Why Does the U.S. Fertility Rate Include 14-Year-Olds?

There’s something really creepy about America’s bi-annual fertility report. Why, in the age of Epstein, is the U.S. government still considering the breeding capabilities of 14-year-old girls?

Why Does the U.S. Fertility Rate Include 14-Year-Olds?
Photo: Everett Collection
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In April, the CDC’s bi-yearly report on U.S. fertility rates came out. The big news: The birth rate had continued to drop, and is now at a record low — down 20% in two decades. The news prompted all the usual concern and finger pointing from major news outlets on both the left and right, some stories measured, others less so. There were stories from NPR; CNN and The Guardian; along with Fox News, Breitbart and The Washington Examiner, which opined, and I quote, “if we do not fix fertility, we will cease to exist.” The actual drop in fertility was 1%, which may not sound like much, but the doom and gloom suggested that a population bust was brewing. The reporting, even from some liberal publications, could make one fear the end was nigh. 

Of course, if you read past the alarmist headlines, the data also includes some positive news: Namely, teenage pregnancy is down by 7%. For any thinking human, the reaction might be, “Wait…isn’t that a good thing?” And, yes, it is: The continued dramatic drop in teen pregnancy, which has been consistently falling since the 1990s, has been a huge public health win

But the CDC doesn’t talk about whether the results are good or bad — that’s not their role. For that kind of interpretation, one that focuses on how America’s demographics are shifting, we can turn to an earlier January report by the Congressional Budget Office. In that report, the data confirms (as the CDC showed) that teenagers are having fewer babies. Except it’s hard to tell, because instead of placing teenagers into their own group, they include them in a broad demographic category called “women of younger childbearing ages.” That’s how we end up with 14-year-old girls in the same bracket as 29-year-old women. 

I have a daughter who will be 14 in less than two years, which is also when these reports will be updated again. I don’t like to think of it this way, but her body will be one of those prompting the hand-wringing conversations about the loss of American breeding potential.   

All of this brings me to a question that makes me queasy: Do these fertility rate demographics reflect who we, as a country, consider to be “women?” Is the female body of a 14-year-old the body of an “adult?” In the age of Epstein, it’s worth asking. 

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Who gets to be considered an “adult,” anyway? 

In the U.S. at least, the question of who gets to do what at which age has long been a point of debate. To do most so-called adult things — go off to war, vote, marry without parental consent — the commonly accepted official age of adulthood starts at 18. When it comes to buying and consuming alcohol or tobacco, we’ve extended the age of adulthood to 21 for health concerns. 

(In case you were wondering, we cannot pinpoint the age at which people can buy firearms in the U.S., since it ranges between 18 and 21 depending on the type of firearm and the state where the purchaser lives. In any case, neuroscientists and advocates for criminal justice reform have also made a compelling case that the brain is not truly “adult” until after age 25).

Yet to my mind, all these lines — even the vague ones — seem to be drawn around the male body, the male brain, and the male experience. Why is it that when the female body and brain come into play, we gauge our nation’s fertility rate by a measure that includes girls in their earliest pre-adulthood years, equating them with adults who can buy alcohol, join the army and vote?

If the U.S. considers citizens to be adults at age 18, the fertility rate, which is often used as a guide for national budget projections and economic forecasting, should include only those over 18. Or we should at least split out the under-18s for fertility purposes, labeling births below 18 as a child or teen pregnancy. (I am also not opposed to the under 18 demographic being further split between chosen and forced births, but that’s a whole other issue.)

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Turning a public health win into a loss

For a country so concerned about its dropping fertility rate, wouldn’t it make sense to just exclude children and young teens from the conversation about what is dragging those statistics down? Looking at it another way, if a reduction in “fertility rates” among teenagers is a public health victory, it’s time to stop linking fertility to an arbitrary age based on what the female body is capable. 

I use the word “arbitrary” deliberately, because, why age 14? That number clearly wasn’t chosen based on the female body’s capacity to become pregnant, when the average age of a girl’s first period is now 11.9. If the average 12-year-old girl has a uterus ready for pregnancy, why not start there? That’s obviously a horrible idea, but you get my point.

It’s likely that 14 is used because that was the age used when these reports first started coming out, in the early 1930s. The thing is, not one state in the U.S. lists age 14 as the age of sexual consent. In most states, that age is 16; in some states it’s as high as 18. Moreover, 16 states have now banned “child marriage,” defined as anyone under the age of 18. 

If you haven’t noticed, child is the key word in all of these rulings. But in the Congressional Budget Office report, a 14-year-old isn’t deemed a child. She is instead referred to as a “woman,” or a “mother.” 

Word choice matters. So do the ways we categorize individuals in our nation’s data collection. If 14 is too young for a girl to vote, order a beer, get a mortgage or buy a car, I’d say it’s also too young to consider her part of the nation’s fertility pool. 

That doesn’t mean we shouldn’t count babies born to people under age 18; we need to count them, for demographic purposes. The point is how we talk about who is having those babies. By shifting the age at which we start tracking fertility to adults only (call it 18 and up), we can let children be what they are: children. 

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Molly Dickens, Ph.D. is a scientist and women’s health advocate. She writes about the intersection of stress, health, and structural changes to better support working parents and caregivers on her Substack — The Maternal Stress Project.