Challenging Pronatalist Narratives on What Defines Family Support

In 2016, while eight months pregnant with my younger daughter, I was confronted with an unexpected $1,000 hospital bill upfront, despite having health insurance through my husband’s employer. Frustrated, I wondered if a birth happening en route would even qualify for a refund. Nonetheless, we paid the amount.

Shortly after my daughter’s birth, an $8,000 charge arrived for a blood test panel that my obstetrician had assured would be covered by insurance. After numerous calls, I managed to negotiate a reduction, though it consumed much of my limited maternity leave.

These experiences came to mind recently when I read about political figures like Senator Josh Hawley advocating for child tax credits designed to boost birthrates and encourage parents to stay home with their children. Hawley noted that such policies could offer families the chance to focus more on raising their kids.

While my family would have welcomed additional financial support, the proposed $5,000 credit barely covered the cost of delivering a second child nearly a decade ago. It falls far short of providing a livable income for one parent to leave the workforce or to comfortably raise a larger family. Expanding child tax credits is a positive step, but treating this sum as a substitute for employment income oversimplifies the challenges parents face.

This policy momentum coincides with efforts during the previous administration to consult so-called "pronatalists" on ways to increase birthrates. Recommendations have included awarding a National Medal of Motherhood to women with six or more children and promoting education on natural fertility tracking. Additionally, a memo from the transportation secretary, a father of nine, urged prioritizing communities with higher marriage and birthrates, despite limited evidence that such measures would effectively support most families or encourage higher fertility.

The reality is that birthrates are declining worldwide, and no single government policy has proven decisive in motivating individuals to have more children. As demographers have observed, governments have historically played a supporting rather than leading role in fertility decisions, and their influence in raising birthrates in today’s low-fertility environment is constrained.