This article originally appeared in The 74.

The fertility rate for the United States has long been on a downward trend and is currently at a historic low. The price of child care, meanwhile, has been steadily rising; it grew 29% between 2020 and 2024, easily outpacing inflation, according to Child Care Aware of America.

Could those two trends be related? New research and surveys indicate yes.

In a recent research paper, Boston University economics Ph.D. candidate Abigail Dow finds that when child care prices increase, some American families decide to put off having more children, and many don’t have more children at all. 

Dow looked at child care prices across the country in a dataset compiled and published by the Women’s Bureau at the Department of Labor with data from 2010 to 2022. 

She then isolated a “shock” to child care prices — an event, unrelated to something like a recession or a spike in inflation, that made the cost of care go either up or down. The shock she identified was that when states mandate smaller group sizes and/or lower child to staff ratios, child care prices rise, so she studied what happened to fertility decisions when states passed such regulations.

“My key takeaway is that child care costs are high in the U.S., and I do find they’re a barrier to having children,” Dow said. She found that a 10% increase in the price of child care for children from birth to 2 years old led to a 5.7% decrease in the birth rate among women aged 20 to 44. Her research also found that the price increase leads to women delaying when they have children: a 10% increase prompts women to push back their first birth by four months and to extend the time between a first and second child by half a month. Dow found that women’s decisions about whether to have second and third children were particularly hampered by high child care prices. 

The findings are strongest for women ages 30 or older. This is, Dow posits, because they have more to lose if they can’t get child care: they’ve invested more time and resources into their careers and likely earn more, making the cost of having to give up on work to care for more children in the absence of affordable child care higher. Younger women have less to lose by having a child and dropping out of the work force if child care can’t be secured.

The research is novel: while there have been studies in European countries which suggest that women rethink having children when child care prices rise, Dow knew that those situations may not be applicable to the U.S., where the government spends much less on child care, it’s a primarily private system, and there is no guarantee of paid family leave. “There wasn’t a robust empirical analysis of: How do child care prices affect fertility rates?” Dow said. 

Dow noted that child care prices aren’t the only factor dampening the country’s fertility rate — other research has found that things like housing and health care prices also make an impact. But it’s clear that the cost of raising children is top of mind for American parents when they’re thinking about the sizes of their families. In a survey of 3,000 nationally representative respondents by YouGov, the Wheatley Institute at Brigham Young University, and Deseret News released in November, a record share of participants — 71% — said that raising children is unaffordable, a 13 percentage point increase over 2024.

That high cost of raising children was listed as the single most important reason survey respondents offered for why they’ve limited the children they either had or planned to have. That response was twice as prevalent as the next two reasons they gave — a lack of personal desire and a lack of a supportive partner — and for the first time in the survey’s 10-year history, it was the top reason respondents gave.

The survey also found that support for government resources aimed at parents through direct payments and better programs had increased since 2021, and opposition to such interventions was 10 percentage points lower. A majority favor universal day care, while just 18% oppose it. Survey respondents also supported increased tax credits for parents.

“If you think about, ‘What do I have to think about when I’m raising a family for those early years,’ child care is going to be front of mind,” Dow said.

The situation is poised to get worse for Americans considering whether and when to have children. Dow’s data only goes through 2022. Since then, the billions of dollars in pandemic-era federal relief for the child care sector has disappeared. In its wake, states like Arkansas and Indiana have cut back on support for the sector. Indiana stopped enrolling new children in its child care subsidy program, and the state has reduced reimbursement rates for providers, leading more than 100 providers to shutter. Arkansas has also cut provider reimbursement rates, put new subsidy applicants on a waitlist, and instituted new copays for parents who receive vouchers. More of the cost burden will now fall on parents in states that pull back.

Dow cautioned that her research shouldn’t be interpreted as an argument for relaxing regulations in order to bring child care costs down and boost births. “These regulations are really important for child health and safety,” she pointed out. “I’m absolutely not in the business of saying we should be making these regulations more lax purely to make child care more affordable for parents.” But, she said, her research makes it clear that parents, and particularly mothers, make decisions about whether to have children and how many to have based at least in part on whether they can afford child care. “Anything we can do to make child care more affordable seems important from a policy perspective,” she said.