In 2017, the nationwide fertility rate was 1,765.5 births per 1,000 women of childbearing age—well below the rate of 2,100 births per 1,000 women necessary to keep the population stable. There were major regional differences: South Dakota, for example, had the highest rate in the nation, with 2,227.5 births per 1,000 women, while Washington, D.C., had the lowest with 1,421. Only two states—South Dakota and Utah—had birth rates above replacement levels.