Don't forget if you have life-threatening complications in certain states the local populace might try to sacrifice you to their god.
It all boils down to choice. And women are choosing "No thanks" in high numbers even in countries where you'd think most of the barriers are quite low.
being pregnant and giving birth aren't easy, but we literally evolved specifically do be able to do that -- hence the big hips and other body dimorphism, etc.
it's a function of stress, economics, and loss of social cohesion via things like "the third place" and large family groups.
all of the people I know having kids live in small towns and have tons of relatives nearby, while the doctors and office slaves living in a tech-bro city on the other side of the country from their family struggle to have a cat.