As we get ready to celebrate Mother’s Day on May 10, we need to take a closer look at some of the realities of motherhood in the United States.

We are all here because of motherhood. Test tube babies, namely those raised without any mother rather than those arising from In Vitro Fertilization (IVF), haven’t made the scene and likely never will.

Consider the fertility rate, which measures how many children are born to women. In America fewer women are having babies than ever before as our rate has reached a record low.

Reasons are many, including desiring pregnancy later in life, when the ability to conceive has declined making a birth less likely, as well career goals supplanting motherhood. More income and wealth inequality leads to higher stress and more future uncertainty prompting people to have fewer children. Lower inequality, present in so-called welfare states, leads to more women having children because of the social supports that are not present in the U.S.

More on the U.S. drop. Many cannot afford even one child. It costs a great deal of money to raise a child these days in the U.S. often over $15,000 annually. And there is little financial support from the government. For example, the United States is one of only two populous nations without a national policy of paid maternity leave. The other is Papua New Guinea. Canada has a national policy providing close to a year of paid maternal and parent leave that is administered by its provinces. Other rich nations have generous policies to support infants and children which results in more women there bearing children.

In many other ways besides not being paid to be with your baby, today’s affordability crisis makes it difficult to put food on the table, fuel the car if you have one, pay for healthcare insurance and pay the rent, even without a child to support.

One way to economize having a baby is to save on hospital bills by having the birth at home.

In 2023 there were 57,359 home births in the U.S., the largest number in 30 years. Of these a significant number were unintended, especially among non-Latinex Blacks living in southern and mid-western United States. A large proportion of them lived in a rural or in a metropolitan area. These women, mostly economically disadvantaged, did not want to be mothers. They can’t afford to raise a child especially in the United States which has more poverty than any other rich nation.

As well as saving medical bills, many of the births were at home in order for the mother to have a more positive experience than that typically available in hospitals

What happens to infants born to those who did not want to be mothers? How will they be raised? Likely not as well as those born to those who wanted their babies. Deaths of infants in the U.S. are much higher than that in other rich nations. Some deaths result from neglect.

One choice available to these mothers is to abandon their babies in baby boxes that are now increasingly c

ommon in America. Not surprisingly they are disproportionately found in the parts of America with the most unintended births. There are more than 425 such boxes nationwide with their numbers growing quickly. One reason is the Supreme Court 2022 decision to give states the ability to outlaw abortion.

Anonymously, you can put your unintended baby in a box, considered a safe haven, typically at a fire station or hospital. States fund them and now they are in more than 18 states. Politicians accept this as a way to save a baby’s life, and not have the mother charged with manslaughter through neglect.

One company, Safe Haven Baby Boxes, sells most of them in this country. Not unexpectedly there is a movement to stop providing these boxes via state legislation.

Abandoning newborns has been around for a long time. In ancient Roman times infants would be left in public places to die or be rescued. By the 18th century estimates suggest a third of babies born in French, Italian or Spanish cities were abandoned. Similar practices appeared in the U.S. a century later leading to foundling asylums to care for those forsaken.

In recent times, Romania made abortion illegal in the 1960s in order to increase the population size. Mass abandonment of children followed with the state setting up orphanages to house them. Such institutions were vastly under-budgeted and under-staffed so children lacked care and were often chained to cribs. The law was repealed in 1989. Children adopted from these orphanages had life-long scars. We must avoid this extreme example.

There is the option for formal adoption. Women who gave up their newborns for adoption often did so for monetary reasons – the affordability crisis.

Many more infants die in the U.S. than in all the other rich nations. For example if we had Iceland’s infant mortality rate were would be 30 fewer deaths here per day! Our infant deaths don’t make news headlines. They constitute social murder, a concept voiced over 150 years ago in England to describe deaths there due to poverty. Something is not going well for American babies.

The United States provides much less financial and social support for child rearing. As mentioned we have no national policy of providing paid maternity leave to mothers (or fathers). Our Family Medical Leave Act, passed in 1993, allows a woman working for a year in a company with over 50 employees to be granted 12 weeks of unpaid leave. After that she can be fired. With so much poverty in America, few women cannot afford to be without paid work for that long.

There is a motherhood crisis in the United States that began long before the current federal administration. Consider maternal mortality, deaths related to child bearing. Back in the 1950s the U.S. had the lowest maternal mortality ratio in the world. Since then other countries saw faster improvements than in America. Then maternal mortality began rising here, something not seen in any other rich nation. This includes White women but for African American mothers, no matter how much education they have, their rates are exceptionally high. The majority of deaths occur after the baby is born relating to medical conditions such as bleeding, high blood pressure and infection – the result of substandard medical care. Structural racism doesn’t help. The high rates of U.S. mental illness contributes to suicide or overdose which are present in over 20% of maternal deaths.

The Trump administration is increasing motherhood problems through major slashes in funding for our already low levels of social support, especially to hospitals for the poor. Huge cuts have been made to Medicaid, SNAP (nutrition support), and other policies. Many hospitals, especially those in rural areas, are being forced to close maternity wards. The assault on diversity, equity and inclusion (DEI) efforts will contribute to further worse outcomes for Black mothers. Efforts are being made to eliminate the Healthy Start Program, Maternal Mortality Review Committees, and other programs in order to ignore the problems.

What should American mothers and the rest of us do? A place to start would be to support a motherhood manifesto to advocate for political policies supporting mothers in the workplace and at home. We must have a generous policy of paid maternity/paternity leave. Have flexible work policies so mothers (and fathers) continue to work while raising a family by being able to exit and enter the workforce without huge pay cuts. Require before and after school programs that keep children attended to and not on social media devices. Restore cuts to healthcare for children. Provide low cost excellent childcare as in Sweden where it costs $160 per month. Finally, raise the minimum wage to a living wage. The current minimum wage is what it was in 2009 ($7.25/hour) while inflation has soared. Supplant the U.S. baby boxes program with those present in Finland where a box containing over 38 products including infant clothes, bedding, baby care items, sanitary towels, nipple cream and bra pads is given free to mothers. They have been adopted by other nations but an attempt to do so in the U.S. was banned.

If this sounds outrageous recognize how much support American billionaires get? They include very low rates of taxation, the ability to hide their wealth offshore, tax write-offs for vacation homes and luxury yachts and much more. We are being burned by billionaires. We must extinguish that fire and rekindle it for mothers and parents.

We are all here because we had mothers. We must do everything possible to celebrate motherhood, and love of/from children, not just on one day, but year round.