“Blessed Be the Fruit”—The Contemporary Rise of Pronatalism

( N Engl J Med . 2024;391(17):1569–1571. doi:10.1056/NEJMp2410208) Margaret Atwood’s novel The Handmaid’s Tale , published in 1985, was influenced by the political changes during the Reagan administration. These changes involved shifts in voter demographics and alliances with religious traditionalists, leading to increased polarization on issues such as abortion and LGBTQIA+ rights. While not as severe as the dystopia in Atwood’s fiction, current policies regarding abortion, contraception, and in vitro fertilization have deviated from the beliefs of the majority of Americans. Present-day politicians still support laws that limit the choices of women who do not have children on purpose or due to circumstances, often using rhetoric associated with White supremacy and eugenics.