stable population. The figure came in lower than the 1.62 children per woman that the Congressional Budget Office had projected in January 2025.

US lifetime fertility has remained below 2.1 children per woman since 2008. Two-thirds of the global population lives in countries where fertility is below that replacement threshold.

The gap between elderly and working-age Americans has widened over recent decades. In 2000, there were about 24 Americans aged 65 and older for every 100 working-age adults. According to CBO projections, by mid-century there will be 43 Americans aged 65 and older for every 100 working-age adults.

Spending on old-age entitlements was 6% of US GDP at the turn of the 21st century and is projected to increase to 12.7% of GDP by 2055. According to CBO projections, the US fiscal deficit excluding interest on the debt is projected to reach about 2% of GDP by the 2040s. Economists at the Federal Reserve and the Aspen Economic Strategy Group estimated that if the ratio between elderly and working-age Americans stabilized in 2025, the US fiscal balance excluding interest on the debt would be in surplus.

Similar pressures are building elsewhere. Among OECD countries, ageing is expected to push pension and health spending up by 3% of GDP. China's one-child policy produced one of the lowest fertility rates in the world, and IMF projections foresee that China's ageing will slow annual GDP growth by nearly two percentage points between 2024 and 2050 and boost pension spending by nearly 10% of GDP.

The Trump White House has put forward several policy proposals in response to falling birth rates, including depositing $1,000 into an account bearing the president's name for every child born during his presidency, teaching women about their menstrual cycles to target conception, and establishing a National Medal of Motherhood. Children typically take at least 20 years to begin contributing economically, according to available data.