In 2024, the United States reached a demographic milestone that sent shockwaves through policymakers, advocacy groups, and families alike: the nation’s fertility rate hit an all-time low, with fewer than 1.6 children born per woman, according to data from the U.S. Centers for Disease Control and Prevention (CDC), as reported by CBS News. This figure falls well below the 2.1 children per woman typically needed to replace each generation, sparking urgent debates about the future of the American family, the economy, and the country’s social fabric.
Against this backdrop, a powerful new push has emerged from conservative circles, led by The Heritage Foundation. Their latest initiative, dubbed “We Must Save the American Family,” is part of the broader Project 2025 campaign and aims to reverse the declining birth rate through a controversial blend of government intervention and cultural messaging. According to The Washington Post, the campaign proposes government-seeded savings accounts exclusively for married couples and seeks to redirect funding away from child care programs like Head Start, instead funneling resources directly to families in the hope of encouraging more Americans to have children.
The Heritage Foundation’s executive campaign summary marks a notable shift from traditional small-government conservatism. The document urges President Donald Trump to issue executive orders requiring all proposed regulations to “measure their positive or negative impacts on marriage and family” before implementation or termination. “For family policy to succeed, old orthodoxies must be re-examined and innovative approaches embraced, but more than that, we need to mobilize a nation to meet this moment,” the summary declares.
Republican leaders have been vocal about what they see as the cultural roots of the crisis. House Speaker Mike Johnson, in an April 2025 interview with Fox News, argued, “The way popular culture has developed in recent decades, they de-emphasize the family. They de-emphasize the merit of marriage, strong, steady, stable marriages between one man and one woman that produce children. This is part of the uphill climb that we have in working against the culture, but we’ll continue to do that, and public policy should reflect it.”
Vice President JD Vance, during his first public speech in office, was even more direct: “I want more babies in the United States of America.” Yet, the reasons for declining birth rates are complex. As Karen Guzzo, director of the Carolina Population Center at the University of North Carolina, explained, “Worry is not a good moment to have kids, and that’s why birth rates in most age groups are not improving.” Many Americans are marrying later, weighed down by concerns over job security, health insurance, and the soaring costs of raising children.
But the push to boost birth rates is not occurring in a vacuum. Alongside these pro-natalist policies, conservative lawmakers have intensified efforts to criminalize abortion and even certain pregnancy outcomes. According to Mother Jones, since the Supreme Court’s 2022 decision to overturn Roe v. Wade, a growing number of bills have been introduced that would treat abortion as homicide and criminalize those who seek it. These legislative trends, embedded in the sprawling Project 2025 document, also call for restricting and potentially eliminating access to Mifepristone—the most common abortion medication—and for reshaping government agencies to advance an anti–sexual and reproductive health agenda.
The consequences of these policies are not theoretical. Women are the fastest-growing incarcerated population in the U.S., and about 3,000 pregnant people are admitted to prisons annually, according to past research cited by Mother Jones. The Bureau of Justice Statistics (BJS) reported more than 320 pregnant women in state and federal custody in 2023, but the true number may be much higher, as many incarcerated women lack access to pregnancy tests.
Rebecca Rodriguez Carey’s 2025 book, Birth Behind Bars: The Carceral Control of Pregnant Women in Prisons, offers a rare and intimate look into the lives of nearly three dozen pregnant women incarcerated across the Midwest. Many of these women described dire circumstances—some even committed crimes intentionally to secure basic needs like food, shelter, and medical care while pregnant. As Rodriguez Carey told Mother Jones, “There’s an absence of a social safety net, and we have people turning to the criminal legal system to ensure their basic needs are met.”
The book reveals a patchwork of care for pregnant prisoners, with some facilities offering wraparound services and others providing scant prenatal or postpartum support. The lack of national mandates or standardized policies means conditions vary widely from state to state and even between individual prisons. The BJS report highlighted that only two percent of incarcerated pregnant women had abortions before Roe’s reversal, with barriers including state laws that block public funding for abortion-related travel and the simple fact that many women do not realize they are pregnant until it is too late for a legal abortion.
Perhaps most harrowing are the stories of women shackled during labor and delivery—a practice condemned by leading medical organizations. Rodriguez Carey recounted interviewees describing the experience as feeling like “caged animals.” She explained, “When you are in the state of giving birth, you are extremely vulnerable… Most women who are incarcerated are there on non-violent crimes, and even if a woman is pregnant who committed a violent crime, she’s not necessarily posing a risk to society while you’re in this very vulnerable state of childbirth.” Although most states now restrict shackling during delivery, enforcement is inconsistent, and exceptions often leave the decision to correctional officers—disproportionately affecting women of color.
Some glimmers of hope exist. There are now 11 state-run and two federal prison nursery programs, which allow mothers to parent their newborns in prison. These programs have been shown to reduce recidivism and improve maternal and fetal health outcomes. Still, such initiatives are rare, and most incarcerated mothers are separated from their babies within 24 to 48 hours of birth, with profound mental health consequences.
Rodriguez Carey’s research also uncovered stories of resilience and solidarity. In the absence of institutional support, incarcerated women form informal networks—sharing food, advice, and emotional support. “Many of the women that I interviewed had been pregnant before… Many of them talked about how being pregnant and incarcerated was rock bottom, and that this was very much a wake up call to do right by their unborn child,” she said. Programs like Play Free at the Kansas Children’s Discovery Center, which allows incarcerated parents to spend time with their children in a nurturing environment, offer a rare reprieve from the harsh realities of prison life.
Meanwhile, the treatment of pregnant women in immigration detention has also come under scrutiny. A September 2025 report from Senator Jon Ossoff’s office alleged more than a dozen credible cases of mistreatment in Immigration and Customs Enforcement (ICE) custody, including denial of urgent medical care and food. The Department of Homeland Security responded that “detention of pregnant women is rare and has elevated oversight and review.”
As the nation grapples with its lowest-ever birth rate, the competing visions for America’s families—one focused on government incentives for marriage and childbirth, the other on increasing restrictions and criminalization—are colliding in the lives of the country’s most vulnerable women. Whether these policies will help, harm, or simply overlook those who need support most remains an open question, but the urgency of the debate is undeniable.
