How infertile are humans in The Handmaid's Tale?

Question

With regards to The Handmaid's Tale, do the books or adaptations give us any clues as to just how infertile humanity has become?

Relatedly, is there any sense as to whether the local or global population is growing, shrinking, or stable?

Answer 1

The implication is that the global population is shrinking, although this has largely affected Caucasian societies.

There was no one cause, says Aunt Lydia. She stands at the front of the room, in her khaki dress, a pointer in her hand. Pulled down in front of the blackboard, where once there would have been a map, is a graph, showing the birth rate per thousand, for years and years: a slippery slope, down past the zero line of replacement, and down and down.

Of course, some women believed there would be no future, they thought the world would explode. That was the excuse they used, says Aunt Lydia. They said there was no sense in breeding. Aunt Lydia’s nostrils narrow: such wickedness. They were lazy women, she says. They were sluts.

_{^{The Handmaid's Tale by Margaret Atwood}}

and

Men highly placed in the regime were thus able to pick and choose among women who had demonstrated their reproductive fitness by having produced one or more healthy children, a desirable characteristic in an age of plummeting Caucasian birth rates, a phenomenon observable not only in Gilead but in most northern Caucasian societies of the time.

_{^{The Handmaid's Tale: Historical Notes}}

Even fertile women are having an increasingly hard time giving birth to viable babies.

A baby, as we all hope? Or something else, an Unbaby, with a pinhead or a snout like a dog’s, or two bodies, or a hole in its heart or no arms, or webbed hands and feet? There’s no telling. They could tell once, with machines, but that is now outlawed. What would be the point of knowing, anyway? You can’t have them taken out; whatever it is must be carried to term.

The chances are one in four, we learned that at the Centre. The air got too full, once, of chemicals, rays, radiation, the water swarmed with toxic molecules, all of that takes years to clean up, and meanwhile they creep into your body, camp out in your fatty cells. Who knows, your very flesh may be polluted, dirty as an oily beach, sure death to shore birds and unborn babies.

That being said, all of the information we get about the environmental damage that caused the infertility crisis comes from government sources and is hence subject to the usual caveats about misinformation.

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In the TV show the position is rather more stark. Outside of the US, certain territories haven't had a single birth in multiple years.

Mexican Ambassador: I am from Xipica, Ms. Offred. It is nice city, maybe the size of Boston. There hasn't been a child born alive in Xipica in six years. My country is dying. My country's already dead.

_{^{The Handmaid's Tale: Episode 6}}