A global decline in fertility rates is emerging as one of the most complex social phenomena of the 21st century, with far-reaching consequences for economies, healthcare systems, and societal structures. A January 2026 study in The Lancet highlights that in more than half of the world’s countries, the total fertility rate—the average number of children a woman is expected to have—has fallen below the replacement level of 2.1. In some nations, such as China, South Korea, Singapore, and Ukraine, this rate has dropped below 1, while in the United States it hovers just under 1.6.
Governments have attempted a variety of policies to boost fertility, from financial incentives and tax breaks to subsidized childcare and social programs promoting parenthood. For example, China recently imposed a 13% tax on contraceptives while offering parental subsidies, South Korea provides exemptions from military service and organizes government-funded matchmaking events, and Hungary grants lifelong income tax exemptions for mothers with two or more children. Despite these efforts, results remain limited. South Korea has invested billions without reversing its declining birth rate, while even Japan and Scandinavian countries, known for extensive family support systems, struggle to reach population replacement levels.
Experts identify multiple factors behind the decline. Widespread access to contraception, higher female participation in education and the workforce, delayed marriage and childbearing, and reduced fertility among both women and men have created a new reproductive landscape. Falling child mortality rates also mean parents are more confident that fewer children will survive to adulthood, reducing the perceived need for larger families.
Societal uncertainty further discourages family growth. Climate change, geopolitical tensions, economic instability, and rising mental health challenges among young adults create conditions where the decision to have children is increasingly difficult.
The demographic shift presents challenges for welfare states. Shrinking workforces, reduced tax bases, and rising healthcare and pension costs coincide with aging populations, increasing the need for long-term care and management of chronic illnesses.
Experts caution against policies that rely solely on increasing birth rates, noting historical abuses such as China’s one-child policy and Romania’s coercive measures in the 1980s. Some contemporary measures, such as raising the price of contraceptives, risk undermining public health and increasing unintended pregnancies or sexually transmitted infections.
Instead, a broader approach is recommended: supporting healthy aging, investing in geriatric care, enhancing preventive healthcare, leveraging technology and artificial intelligence, and relaxing restrictive immigration policies to supplement shrinking workforces. Above all, societies must continue to support children and families, ensure accessible childcare, promote gender equality in parenting, and protect women’s health and rights.
The key challenge is balancing demographic sustainability with ethical, effective, and equitable policies that avoid nationalism, coercion, or setbacks in public health and gender equality.
