Emma Waters stands on the front porch of her house in a tattered former steel mill town outside Pittsburgh. She is pregnant with her third child, and balancing Cordelia, who is a year and a half, on her hip, while hoisting an American flag into its holder, a daily routine.
In the kitchen, her husband, Jackson, is frying up scrambled eggs and sausage for breakfast. Their older toddler, Betsy, 3, slumps on the living room sofa, not feeling well. When they sit at the table, Jackson says grace. Cordelia, sitting in her high chair, happily mashes eggs. Betsy throws up.
It’s a little chaotic, but it is the kind of life — early motherhood and what she describes as “pro-family” values — that Mrs. Waters is urging American women to return to.
Mrs. Waters, 28, works on policy related to reproductive technology and the family for the Heritage Foundation. In a few short years, she has become a rising leader for a conservative movement that is trying to change the trajectory of modern life. And she is at the movement’s vanguard, driven by her belief that life begins at conception — which she says is grounded in biology and her Christian faith — and that family life is paramount for women.
She pointedly asks to be called “Mrs. Waters.” If women and men married and had children earlier, as she believes they should, some of society’s problems would become easier to solve, she says. The birthrate, which has dropped precipitously, would rise. And infertility would become less of a threat. In vitro fertilization, egg freezing and delayed marriages point to women who are “running out of time,” she says.
In a Heritage Foundation report that she co-wrote, there are proposals to give Americans financial incentives to marry by the age of 30 and a “large family bonus” for married parents with more than two children.
Another goal is to evangelize a competing system of reproductive care, called “restorative reproductive medicine.” It is based on the idea that “natural” fertility has been impaired by untreated health problems or poor lifestyle choices, and that it needs to be repaired and restored — an approach that many medical experts argue may give false hope to couples who have not been able to have children.
Professional medical associations have characterized the restorative reproductive medicine movement as motivated by ideology rather than solid clinical evidence — a backdoor way to further limit reproductive rights on religious grounds without taking a politically disastrous stance against I.V.F. They say the allure of a more “natural” antidote to infertility could steer couples with fertility issues away from more sophisticated technologies like I.V.F. until it is too late for them to conceive.
But Mrs. Waters and her allies are looking to seize the opportunity presented by the Trump administration to change the basic shape of American life — and to do it in the image of young women like her.
The conservative agenda “is heavily focused on marriage — marriage being the linchpin for most people of a satisfying, productive fulfilled life,” said Roger Severino, the foundation’s vice president of economic and domestic policy.
“And we want to get rid of as many impediments as possible,” he said.
Others urge caution. Romanticizing “traditional” family life, when in reality infant mortality was high and standards of living were low, is an “unhealthy kind of nostalgia,” said Philip N. Cohen, a sociologist at the University of Maryland.
Finding Her Way
Mrs. Waters did not always feel this way. As a student at Lee University, a Christian college in Cleveland, Tenn., she worried that having children would interfere with her career, she recounts in her book, in which she offers Bible-based life coaching. She even broke up with Jackson, then her boyfriend, when the relationship started to get serious.
“I knew God was calling me to a great and impactful future, and children felt like a hindrance and distraction,” she wrote in the book, “Lead Like Jael.”
She graduated from college in 2021 as valedictorian and by the summer of 2022, had pitched her way into a job at the Heritage Foundation as a policy analyst specializing in the family and technology.
Given her belief that life begins at conception and the realization that more than a million embryos lie frozen, perhaps never to be used, she focused on the morality of I.V.F. and the treatment of infertility.
Looking for alternatives, she found her way to the International Institute for Restorative Reproductive Medicine, an organization of health care professionals founded in 2000. They back a variety of lower-tech methods to achieve pregnancy by treating what they call the “root causes” of infertility, like endometriosis, blocked fallopian tubes, hormonal imbalances, low sperm count and lifestyle.
She helped craft the model language for a bill called the Restore Act, which explicitly mandates insurance coverage for “restorative reproductive medicine” — endorsing an alternative to I.V.F. that does not involve creating embryos in a lab. Last year, Arkansas became the first state to adopt it.
Mrs. Waters joined forces with other young conservative women to coax the bill through the Legislature. “Emma was our point person,” said Alyssa Brown, 28, a first-term Arkansas lawmaker, who was a primary sponsor of the bill.
In a similar vein, the Trump administration is proposing a rule to encourage employers to offer optional insurance coverage to diagnose and treat the “root causes” of infertility, a synonym for restorative reproductive medicine. It is a development that Mrs. Waters played an “instrumental” role in, said Mr. Severino, her boss.
“It sounds very appealing — it borrows the language of good medicine,” said Dr. Amanda N. Kallen, who runs the reproductive endocrinology and infertility division at the University of Vermont medical school.
But, she said, “it’s essentially a repackaging of treatments that are already part of standard fertility care, to the detriment of patients who cannot conceive with these kinds of treatments.”
And it overlooks that people who marry young tend to have shakier finances and marriages, says Stephanie Coontz, a historian who studies the family.
Mrs. Waters’s own family life, at this moment, is busy.
She has a contract for a second book, and is in demand as a panelist. Separate from her Heritage work, she has started a podcast, “Rethinking Fertility,” which will address “how we understand what it means to be human.” The podcast is produced by Frozen Orphans, a California nonprofit that is developing a documentary critical of I.V.F. She says it helps that, true to its pro-family values, the Heritage Foundation is generous with virtual work.
She anticipates that when Jackson graduates from the seminary and gets a full-time job, she will slow down and spend more time with their kids.
“I’ve relied on a ‘seasonal approach to life that puts first things first,’ ” she said, loosely quoting C.S. Lewis and the Gospels.
At home the other day, after her family breakfast, her younger sister took over child care, while Mrs. Waters worked on and off before the arrival of dinner guests — a seminary schoolmate, his wife and their two small children.
The guests brought homemade sourdough. Mrs. Waters served it with raw-milk butter — a MAHA elixir — that she had churned herself. With Vivaldi’s “Four Seasons” playing in the background, the dinner conversation turned to the falling birth rate.
The seminary student wondered which “cultural agent” would be able to persuade Gen Z that “having kids is cool.”
The challenge, Mrs. Waters agreed, is “how do you make motherhood and family a high-status venture?”
Sheelagh McNeill contributed research.