Christian groups that identify as “pro-family” say America’s declining birth rates are an urgent crisis, and they support President Trump’s efforts to spawn a “baby boom.” But policies promoted by these groups may actually make becoming mothers more difficult — and more deadly.
Groups that monitor maternal health — the health of women during pregnancy, childbirth and the postpartum period — see a worsening crisis of maternal mortality. “The United States continues to have the highest rate of maternal deaths of any high-income nation,” a 2024 report from The Commonwealth Fund said.
For years, American mothers have died at much higher rates than mothers in other wealthy nations. The United States experiences 22 maternal deaths for every 100,000 births, compared to 8.4 maternal deaths in Canada, 5.5 in the United Kingdom, 1.2 in Switzerland and none in Norway.
Maternal mortality is even worse for American’s Black mothers — 49.5 deaths per 100,000 births — due to pre-existing health issues and poor access to medical care.
Maternal mortality is even worse for American’s Black mothers — 49.5 deaths per 100,000 births — due to pre-existing health issues and poor access to medical care.
State abortion bans enacted after the U.S. Supreme Court overturned Roe v. Wade in 2022 have added to the challenges birth mothers face. But pro-family groups claim the real problems are cultural and ideological. As Focus on the Family argued in a July 9 article, “Maternal health is declining because we are ignoring mothering.”
Here’s a look at family policies and how they affect America’s maternal health and birth rates.
Opposing paid family leave
Nearly two-thirds of U.S. maternal deaths occur during the postpartum period, but pro-family groups have long opposed the one policy that experts say could bring profound and immediate help to mothers and families — mandated paid family leave.
“The U.S. stands alone as the only high-income country where there is no federally mandated paid leave policy,” The Commonwealth Fund reported.
In 1993, President Bill Clinton signed the Family and Medical Leave Act into law, giving many American workers up to 12 weeks of unpaid time off to recover from major illness or childbirth or to take care of sick family members. Democrats favored mandated paid leave, but Republicans and their pro-family supporters opposed it then and still oppose it today.
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Beverly LaHaye of Concerned Women for America explained the group’s opposition to Clinton’s paid leave bill, saying, “I don’t like big government telling free enterprise what it must do.”
Another reason pro-family groups oppose mandated paid leave is because it makes it easier for women to return to the workforce after having children, as the “feminist” movement suggests, instead of quitting their jobs to become full-time mothers.
“The way to help mothers become healthier is to better understand and support that which mothers actually do, as mothers,” Focus on the Family said.
“Pressuring a woman to return to work too soon harms not only the couple’s relationship but also their child’s development,” Institute for Family Studies insisted.
Applauding Trump budget cuts
“This has been an unhappy episode here in Congress, this effort to cut Medicaid,” one GOP Senator said. “And I think, frankly, my party needs to do some soul-searching. If you want to be a working-class party, you’ve got to deliver for working-class people. You cannot take away health care from working people.”
Sen. Josh Hawley criticized the Trump tax bill mandating Medicaid cuts but ultimately voted for it. He said he will work on legislation to reverse the Medicaid cuts. But meanwhile, the implications of these cuts on maternal health could be significant.
Cuts to Medicaid, the health program that pays for 41% of U.S. births, will likely speed the closure of maternity wards in rural hospitals.
Cuts to Medicaid, the health program that pays for 41% of U.S. births, will likely speed the closure of maternity wards in rural hospitals.
“Pregnancy is going to be even more dangerous in America,” a New York Times article said, citing a study showing Medicaid cuts pose risks to 144 rural hospitals with delivery rooms. That’s after more than 100 rural hospitals have closed or announced closures since 2020.
Urban maternity wards have been closing at even higher rates, leading to even higher risks for Black mothers.
Pro-family groups support Trump’s “big beautiful bill” and its major cuts to Medicaid. But Focus on the Family disputes reports from “the legacy media” that Trump’s Medicaid cuts will reduce the number of people covered by Medicaid over the next decade. And Focus says media should not use the verb “slash” to describe Trump’s $1 trillion worth of Medicaid cuts.
Trump also has made significant cuts to the federal Division of Reproductive Health, which promotes maternal health and in vitro fertilization, The New York Times reported. Trump supports IVF, but pro-family groups oppose it because of the embryos destroyed during the process.
Abortion bans add to risks
For decades, stopping abortion was goal No. 1 for pro-family groups, and many states instituted total or near-total bans after Roe was overturned.
These abortion bans already have resulted in higher maternal mortality rates in these states, according to a study from Tulane University. An earlier study covering 2015-2018, when Roe was still the law of the land, found “restricting access to abortion care at the state level may increase the risk” of maternal mortality.
Many pregnancies involve complications, some of them urgent, but doctors who work in states with abortion bans often are required to collaborate with hospital risk-management committees that are tasked with determining whether an abortion may be warranted.
“In this environment, it’s getting harder for hospitals in abortion-hostile states to attract and retain obstetricians and gynecologists and raising questions about the future of training for these specialties in those states,” the Johns Hopkins Bloomberg School of Public Health said.
American women often face more challenges in childbirth than women elsewhere because they are older and less healthy. Americans also undergo more C-sections than women elsewhere, with many of these procedures being unnecessary.
Pronatalism policies unproven
The Heritage Foundation’s Project 2025 said the nation’s top priority is to “restore the family as the centerpiece of American life and protect our children.” And Trump calls himself “the fertilization president” and supports “baby bonuses for a new baby boom.”
Trump’s big tax bill says each of the millions of babies that will be born between Jan. 1, 2025, and Dec. 31, 2028, are eligible to receive a $1,000 government payment, which will be invested in Trump Accounts for 18 years. Families can add to these accounts year by year.
And Trump’s Department of Transportation has proposed more transportation funding for regions of the country with higher rates of marriage and childbirth.
Additional proposals include two from the Institute for Family Studies:
- “Families need affordable houses. Let’s build them on federal land.”
- “Baby on board: Why states should embrace pro-family parking,” which calls for accessible mom-only parking spots during the first three months after birth.
But such indirect inducements rarely deliver, as Christianity Today reported in an article about Trump’s baby boom policies: “While nothing like this has ever been done in the U.S., these ideas are not entirely new. They follow a global pattern seen in countries like France, Japan and South Korea, all of which have poured billions of dollars into similar initiatives. However, they haven’t moved the needle, and the birthrates in these nations continue to fall.”
A Washington Post opinion piece chided pronatalist GOP leaders, saying, “Republicans are waking up to the motherhood crisis, but their ideas won’t help.”
“Republicans have finally noticed that American motherhood is in crisis. But they still don’t understand — or don’t want to admit — that their policy choices have hurt moms,” the article said.
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Remember: The first goal of Project 2025 is to creat a ‘baby boom’