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Yes, but I'd argue that capital has a more profound impact than "modern medicine".
There is a massive MASSIVE selection pressure against reproduction for if you can afford kids or not.
You can look around the world and see countries with amazing health outcomes, beyond anything our ancestors even a few generations back could have dreamed of...
... And yet these countries no longer even have children at a replacement rate.
I'm not saying medicine isn't a factor... Just saying that in terms of evolutionary pressure, capitalism is even greater a pressure.
To amend that, if you are responsible and think you can't afford kids and have the restraint and planning to select not to have children.. there are plenty of people that can't afford as many children as they have.
In fact of those that can "afford" kids easily, they are still more likely to stay at one or two.