According to data from the Centers for Disease Control and Prevention, the United States' fertility rate has reached a new historic low.
Since 2022, the U.S. fertility rate has decreased by 3%.
Gretchen Eckel, a pediatric program director and population health director at Wellfleet’s Outer Cape Health Services, has noticed new birth trends on the Cape and Islands.
“Our internal newborn birth rates have been declining slowly but steadily over the last five to six years,” Eckel said.
Cultural and generational changes have influenced reproductive planning, Eckel said, “I have observed anecdotally that my younger populations are choosing to delay having children to build up their financial security first. My younger group, in their 20s, choose contraception over family planning. I’ve also seen families co-habiting in ways to maintain housing that is affordable.”
In April 2024, the Barnstable County Assembly of Delegates officially declared a housing crisis on Cape Cod. The average price of a single-family home on Cape Cod has risen 62% from $449,000 in 2019 to $730,000 in 2023.
Eckel said, “Since the COVID pandemic, affordable housing has certainly made it challenging for families of single or dual income to remain in place on the Outer Cape.”
Eckel continued, “Families move either because they can’t afford to find a home on the Outer Cape or because they don’t have affordable childcare. For some families, childcare for a toddler before they’re eligible to enter preschool in the public school system is like having a second mortgage. I’ve also seen the enrollment rates at our public schools decrease as well.”
Despite the decline in birth rates and the housing crisis on Cape Cod, Eckel said, “Our services have not changed. We continue to provide prenatal care for pregnant woman, post-natal care, and pediatric care.”
To serve its pediatric and prenatal care population, OCHS has five providers at its Harwich Port office, three in Wellfleet, and one in Provincetown.
“Our organization and our pediatric providers are committed to remaining here for our youth population because they are our future. We want to remain here providing them with pediatric care. As our organization’s program director, I’m committed to continuing clinical education for our providers and continuing recruitment. We have to be able to continue family care, and that includes our prenatal program with our midwife. We’re committed to ensuring that we can provide those services indefinitely,” Eckel said.
