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20 States with the Highest Fertility Rates in the US

In this article, we will be taking a look at the 20 states with the highest fertility rates in the US. If you do not want to learn about the US fertility services market, head straight to the 5 States with the Highest Fertility Rates in the US.

Expanding Horizons: The Global and US Fertility Services Market

The global fertility market is a rapidly growing industry, with the potential to reach $1.7 trillion in total demand for assisted reproductive technology (ART) services which includes in-vitro fertilization (IVF), surrogacy, and fertility medications. According to the Business Research Company, the global fertility services market which was valued at $54.12 billion in 2023, is expected to grow at a compound annual growth rate (CAGR) of 14.7% to reach $62.07 billion in 2024. Globally, the fertility rate has been declining, with the total fertility rate (TFR) projected to decrease from 2.21 in 2022 to 1.83 in 2050 and 1.59 in 2100.

In the United States, the fertility services market is also experiencing growth, with the market being valued at $22 billion in 2022 and is expected to reach $68.32 billion by 2032, growing at a CAGR of 12% during 2023-2032. According to the Centers for Disease Control and Prevention (CDC), around 12% of women in the United States between 15-44 years have difficulty getting pregnant or carrying a pregnancy to term, which makes up around 6 million women in the US struggling with infertility issues, per CDC. If we talk global, around 1 in 6 people are suffering from infertility which makes up around 17.5% of the adult population worldwide. The major players in the global infertility treatment market include Thermo Fisher Scientific Inc. (NYSE:TMO), Cook Group, and Vitrolife, among others.

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Thermo Fisher Scientific Inc. (NYSE:TMO) has partnered with Predictive Laboratories to study the genetic factors underlying infertility in women. The collaboration aims to elucidate the genetic basis of conditions like endometriosis, which affects fertility in up to 40% of infertile women according to the American College of Obstetrics and Gynecology. In 2023, Thermo Fisher Scientific Inc. (NYSE:TMO) introduced two new next-generation sequencing-based assays to accelerate fertility research. The Ion ReproSeq PGT-A Kit and the Ion AmpliSeq Polyploidy Kit are designed to support preimplantation genetic testing for aneuploidy (PGT-A) used in IVF and intracytoplasmic sperm injection (ICSI) research.

The Dynamics of the Global Contraceptives Market 

The global contraceptives market is experiencing significant growth, driven by factors such as the rising need for family planning, increasing awareness of modern contraception, and concerns over health issues associated with teenage pregnancies. The global contraceptives market size is expected to grow from $33 billion in 2023 to $62 billion by 2033, at a CAGR of 6.5%. The contraceptive devices segment, which includes condoms, subdermal implants, and intrauterine devices (IUDs), also holds a significant market share and is expected to grow at a CAGR of 7.3% from 2022 to 2032, based on an anlysis by GM Insights.

In terms of regional analysis, North America dominated the global contraceptives market in 2021, with a market share of over 32.90%, driven by factors such as the rising population of women within the age group of 15-44 years and high patient awareness levels in the region. In the United States, the contraceptive prevalence rate among married or in-union women of reproductive age (15-49 years) was around 76% in 2019, according to the United Nations Population Division.

Key players like Teva Pharmaceutical Industries Limited (NYSE:TEVA), Organon Group Of Companies, and Church & Dwight Co., Inc. (NYSE:CHD) dominate the contraceptive sector.

Teva Pharmaceutical Industries Limited (NYSE:TEVA) is a major manufacturer of a wide range of hormonal contraceptive products, including oral contraceptive pills, emergency contraception, and intrauterine devices (IUDs). Plan B One-Step is one of their key contraceptive brands which is available over the counter. Revenues in Q1 2024 were $3,661 million, flat compared to Q1 2023. Teva Pharmaceutical Industries Limited (NYSE:TEVA) reported Q4 2023 revenues of $4.5 billion, up 3% compared to Q4 2022. For the full year 2023, Teva Pharmaceutical Industries Limited (NYSE:TEVA)reported revenues of $15.85 billion, up 7% compared to 2022. This included 28% growth in European generics and 16% growth in International Markets Generics.

On the other hand, Church & Dwight Co., Inc. (NYSE:CHD) also plays an important role in the contraceptive market. The company's TROJAN brand is one of the most prominent condom brands in the world, which provides a reliable and widely used form of contraception. additionally, Church & Dwight Co., Inc. (NYSE:CHD)'s FIRST RESPONSE brand offers home pregnancy and ovulation test kits, which help individuals plan and monitor their reproductive health. Their net sales grew 10.5% to $1,455.9 million in Q3 2023, exceeding the Church & Dwight Co., Inc. (NYSE:CHD)'s 8% outlook and their organic sales grew 4.8%, driven by 2.7% volume growth and 2.1% positive product mix and pricing during the same period.

20 States with the Highest Fertility Rates in the US
20 States with the Highest Fertility Rates in the US

Andrey_Popov/Shutterstock.com

Our Methodology 

For our methodology, we have ranked the states with the highest fertility rates in the US based on the general fertility rates per 1000 women aged 15-44 in 2021. For the accuracy of data, we relied on CDC.

Here is our list of 20 states with the highest fertility rates in the US.  

20. Missouri 

Fertility Rate per 1000 Women: 58.4 

Missouri stands among the states with the highest fertility rates in the US with the fertility rate per 1000 women standing at 58.4. In 2021, there were a total of 69,453 births. In 2021, there were only 150 reported abortions performed in the state. Regarding contraceptive use, a 2019 survey found that 65.3% of Missouri women aged 15-49 were currently using some form of contraception. The most common methods were female sterilization (18.1%), oral contraceptive pills (14.0%), and long-acting reversible contraceptives like IUDs and implants (10.4%).

19. Minnesota 

Fertility Rate per 1000 Women: 58.6 

Minnesota is one of the US states with the highest fertility rates with a rate per 1000 women of 58.6. There were a total of 64,425 births in 2021. There were around 370 stillbirths in Minnesota in 2017. Around 1 in 185 pregnancies ended in a stillbirth.

18. Hawaii 

Fertility Rate per 1000 Women: 59.2 

Hawaii had a fertility rate of 59.2 per 1000 women in 2021 with around 15,620 births. The teen birth rate in Hawaii has been declining, dropping from 28.1 per 1,000 girls ages 15-19 in 2012 to 11.7 per 1,000 in 2022. According to data, around 15% of pregnancies in Hawaii end in miscarriage while 67% end in live births, and 18% of those pregnancies end in stillbirths.

17. Alabama 

Fertility Rate per 1000 Women: 59.5 

Alabama is one of the most fertile states in the US with a fertility rate of 59.5 per 1000 women in 2021. The infant mortality rate in Alabama was 7.56 infant deaths per 1,000 live births the same year. Racial disparities still exist, with the preterm birth rate for Black infants in Alabama at nearly 17%, compared to 16% for Native American infants, and lower rates for other racial groups.

16. Tennessee 

Fertility Rate per 1000 Women: 59.8 

Tennessee is one of the most fertile states in the US with around 58,054 births in 2021. The total number of live births in Tennessee was 81,717 in 2021, which represented a 4% increase from 2020. In 2019, around 26 cases of failed abortion occurred in the state with no complications at all.

15. Indiana 

Fertility Rate per 1000 Women: 60.2 

Indiana stands fifteenth among the states with the highest fertility rates in the US with a fertility rate of 60.2 per 1000 women. Around 9,529 pregnancies ended in the state in 2022 with around 80.8% of these people being Indiana residents and 19.17% were out of state residents. There were a total of 79,946 births in the state in 2021, which makes Indiana stand among the most fertile lands in the US.

14. Texas 

Fertility Rate per 1000 Women: 60.7 

The fertility rate per 1000 women in Texas is 60.7 in 2021. In 2022, there were 389,741 live births in Texas, a 2% increase from 2021. There were around 50,000-55,000 abortions performed in the state from 2014-2021.

13. Mississippi 

Fertility Rate per 1000 Women: 60.7 

Mississippi stands thirteenth among the US states with the highest fertility rates with a fertility rate of 60.7 per 1000 women in 2021 with around 35,156 total births the same year. The state's infant mortality rate was 9.39 deaths per 1,000 live births in 2021. Mississippi also has high rates of preterm births (14.96%) and low birthweight babies (12.35%).

12. Idaho  

Fertility Rate per 1000 Women: 60.7  

Despite Idaho's robust population growth of 45% over the past 20 years, the total number of births in the state has only increased by 7% (1,500 more births) during that time, from 20,973 births in 2002 to 22,382 births in 2022. The fertility rate per 1000 women in the state was 60.7 in 2021, placing Idaho among the most fertile states in the US.

11. Kentucky 

Fertility Rate per 1000 Women: 60.8 

The fertility rate per 1000 women in Kentucky was 60.8 in 2021 with around 52,214 total births. Around 3,788 abortions occurred in the state in the same year. Kentucky has one of the highest teen birth rates in the US at 2.18 births per 1000 women aged 15-19.

10. Iowa 

Fertility Rate per 1000 Women: 60.8 

Iowa stands tenth among the states with the highest fertility rates in America with a fertility rate of 60.8 per 1000 women in 2021. There were a total of 36,835 births in the state in the same year. The teen birth rate stands at 12.7 per 1000 females aged 15-19 and the infant mortality rate is 3.99 per 1,000 live births.

9. Kansas 

Fertility Rate per 1000 Women: 61 

Kansas saw a total 34,705 births in 2021 with a fertility rate of 61 per 1000 women. A total of 12,318 abortion procedures occurred in the state in 2022. The teenage birth rate was 16.3 per 1000 females aged 15-19 in 2021 and the infant mortality rate stood at 5.30 per 1000 live births.

8. Oklahoma 

Fertility Rate per 1000 Women: 61.5 

Oklahoma stands among the states with the highest fertility rates in the US with a fertility rate of 61.5 per 1000 women with a total of 48,410 births. About 106,173 induced abortions occurred to Oklahoma residents between 2002-2022.

7. Arkansas 

Fertility Rate per 1000 Women: 61.7 

Arkansas had a fertility rate of 61.7 per 1000 women in 2021 with a total of 35,695 births. Of all the births in Arkansas during 2020-2022, 11.2% were Hispanic, 0.6% were American Indian/Alaska Native women, and 3.7% were Asian/Pacific Islander women. The teenage birth rate was 26.5 per 1000 females aged 15-19 in 2021 and the infant mortality rate stood at 8.59 per 1000 live births in the same year.

6. Louisiana  

Fertility Rate per 1000 Women: 62.7 

Louisiana stands sixth among the states with the highest fertility rates in the US with a fertility rate of 62.7 per 1000 women in 2021. Black women in Louisiana experienced premature births at a rate of 16%, which is about 52% higher than all other women in the state. There were a total of 7,444 abortions reported in the state in 2021 and a total of 57,437 births were reported in the same year.

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Disclosure. None: The 20 States with the Highest Fertility Rates in the US is originally published on Insider Monkey.