Behind the rhetoric of “family values” lies a landscape of toxic water, Medicaid cuts and maternal mortality.
In February 2025, President Trump signed an executive order pledging to expand access to in vitro fertilization. A month later, he called himself the “fertilization president.” Although the EO directed officials to draft recommendations for expanding access, it has not resulted in a federal mandate requiring insurers to cover IVF. Still, IVF and other fertility treatments have become a political brand, a symbol of pro-family values and a promise of new life.
But there is a core contradiction: The same administration purporting to champion fertility treatments is simultaneously rolling back protections against toxic chemicals, cutting Medicaid, and forcing women to give birth in states that deny them healthcare and safe environments. This competing approach exposes the reproductive paradox at the heart of current policy.
Paper Straws, Contaminated Water
The hypocrisy is clearest in the handling of PFAS, the toxic “forever chemicals” tied to reproductive harm.
In April 2024, the Biden administration established the first national drinking water standards for six PFAS chemicals, citing risks of cancer and developmental damage in pregnancy and childhood. Water systems were required to be monitored by 2027 and meet strict limits by 2029, with a Hazard Index to capture cumulative risk.
In February 2025, President Trump appeared to echo the danger of PFAS, issuing an executive order banning paper straws in all federal facilities. The accompanying Domestic Policy Council report declared even more strongly than the Biden administration that PFAS, including PFHxS and PFNA, “are harmful to human health” and linked to cancer, hormone imbalance and reproductive harm, citing EPA research dating back to 2021.
By May, however, his EPA reversed course. It delayed enforceable drinking water limits for PFOA and PFOS until 2031, scrapped the Hazard Index, and withdrew protections against PFHxS and PFNA. The contradiction is stark. PFAS in straws were treated as too hazardous to sip through, yet PFAS in drinking water, the main route of exposure for mothers and babies, were delayed or deregulated. Ironically, the chemicals left in the water are also linked to reduced sperm counts and risk of miscarriage.
Fertility Without Healthcare Coverage
The foundation of reproductive health is healthcare coverage—and here, too, the administration undermines its own fertility promises.
Medicaid finances 42 percent of U.S. births and covers two-thirds of women of reproductive age. Yet Trump’s “One Big Beautiful Bill,” signed July 4, 2025, slashes nearly $1 trillion in Medicaid spending over the next decade. Analysts estimate that 100,000 to 200,000 new parents could lose postpartum coverage.
The consequences will be most severe in the country’s 1,100 maternity care deserts, over a third of U.S. counties, home to 2.3 million women of reproductive age.
These are places where hospitals have shuttered, obstetric units have closed and clinics have disappeared, leaving whole regions without labor and delivery services. Cuts to Medicaid will deepen these deserts, forcing women to travel hours for care or give birth in unsafe conditions. IVF may become more available on paper, but families who do conceive risk being stranded in collapsing health systems.
Fertility, But More Maternal Mortalities
The United States already has the highest maternal mortality rate in the developed world, and the trajectory is worsening. States that did not expand Medicaid under the Affordable Care Act experienced maternal mortality rates 35 percent higher than states that did. For example, in 2023, California reported 10.2 deaths per 100,000 live births, while Alabama’s rate was 36.2. Women of color fared the worst of all.
Trump’s Medicaid cuts, combined with abortion bans and restrictions on reproductive healthcare, will widen these disparities. By capping provider taxes and limiting federal matching funds, the new law undermines states’ abilities to finance maternal and postpartum care for those most in need.
Some states may tighten eligibility or end Medicaid expansion, pushing more women out of coverage altogether.
At the same time, several states have weakened or disbanded maternal mortality review committees—the very institutions designed to identify preventable deaths. Women in abortion-ban states already face nearly double the risk of dying during pregnancy or postpartum.
Fertility, But Less Postpartum Care and Bad Outcomes for Moms and Babies
Before 2021, most states terminated postpartum Medicaid coverage after 60 days. Now, nearly all cover 12 months. That fragile progress is threatened with looming Medicaid cuts, and this is not a marginal issue. Perinatal mood and anxiety disorders (PMADs), also referred to often as postpartum depression, are among the most common complications of childbirth and a leading cause of maternal death.
One in five new mothers experiences a PMAD, and Medicaid is the largest single payer of postpartum mental health treatment. Women with unintended or unsupported pregnancies are twice as likely to experience postpartum depression within 12 months while those denied abortions face higher anxiety and lower life satisfaction.
As more women are forced to carry high-risk pregnancies to term without adequate prenatal care, rates of gestational diabetes, preeclampsia, postpartum hemorrhage, long-term mental illness and other serious health complications will rise. The result is not only lifelong suffering but preventable deaths. PMADs also create lasting harm for families, increasing the likelihood of low birth weight, developmental delays, and chronic health issues in children.
The Reproductive Hypocrisy
This hypocrisy is most visible in the “triple threat states”: Alabama, Mississippi, Tennessee, Texas and others across the South. These states enforce near-total abortion bans, refuse to expand Medicaid and decline to adopt PFAS drinking-water standards.
The contrast is stark: A pregnant woman in Massachusetts can rely on her water being tested for PFAS, on legal access to abortion and on Medicaid coverage. A woman in Mississippi, by contrast, may face forced birth, no health coverage, a shuttered maternity hospital and drinking water contaminated with chemicals linked to miscarriage, preeclampsia and low birth weight.
The difference in maternal mortality rates, healthcare access and outcomes for mothers and infants in these two settings speaks for itself. And more restrictions are expected.
Taken together, these policies do not form a coherent pro-family agenda. Good policy starts with clear goals, defines the problems and builds resources to solve them. If the goal is more births, then prenatal and postpartum care must be expanded, not cut. If the goal is healthier mothers and children, then chemical protections must be enforced, not rolled back. If the goal is stronger families, then science, not conspiracy theories, must guide decision-making.
Instead, what we see is chaos masquerading as care, pro-fertility when politically useful, antiabortion when demanded by religious allies, deregulatory when corporations push back, conspiratorial when voiced by the U.S. health and human services secretary. It is never consistent, never protective of mothers and children, never truly pro-family. IVF is promised, but maternity wards are shuttered. Fertility is celebrated, but postpartum depression ignored.
Until mothers and children are placed at the center of policy—not as props but as the purpose—this reproductive hypocrisy will persist. Birth may be compulsory, but care remains expendable.
Great Job Allison Carmen & the Team @ Ms. Magazine Source link for sharing this story.
