The “Pro-Family” Party’s War on US Mothers
When given the choice between funding prenatal care or financing tax breaks, Republicans chose tax breaks. When faced with evidence that these cuts will increase maternal mortality, they shrugged.
So here we are again. The government is about to shut down, and Democrats are demanding one thing: reverse the nearly $1 trillion in Medicaid cuts that will strip healthcare from pregnant women and new mothers. How dare them support US pregnant women?
Republicans say no. Speaker Mike Johnson declares there’s “zero chance” of restoration. Senate Republicans won’t negotiate. The cuts stay.
Let’s be clear about what’s happening here. The same party that wraps itself in “family values” and “pro-life” rhetoric just enacted the largest cut to maternal healthcare in American history. And when given the chance to reconsider, they doubled down.
This isn’t about fiscal responsibility—the tax cuts in the same legislation dwarf any Medicaid “savings.” This is about priorities. And the data show exactly what Republicans prioritize: tax breaks for the wealthy over prenatal care for the poor.
What They Actually Cut: The Damage Ranked
1. Killing Postpartum Coverage When Death Risk Is Highest
The most lethal cut: gutting the 12-month postpartum Medicaid coverage that 48 states adopted to prevent maternal deaths.
Here’s what the evidence shows. Forty-seven percent of maternal deaths occur between 7 days and 365 days postpartum—after the federally required 60-day coverage ends. Women die from hemorrhage complications, untreated hypertension, and suicide. These deaths are overwhelmingly preventable with continued healthcare access.
States responded to this data by extending postpartum coverage to 12 months. Women with extended coverage are three times more likely to access mental health services, ten times more likely to get contraception, and significantly less likely to die.
But—and here’s the kicker—this coverage is optional. As states face budget crises from federal funding cuts, they’ll drop it. CBO estimates 100,000 to 200,000 new mothers will lose postpartum coverage.
Translation: New mothers lose health insurance when their death risk is highest. That’s not a bug—it’s the design.
2. Defunding 42% of American Births
The numbers are stark. Medicaid finances 42% of all U.S. births—1.47 million births in 2023. In some states, it’s nearly half.
The cuts reduce federal matching rates from 90% to 80% for 33 states, effectively doubling their expansion costs. Several states have trigger laws that automatically terminate expansion if federal rates drop. CBO projects 7.8 million people will lose coverage.
Republicans claim they’re eliminating “waste and fraud.” But CBO data show the cuts work not by catching cheaters, but by denying coverage to eligible people through administrative barriers.
So let me get this straight: The “pro-family” party just defunded nearly half of American births to finance tax cuts. That’s the policy. Those are the priorities.
3. Closing Prenatal Care Clinics
From July 2025 through July 2026, the law completely defunds nonprofit community health centers that primarily provide family planning services—the very clinics offering prenatal care, ultrasounds, and STI screening in underserved communities.
For many low-income women, these are the only accessible healthcare providers. The “pro-life” party just eliminated their prenatal care. The logic is, to put it mildly, elusive.
4. Shuttering Rural Maternity Wards
The Kaiser Family Foundation projects $119 billion in cuts to rural Medicaid spending. The National Partnership for Women and Families estimates over 140 labor and delivery units will close.
Currently, 36% of U.S. counties are maternity care deserts. These cuts will dramatically expand those deserts. Rural hospitals operate on razor-thin margins; when federal Medicaid funding drops, obstetric units close first.
Here’s the political irony: Republicans represent most of these rural districts. They just voted to close their own constituents’ maternity wards. Somebody should ask them how that squares with “family values.”
5. Eliminating Mental Health and Doula Services
Twenty-three states now reimburse doulas through Medicaid—support that reduces cesareans, preterm births, and postpartum mental health conditions. This coverage is optional and vulnerable to state budget cuts.
Remember: Mental health conditions, including suicide, are the leading cause of pregnancy-related deaths. Medicaid provides the mental health services that prevent these deaths. Republicans just put those services on the chopping block.
The policy literally increases maternal suicide risk to finance tax cuts. Let that sink in.
6. Driving Obstetricians Out of Medicaid
Beginning in 2027, states can’t increase provider taxes to draw federal matching funds—a critical Medicaid financing mechanism. States will respond by cutting provider reimbursement rates. Fewer obstetricians will accept Medicaid. Pregnant women will struggle to find care.
The economics are simple: reduce reimbursement, reduce provider participation, reduce access. It’s not mysterious. It’s predictable.
The Staggering Hypocrisy
Let’s talk about Republican “family values.”
They claim to be “pro-life”—then eliminate healthcare for women carrying pregnancies to term.
They champion “family values”—then abandon new mothers when mortality risk peaks.
They oppose abortion—then defund the contraception that prevents it.
They call themselves the party of “traditional families”—then close rural maternity wards.
In February, President Trump called himself the “fertilization president,” pledging IVF expansion. In July, he signed legislation stripping healthcare from pregnant women who successfully conceive. Medicaid covers two-thirds of women of reproductive age. The administration celebrates conception while defunding prenatal care.
This isn’t complicated. The rhetoric is “pro-family.” The policy is anti-mother. The evidence is overwhelming. And they simply don’t care.
Who Pays the Price?
The answer is depressingly predictable.
Low-income women. Black women facing three times the baseline maternal mortality risk. Rural women in maternity care deserts. Young mothers losing postpartum coverage after 60 days. Immigrant women in the 33 states facing doubled expansion costs.
These are the women Republicans abandoned to finance tax cuts for the wealthy. The distributional implications couldn’t be clearer: maternal healthcare down, top-bracket tax rates down. That’s the trade-off Republicans made.
The Maternal Mortality Reality
Let’s look at the data. The United States has the highest maternal mortality rate in the developed world. Black women die at three times the rate of white women. Women in abortion-ban states face double the mortality risk.
The evidence for solutions is equally clear. Medicaid expansion reduces maternal mortality. Extended postpartum coverage prevents deaths. Prenatal care access improves outcomes. The research isn’t ambiguous.
Republicans examined this evidence and cut $840 billion anyway. When states expanded postpartum coverage and maternal deaths fell, Republicans threatened that coverage. When Medicaid expansion narrowed racial health disparities, Republicans undermined it.
We have a maternal mortality crisis. Republicans responded by eliminating healthcare for pregnant women. The policy makes sense only if you don’t actually value maternal lives.
What This Actually Looks Like
I’m an ObGyn. Here’s what these cuts mean in practice:
More patients arriving for first prenatal visits in the third trimester—or not at all—because they lost coverage and can’t afford care.
More severe preeclampsia because patients couldn’t afford blood pressure monitoring after 60-day postpartum coverage ended.
More postpartum mental health crises because patients lost access to treatment.
More closely-spaced unintended pregnancies because contraception became unaffordable.
More deaths from hemorrhage, infection, cardiovascular disease, and suicide.
These aren’t hypotheticals. They’re predictable consequences of predictable policies. We’ll see the mortality spike in the data within two years. And Republicans will claim surprise.
The Bottom Line
Actions reveal priorities. Republicans chose tax cuts over prenatal care. They chose ideology over maternal lives. When given the opportunity to reverse course, they refused.
The maternal mortality crisis will worsen. More women will die. Those deaths will be policy choices, not accidents.
The evidence was clear. The warnings were explicit. They knew. They did it anyway.
That’s not “pro-family.” That’s not “pro-life.” That’s abandonment wrapped in rhetoric, financed by eliminating healthcare for the most vulnerable mothers in America.
And when the mortality data come in—when the deaths Republicans enabled become statistically undeniable—remember this moment. Remember that they knew. Remember that they chose.
Because the numbers don’t lie. The policy kills. And Republicans own it.
The views expressed are those of the author and do not necessarily reflect the position of any institution or organization.