In a bold move to combat America’s declining birth rate, the Trump administration is positioning itself as a champion of pro-natalist policy — with President Trump even calling himself “the fertilization president.” 

Among the most contentious proposals under review are government-funded programs to educate girls and women on tracking their ovulation and identifying peak fertility. Touted as a strategy to boost birth and marriage rates amid an aging population, the initiative has ignited fierce debate across the political divide.

“Fertility and menstrual health education often focuses mainly on contraception and sexually transmitted infections, leaving many other important aspects of reproductive health underexplored,” an academic endocrinologist and obesity specialist at Harvard Medical School, Mehmet Burak, tells The New York Sun. 

“As a result, many young people are unprepared to handle common issues related to menstrual health, such as managing menstrual discomfort or understanding fertility changes as they age.”

The Trump administration has unveiled other incentives in its pronatalist plan to boost birthrates, including a proposed $5,000 “baby bonus” for new mothers and increased tax credits for larger families. Symbolic incentives like a “National Medal of Motherhood” for women with six or more children are also being considered. Additionally, an executive order aims to expand access to IVF by lowering treatment costs. 

While the exact mechanisms for implementing a program to educate girls and women on identifying peak fertility are not yet clear, the idea is based on the premise often deemed the “fertility awareness method” to predict ovulation and fertility windows to avoid or bolster chances of conceiving. 

“Fertility awareness-based methods, which track biomarkers like cervical mucus or body temperature, offer a non-hormonal alternative for contraception,” Dr. Burak explained. “These methods are generally safe and effective when used correctly, but their success relies on accurate tracking and the user’s commitment.”

Proponents of this approach argue that it could be a healthier and more natural alternative to current contraceptive methods. They contend that increased awareness of one’s fertility could empower women with better knowledge of their bodies. 

“I know so many people who thought they’d get pregnant straight away, and then they try — and it takes two or three years,” writer Kara Kennedy, who had her first child last year at 26, tells the Sun. “I know 28-year-olds doing IVF. Fertility issues are becoming so common, and people should be aware of that. It shouldn’t just be 45-year-old women being told to look into their fertility.”

She pointed out that “most women on birth control, and even those getting pregnant, are kind of just guessing.”

“Nobody tells you what your chances are of getting pregnant,” Ms. Kennedy continued.

A 2019 survey published in Obstetrics & Gynecology showed that only 14 percent of American women aged 20-45 could accurately describe their menstrual cycle, and just 27 percent correctly identified their fertile window.

Big Pharma Influence 

Who stands to lose from intervention-free modalities when it comes to both causing and preventing pregnancy? Major drug companies, as the bolstering of this method could reduce reliance on synthetic hormonal contraceptives, which, while widely used, have been associated with a range of rare potential side effects. 

For example, the birth control pill, particularly brands like Bayer’s Yaz and Yasmin, has been the subject of thousands of settled lawsuits due to serious side effects, including blood clots, strokes, heart attacks, and even death. Furthermore, Bayer’s Essure, a permanent contraceptive device, was withdrawn from the American market in 2018 after more than 16,000 lawsuits claimed it caused complications such as organ perforation, severe pain, and unintended pregnancies.

Similarly, Pfizer’s Depo-Provera and Merck’s NuvaRing, both of which are popular contraceptive options, have also faced legal challenges related to health complications. Depo-Provera has been potentially linked to brain tumors, while NuvaRing’s manufacturer, Merck, has faced a number of lawsuits related to alleged health risks, including the device’s possible link to fatalities. 

Most lawsuits focus not on the side effects but on the lack of consumer warnings. Although these contraception health risks are statistically rare, they raise important concerns about the safety and oversight of hormonal contraceptives, and many argue that women have a right to be fully informed about the potential risks. 

Legal analysts say that even though most of the products under scrutiny are still on the market, warnings have dramatically improved. 

In contrast, the proposed fertility awareness method is often seen by its supporters as an empowering alternative that does not involve the introduction of synthetic hormones into the body, which some argue could have long-term health consequences. 

Pushback 

The proposal for government-funded fertility education is not without its critics. Many opponents argue that the initiative is politically motivated, relying on “outdated” modalities, gender norms, and assumptions about women’s roles in society. 

“The idea that women need to be properly taught how to conceive a child through a government program is a particularly insulting proposal,” the founder and CEO of Moms First, Reshma Saujani, says. “Women aren’t having fewer kids because we’re confused about ovulation or waiting on a medal for motherhood — we’re drowning because of the crushing cost of raising a child in America.”

Critics like Ms. Saujani underscore that the Trump team’s potential approach reflects a misunderstanding of the complex reasons behind low fertility rates, which are influenced by factors such as economic insecurity, limited access to affordable childcare, and the increasing participation of women in the workforce. 

The United States is the only high-income country that does not guarantee paid maternity leave at the national level, offering only unpaid leave. It also lags behind most developed nations in providing affordable, subsidized childcare, with limited and often inaccessible programs. 

By focusing on fertility education rather than addressing these structural issues, critics argue that the administration risks framing the issue as one of individual responsibility rather than systemic challenges. At the same time, a team that monitored the success of in vitro fertilization across the country was disbanded last month as part of extensive layoffs at the Department of Health and Human Services, drawing condemnation. 

Others, meanwhile, stress that it is also important to note that the fertility awareness method is not without its challenges. For one, it requires careful tracking and knowledge of one’s cycle, and it may not be as effective as hormonal methods in preventing pregnancy.

“I think more women in their 20s and 30s are really receptive to diving in and experimenting with their body’s natural cycle. But teenagers? Even if they do find the information on their own because, who would be teaching them about their long-term fertility?” a women’s health advocate and author of “Medical Gaslighting,” Ilana Jacqueline, tells the Sun. “And it might not resonate with them at this age.” 

Lack of Good Options 

Despite these concerns, some say that the real issue at hand is the lack of innovation in women’s birth control options. For decades, the development of new and improved contraceptive methods has stalled, largely due to limited financial incentives from the pharmaceutical industry and challenges in the development phase. 

“The development of new female contraceptive methods has remained relatively slow in recent decades. While the birth control pill revolutionized contraception, most newer methods have primarily involved small adjustments to existing hormonal formulas,” Dr. Burak said. 

“Producing very innovative contraceptives is a significant scientific challenge. Any new method must effectively prevent fertilization while not disrupting other bodily processes. Additionally, contraceptive safety standards are stringent, as healthy individuals use these products over extended periods. Even mild side effects or infrequent risks can halt the development process.”

It is estimated that drug companies invest only about 2 percent of their contraceptive revenue — roughly $100 million annually — into research and development, a small fraction compared to the billions spent on high-profile drugs like cancer therapies. As a result, many feel that there is a significant gap in options available to women who seek alternative methods of contraception that are safe, effective, and free from serious side effects.

“The recurring theme we see is profits over safety. You’ll find these massive marketing budgets for the drugs, and then when you compare them to what companies spend on research and development, the R&D budgets pale in comparison,” a Washington, D.C.-based attorney involved in such suits tells the Sun. “It’s a pretty consistent pattern.”

A professor emeritus of pediatrics in the Division of Endocrinology at the University of California, Robert Lustig, also says that taking the pill doesn’t necessarily cause problems but does run the risk of “masking” potential hormonal issues that impact fertility.

Going Forward

Dr. Burak also pointed out that “current family planning programs focus predominantly on contraception, with little emphasis on planning for a healthy pregnancy in the future.”

“In the long run, widespread fertility education could lead to positive public health outcomes, such as a reduced reliance on costly fertility treatments,” he observed. “More informed individuals will be empowered to approach their health proactively, making thoughtful reproductive choices.”

The United Kingdom, for one, has integrated fertility awareness into its national curriculum since 2020, requiring secondary schools in England to teach students about reproductive health and the impact of lifestyle on fertility. Research from University College London, though, shows that many students still leave school without adequate knowledge about key reproductive issues, highlighting gaps in how the curriculum is being implemented.

Regardless of the political ramifications, the conversation surrounding fertility and reproductive health is important and long overdue. 

“Reproductive health education should be grounded in medically accurate, age-appropriate curricula,” Dr. Burak said. “Ensuring that menstruation and fertility are treated as a regular part of human development and core elements of overall health can help create a more inclusive and supportive environment for all students, regardless of gender or experience with menstruation.”

As Ms. Kennedy pointed out, “The problem is, as soon as you say, ‘This should be government-funded,’ people jump to, ‘Oh, so you want everyone to have babies?’ And it’s not that.”

“It’s just wanting people to have enough information to make their own decisions — which I think has really been taken away from us,” she added. “It’s all become so polarized and politicized. People no longer have the ability to make an informed decision on their own.”