For decades, teen motherhood dominated headlines about “young parents,” but in 2023, the timeline of motherhood quietly shifted. The Centers for Disease Control and Prevention (CDC) reported that women in their 40s had more babies than teenagers—a first in U.S. history. 

This milestone reflects two powerful shifts in family-building in America: a steady decline in teen birth rates since the 1990s, and a growing number of women choosing to start or expand their families later in life. Once, pregnancies in one’s 40s were rare, while teen parenthood was more common and widely reported. Today, advances in medicine, evolving career priorities and changing views on independence are reshaping the timeline of parenthood. 

To better understand what’s driving this change, we spoke with Tanise Branche, assistant professor of obstetrics, gynecology and reproductive sciences at Temple University’s Lewis Katz School of Medicine. Branche shared her perspective on what this moment means for reproductive health and the future of family planning. 

TN: What was your initial reaction to the CDC report? From your professional perspective, what factors do you see driving this trend of more births among women over 40 than teens? 
Tanise Branche: I wasn’t surprised. We’ve seen this shift for years, both in medicine and in everyday life. Teen pregnancies have steadily declined as young people have more access to contraception and clearer information about the realities of parenthood through education, social media and broader cultural conversations. At the same time, more women are intentionally waiting until their late 30s and 40s to start families—often because of financial stability, career goals or personal readiness. Advances in reproductive technology, like in vitro fertilization (IVF) and donor eggs, have also expanded what’s possible. Together, these forces explain why the numbers look so different today. 

TN: How does this delay in childbearing reflect broader societal changes around how women approach family planning and personal fulfillment? 
Branche:  More women are prioritizing personal growth, education and career before starting a family. Society has become more accepting, even encouraging of that choice. Social media also highlights intentional approaches to parenting and the value of stable partnerships and financial readiness. Delaying pregnancy is increasingly viewed not as an exception, but as a thoughtful decision that benefits both parents and children. 

TN: When you think about teenagers who become parents, how do you see their stage of life—emotionally, mentally and developmentally—shaping their experience of raising a child? 
Branche: Teen parents are still growing themselves, which makes the demands of caring for a child especially difficult. Many struggle with anxiety, depression, or balancing school and finances. Some also face risks like intimate partner violence or substance use. The biggest difference-maker is support. When teens have strong emotional, financial and social networks, they’re better able to care for their children while continuing their own growth into adulthood. 

TN: For women having children after 40, what precautions and screenings are important for a healthy pregnancy? 
Branche: Pregnancy after 40 can absolutely be healthy, but it does carry higher risks, including high blood pressure, diabetes or genetic concerns. Preparation makes a big difference. I encourage patients to meet with a maternal-fetal medicine specialist before conception to optimize chronic conditions, prioritize healthy nutrition, establish a regular exercise routine and start a daily prenatal vitamin.  Genetic screening is also useful for both partners. Once pregnant, early and consistent prenatal care is critical. With the right planning and support, women can significantly improve their chances of a healthy outcome. 

TN: How does this trend intersect with race, class or access to healthcare? Are some groups disproportionately affected or left behind? 
Branche: Access is a major factor. Women from lower-income or underserved communities, including many African American patients, often face limited access to fertility services. Advanced reproductive options like IVF, donor eggs or gestational carriers are expensive and insurance coverage is limited. Meanwhile, women with more financial resources can afford these technologies, creating disparities in who can delay pregnancy and still have children later in life. Even routine prenatal care can be challenging for underserved patients, especially if they have chronic health conditions like hypertension or diabetes. Multiple visits, tests and treatments can conflict with work or transportation, increasing the risk of adverse outcomes. These challenges aren’t about willingness or desire to have children, they’re about structural and financial barriers that disproportionately affect certain communities. 

TN: Have you seen this trend reflected in your own clinical research, and what resources or programs at Temple Health or Temple University Hospital are in place to support older first-time mothers? 
Branche: Absolutely. Many patients ask me when the “right time” is to start a family. We often begin that conversation in the early 30s, using tools like ovarian reserve testing to help women understand their fertility potential. At Temple, our maternal-fetal medicine team provides comprehensive preconception counseling, genetic services, nutrition guidance and behavioral health support—all under one roof at our Women and Families Hospital. We also use digital tools like the Lena app to guide patients through pregnancy and keep them connected to their care team. Our goal is to make the process informed, safe and supportive at every step.