Are Pokemon always born in their least evolved state?
Almost always. There are exceptions, though, mostly rare- sometimes, due to exposure to massive amounts of evolution stones during pregnancy, or even mild inbreeding, a Pokemon is born to evolved parents and evolves either immediately or almost immediately after birth. This is extremely rare, however, and most doctors will never encounter such a case in their lifetime. Note that this has never been noted to happen to first-stage evolution parents; only second-or-third-stage evos have ever had something like this happen. However, that no Pokemon with with a second-stage evolution will ever be BORN in that form, especially if it’s an item-based evolution. You can have a Pikachu baby but NOT a Raichu one, or you could (with some great deal of effort on the mother’s behalf!) have a Rhydon child but NOT a Rhyperior.