America has suffered a significant birth rate decline in recent years that President Trump has made this a national issue. By promoting policies such as a “baby bonus” tax credit and increased menstrual education, President Trump hopes to push more Americans into the throes of parenthood. But due to the costs of parenthood it’s no wonder that Americans are more likely to have pets than kids. As childcare costs continue to rise, it is unlikely that many will make the switch from dog mom any time soon.
In my work as a doctor and my own experiences as a mom, I have seen how the lack of affordable, accessible child care harms not just children but entire families— fueling stress, health disparities and long term economic instability.
The average cost to deliver a baby in America comes out to more than birthing a royal baby in the Lindo wing, the luxurious London maternity ward,even with our higher maternal mortality rates and increased risk of c-section. America spends twice as much as all high income nations, about $111 billion yearly, on maternal care, according to a 2017 study from Indiana University School of Medicine. And that’s just through the moment of birth. After the baby is born, the cost just continues to pile on.
According to the US Department of Labor, in 2022 United States families spent between 8.9% – 16.0% of their median income on full-day care for just one child, ranging $6,552 to $15, 600. Even part-time care can cost over $8000 for the year for some. With the median U.S.household income at approximately $80,000, it’s no wonder many are opting out of the additional cost of child rearing.
The issue has become so pervasive that it is now a bipartisan one. In 2024, Congress passed a child care and development block grant that increased the allotment of funds for child care by $1 billion for low income families. The grant also funded programs such as Head Start, an early childhood education program. Unfortunately, in a push to cut “wasteful spending”, Head Start funding has decreased significantly under the current administration.
Even for those who may be more financially stable, having a child could mean a major stall in their career. Forty-seven percent of women and 36% of men worry that having a child could affect their job security, according to a 2021 poll from the University of Chicago. Coupled with the lack of comprehensive parental leave, many choose to be more stable in their career prior to starting a family. Though the Family and Medical Leave Act (FMLA) provides 12 weeks of unpaid parental leave, twelve weeks is a long time to go unpaid… especially since 70% of Americans are considered financially “unhealthy”, according to a 2024 report from the Financial Health Network.
This is not only an American issue: the birth rate globally has continued to decline. Many countries are trying to solve this issue. Japan, through its “Childcare Access for All” program , has started providing free daycare to all children 6 months to 2 years old, regardless of their parents employment status. Bulgaria provides 410 days of paid maternity leave, up to 90% of one’s salary.
Americans need to follow the lead of other industrialized countries. We need more than a $5000 child tax credit. We need a longitudinal child care plan.
We nearly had one almost 50 years ago. The bipartisan Comprehensive Child Development Act, would have provided free and low cost child care for Americans with a focus on the economically disadvantaged and single parents including 24 hour child care services. It also provided funding to appropriately train early childhood educators under the Higher Education Act. Passed by both houses, the act was vetoed by Nixon. Had it been enacted, it is likely our birth rate would not have experienced such a sharp decline.
To be sure there are many Americans who choose not to have kids for many reasons. Some loathe to bring children into the world due to concerns about the environment. Others feel no need to become parents but many Americans do want to have kids if they could afford it. The child tax credit may be helpful to some parents, but it is not enough. A one-time credit in a sea of debt is akin to a buoy without a lifeboat. It’s not a long term solution.
Only through policies such as universal child care, funded parental leave and early education programs can we hope to persuade dog moms and dads to seriously consider having human babies—who, unlike our fur babies, will grow up to make our economy stronger.
About the Author: Dr. Shacelles Bonner is a Yale-trained doctor, social health advocate and Public Voices fellow of the OpEd Project.