Fertility in McLean County has fluctuated in recent years, but remains low compared to adjacent counties — in a state and a region that trend well below average.
According to the U.S. Census Bureau, each woman in McLean County needs to have approximately 2.1 births to replace the aging portion of the population. McLean County’s Generalized Fertility Rate [GFR] has been well below replacement level since at least 2017. This raises questions about planning for the future, especially implications to childcare, school enrollment, the workforce and elder care.
Healthcare professionals said prospective parents worry about the costs associated with having and raising children.
‘Special and individualized’ care
Lexi Farmer is a physician assistant at Bloomington's Obstetrics and Gynecology [OB/GYN] Care Associates. Farmer was born and raised in Bloomington-Normal and now spends her time helping women plan their fertility and care for their reproductive health.
Farmer said she begins seeing patients at age 21 to discuss preventative screenings and pregnancy planning. After that, Farmer said she will check in at least annually with each woman.
"Women's health can be very difficult because everything can be very generalized," Farmer said. What some describe as "normal" may not be normal for each woman, she said. "Their care really is going to be specialized and individualized for them."
Farmer said these days, she is having more early planning conversations about fertility, but women are having babies later. She said women are curious about their fertility long before they’re ready to have a baby. They ask her about "things they should be doing now, things they could be doing that could be harming their fertility, things that they should plan ahead for or when they should plan to have children."
Delaying fertility, or having babies later in life, is a worldwide trend, Farmer said.
"Women are starting to have babies later in life than what they would have 20 years ago," Farmer said.
She added that when a woman over 35 years old is pregnant, she's considered of "advanced maternal age," which includes higher risks and more testing. But, she said her office sees "lots of patients" in that category.
"We're noticing women are having babies a little bit later in life," she said.
Financial impact is a ‘bigger issue’ than before
Farmer said women pursuing further education may delay fertility until they get out of school. In McLean County specifically, she said the multiple educational institutions here and in surrounding counties do draw women who want to focus on education, not motherhood. However, not all the women of reproductive age in McLean County are here for school. Farmer said patients from more rural surrounding communities may opt to have families earlier.
Other lifestyle factors also play a role, Farmer said. For example, she has noticed that people from big families tend to want to have their own big families.
"If you married your high school sweetheart and you've been together forever and are still living in the same area, you already kind of know what you want with your life," Farmer said. "You may be ready for children sooner than somebody who has no idea what they want to do."
Farmer also cited the housing market, low supply of childcare options, and the general expense of raising a child as factors that may influence a woman to have children later in life, or not at all.
"Financially it can be very expensive to have babies, especially thinking forward to daycare if they're going to need that option," Farmer said.
Women who opt to have a family may have fewer children than they originally planned, Farmer said. Some of her patients already have children and are interested in having more, but are concerned about "how much those costs could increase based on a new another child."
The financial impact of growing a family is not a new consideration for women, Farmer said, but she's "definitely starting to notice more and more of it, that that's being a bigger issue or a bigger conflict for them."
‘Terrified they’ll never have a baby’
Not every woman who decides to have a baby is able to do so easily. Dr. Helen Ejiogu is an OB/GYN at OSF St. Joseph Medical Center in Bloomington who works with women across the spectrum of reproductive age. She specializes in infertility.
Ejiogu said endometriosis, a condition that causes painful periods and contributes to infertility, impacts about 20% of the general population — but most of the patients she sees. Her patients are commonly in their 30s and trying to resolve health problems that are preventing them from achieving their fertility goals.
In addition to the expense of pregnancy and parenting, Ejiogu said patients with infertility are very concerned about the expenses they could incur treating their condition. She said the financial and emotional concerns of pursuing infertility treatment weigh on them.
Ejiogu said women of all ages come to her feeling pressure to have babies.
"By the time they get to me, honestly, they are terrified they'll never have a baby," Ejiogu said. "And that's hard to deal with as a doctor because you can't take that away from them. But the stress actually worsens fertility."
Encourage young women to ‘seek health’ in a dwindling system
Ejiogu said women will put up with a lot of irregularities, pain and other reproductive health issues without seeing a doctor. When they decide to have a baby, they are forced to confront these issues.
"It's only after they meet their person that they then think, 'Hmm, maybe I should get that taken care of.'"
Ejiogu said this approach is backward.
"We should really be encouraging young women to seek health, whether or not they're pursuing fertility," she said.
Both Farmer and Ejiogu said shifting cultural and media landscapes impact how people plan their families. Both regularly discourage patients from getting medical advice on TikTok, Instagram and other social media platforms.
Farmer said the politicization of women's healthcare is leading to hospitals closing OB/GYN floors and creating maternal care deserts. She said there are no delivering hospitals in Decatur, Lincoln or the La Salle-Peru area. For this reason, many women in counties surrounding McLean come here for reproductive healthcare.
Ejiogu said that while McLean County is strong in comparison, we still need more obstetricians here.
"I think the surrounding counties are even in greater need, but I know for sure McLean County needs more OBs," she said, adding she "definitely hear[s] from patients all the time that they can't find an OB."
And she said when patients do get into a doctor, they often don't feel heard.
"I have a lot of women who come to me who say, 'A doctor has never been, like, able to sit down with me and talk through all of this.’"
Some women these days are reluctant to bring children into the modern world with all of its hardships, Ejiogu said. She sees it differently.
"It's a chance to change the world, to bring a new life into the world, and so I think that's very beautiful. And yeah, can be life giving and renew the face of the world."
Smaller kindergarten classes
The ongoing fertility decline in McLean County has had notable impacts on school enrollment. At a school board meeting this year, District 87 Chief Financial and Facilities Officer Michael Cornale told the board overall, the number of students eligible to enroll in District 87 is trending down. He said this is not specific to District 87 but is a statewide issue.
"I think it's reflective of societal things, the size of families, all the things, it's catching up with us."
Cornale said the school board has noticed smaller kindergarten classes, which sets up lower school enrollment for the next twelve years.
"We're talking about it as we're thinking through things," Cornale said. "It's an important consideration for the future trajectory of the district."
Over at Unit 5 they’re seeing similar trends. In 2025 the district brought in Cropper GIS, a demographic and facility planning consulting firm, to evaluate trends in enrollment.
The firm found “the primary factor causing the district’s enrollment to decrease over the next 10 years is the low fertility not sufficiently supplanted by in-migration.”
Additionally, the costs to bring facilities up to date were hard to justify with such low enrollment.
This study ultimately led to the recommendation to close Carlock Elementary School, which was roundly rejected by the community. The school remains open, for now.
More about the General Fertility Rate
The U.S. Census Bureau combined historical population data with birth data to determine the fertility rate of each county. To get to the General Fertility Rate [GFR] of each county, they compared the number of live births per 1,000 females aged 15 to 44.
They found that, while fertility has been dropping nationwide for nearly 20 years, there are notable regional differences.
In 2007, the U.S. had a GFR of 69.5. This is considered “replacement rate” at about 2.1 births per woman. By 2025, the rate had plummeted to 53.1. The Census Bureau reports this is the lowest level recorded since 1909, when they began gathering data. The current 53.1 rate is below "replacement level" for the population.
Overall, Illinois has lower fertility rates than surrounding states. McLean County's GFR sits right around 60 or less, with surrounding counties such as Livingston, Woodford and Piatt having higher fertility rates.
WGLT used population data from the U.S. Census Bureau and live birth data from the McLean County Health Department to calculate the GFR for 2017-2024. This data omits the year 2020 due to COVID-related Census impacts.
In 2017, the McLean County GFR was the highest it's been recently, at 61. Throughout 2018-2023, we dipped as low as 55 for three years. In 2023 and 2024, fertility began climbing again and reached 60. This is just shy of a full recovery to the 2017 rate — which still does not replace the aging population.
GFR data for 2025 and 2026 will not be available until the Census Bureau announces population data for those years.
