In April, President Donald Trump said he was considering a “baby bonus,” i.e., cutting $5,000 checks to incentivize families to have more children in response to declining birthing rates.
While still just an idea, it spurred concern among reproductive health experts. They told Healthcare Brew pregnant patients face many challenges, from lack of access to care and fewer maternity wards to high costs to the rapidly changing reproductive rights landscape across the country.
For instance, it costs $18,865 to have babies in hospitals, including pregnancy, birth, and postpartum care, according to KFF. Further, over 40% of people who give birth are on Medicaid, and with Congress considering cuts to benefits, patients may soon pay those costs out of pocket.
“$5,000…is probably a drop in the bucket in terms of raising a child. But is it maybe a step in the right direction? Yes,” Monica Cepak, CEO at women’s digital health company Wisp, said. “I think it should be part of a broader policy around reproductive health and childcare in our country.”
Unit cuts. First and foremost, the number of places to give birth in the US is on the decline.
March of Dimes, a nonprofit that works to support maternal and infant health, reported that in 2021 and 2022, about 1 in 25 obstetric units closed in the US and 70% of birthing units are located within 10 states. The organization also reported 35% of US counties don’t have a single birthing facility or obstetric clinician.
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“To have wide swaths of this country without the presence of a maternity ward makes it seem more like a developing nation as opposed to one of the most industrialized nations with one of the best healthcare systems on the planet,” Melissa Simon, an ob-gyn at Northwestern Medicine in Chicago, said.
Health risks. Meanwhile, since Roe v. Wade was overturned in 2022, there’s been a rise in maternal mortality rates in the US, meaning it’s more dangerous to have children now.
Research from nonprofit research organization the Gender Policy Institute found that in Texas, which has a strict six-week ban on abortion with no exceptions for rape or incest, maternal mortality rates rose by 56% between 2019 and 2022, compared to an 11% increase across the US overall.
Infant death rates have also risen, with March of Dimes reporting 5.6 deaths for every 1,000 live births in 2022, up from 5.4 in 2021.
“Women who are in states where there’s restrictive reproductive healthcare laws…they’re scared,” Simon said.
Pregnant people living in states with “full support of reproductive healthcare,” like Illinois, New York, or California are also hesitant to travel to states with bans, she added. Some people from states with bans are choosing to stay in states with abortion access throughout their pregnancy, she said.
“It is unconscionable to think that the president or the government would give $5,000 to incentivize having a child while not taking care of the woman herself,” she said.