More Babies or Better Care for Newborns?

Pronatalists show remarkably little concern for the well-being of children already born—or their parents. 

As an advocate for profamily policies that support commitments to the care of dependents, I am sometimes grouped with pronatalists who, like Elon Musk, believe that below-replacement fertility is an immediate threat to the future of civilization. 

Those who believe they can overcome this immediate threat include the vocal and media-savvy Simone and Malcolm Collins, who have proudly announced that they have frozen 32 embryos as part of their effort to advance the movement to Make America Procreate Again. 

No, I am not a part of this movement. 

Panic about underpopulation is now reaching levels similar to earlier panic about over-population, and it can serve as clickbait. A recent New York Times article describing my research on the remarkably high cost of childrearing in the United States was headlined “The Feminist Case for Spending Billions to Boost the Birthrate.” My main point was quite different—that most so-called pronatalist policies seriously underestimate the costs and risks of raising children in today’s economic environment.  

The tension between pronatal and pro-family policies arises from what many economists coldly refer to as a quantity/quality tradeoff. In this context, “child quality” is typically defined as time and money spent per child—implying that richer families have “higher quality” children. 

This definition is inaccurate and off-putting. The real trade-off lies between the number of children and their well-being. Many parents limit their family size in order to provide better care for the children they have. The most common reason that people give for seeking an abortion is that they are not financially prepared to become parents. Child poverty constricts opportunities, wastes human resources, and often imposes social costs on the rest of us. 

The gradual fertility decline that has taken place in most areas of the world over the last two centuries has contributed to a significant improvement in living standards, including dramatic reductions in infant mortality. Indeed, for much of the 20^th century, explicit efforts were made to introduce family planning and lower fertility precisely because of their positive economic impact. 

Yet the so-called pro-life movement (which, by the way, does not approve of freezing embryos) implicitly endorses pronatalism, with little regard for the consequences. The oft-repeated promise that states would respond to restrictions on abortion access by providing more support for mothers has proved completely empty, apart from the occasional donation to a baby shower. 

State policy patterns exemplify the contrast between pronatal and pro-family policies. Of the eight states with child poverty rates above 20% in 2025, seven have greatly restricted abortion rights. No state that has banned abortion offers  paid family and medical leave from employment, and none of the 9 states that offer paid family and medical leave   has banned abortion. 

The coercive pronatalism driving efforts to restrict reproductive rights is by no means limited to the legal arena. Economic strangulation also comes into play. The Hyde Amendment, passed in 1976, prevented the use of federal Medicaid funds for abortions, leaving many low-income mothers without recourse. The recently approved Big Beautiful Bill contains little-publicized provisions that are designed to drive Planned Parenthood—a major source of contraceptive and gynecological care for low-income women—out of business even in states that protect reproductive rights. A recent opinion piece in The Wall Street Journal described the bill as “the most significant pro-life law ever.”

Some on the left argue that coercive pronatalism reflects the interests of employers hoping to increase the size of the reserve army of labor. These interests may well come into play, but don’t seem salient in a world with a large global supply of workers and growing capabilities for lowering labor costs. 

Perceptions of collective interests based on gender and race are probably more consequential. Reproductive rights have contributed enormously to the economic empowerment of women, enhancing their ability to compete with men in the labor market, and the pronatalist movement has some obvious eugenic undertones. 

Women currently bear a very large share of the costs of care provision—the production, development, and maintenance of human capabilities, sometimes referred to as “social reproduction.” While these activities clearly offer intrinsic rewards, they don’t help pay the bills. As I’ve been explaining for many years, both unpaid and paid care work are penalized in the labor market and a large percentage of mothers in the United States are raising children on their own, without much financial or other assistance from fathers. 

The voices of U.S. mothers in a recent set of video interviews speak even more loudly than the numbers. Many spoke about the “motherhood penalty” and the financial burdens of having children: “Motherhood should come with a warning label,” and “I’m being penalized for giving birth.” The more than 50-year transition to birth rates that are too low to replace the existing population can’t be construed as a simple “birth strike,” because it represents the outcome of many individual decisions rather than a collective bargaining strategy. However, both women and men are responding to an economic environment that can only be described as hostile to parents, especially those already struggling to find decent jobs and affordable housing. 

Many pro-family policies “socialize” some of the costs of raising the next generation by providing more public support. Such support may well have some pronatalist effects, but comparative international research shows that such effects are small. They have a greater positive impact on the well-being of both parents and their children—what we might call the quality, rather than the quantity of human life.  

As Dean Spears and Michael Geruso put it on page eight of  their new book, After the Spike: Population, Progress, and the Case for People: “If we want there to be a thriving future, then it’s time to start taking better care of one another and our caretakers.” 

In the meantime, we should pay attention to just how costly children have become in the United States—the topic of my next post.