A new national study has ranked Louisiana as the No. 8 worst state to start a family, highlighting longstanding challenges in affordability, healthcare access, safety, and educational outcomes. The findings come at a time when the United States is grappling with a historic decline in its fertility rate, raising new questions about whether young families believe they can build secure and prosperous lives in the current economic climate.
A Nation Facing a Fertility Crisis
The U.S. fertility rate reached an all-time low of 1.6 births per woman in 2024. Experts point to unaffordable housing, stagnant wages, shifting social norms, and persistent concerns about school gun violence as major reasons many young people are delaying or entirely forgoing having children. Throughout history, nations with prolonged declining birth rates have experienced economic instability, labor shortages, and weakened social safety nets.
If the country hopes to reverse the trend, prospective parents must feel confident they can meet their children’s needs for stability, opportunity, and safety. The new study by Ivy Surrogacy attempts to measure where in America those conditions are most and least attainable.
How the Rankings Were Determined
Ivy Surrogacy analyzed all 50 states and Washington, D.C. across nine key indicators grouped into four categories: affordability, healthcare, education, and safety. The data used in the study comes from sources including the Centers for Disease Control and Prevention, the Bureau of Labor Statistics, and the National Center for Education Statistics.
The final rankings reveal a stark national divide: the ten best states to start a family are clustered in the Midwest and Northeast, while nine of the ten worst are located in the South or West. Washington, D.C. ranks as the worst place in the country to start a family overall.
Louisiana’s Ranking: Where the State Struggles
Louisiana placed No. 8 among the worst states to start a family, driven by weaknesses across nearly every category measured.
Key findings for Louisiana include:
Median housing price compared to median income: 3.2, ranked 8th
Cost of living index: 92.3, ranked 15th
Uninsured rate for children under 19: 4.1 percent, ranked 17th
Average reading and math assessments for grades 4 and 8: 243.8, ranked 34th
Vehicle fatality rate per 100 million miles traveled: 1.4, ranked 36th
Public high school graduation rate: 83 percent, ranked 37th
Pediatrician employment per 100,000 children: 6.6, ranked 47th
Homicide rate per 100,000 residents: 19.3, ranked 48th
Life expectancy at birth: 72.2 years, ranked 48th
The data reveals a pattern familiar to many Louisiana families. While the cost of living is relatively low compared to other states, the benefits are overshadowed by high homicide rates, low life expectancy, limited access to pediatric care, and ongoing challenges in public education. Safety concerns and healthcare shortages remain two of the most serious obstacles for young families considering raising children in the state.
Surrogacy in Context: What This Means for Growing Families
Ivy Surrogacy’s involvement in this analysis highlights an important trend: more Americans are turning to assisted reproduction, including surrogacy, as they weigh decisions about family-building. Surrogacy has become a critical pathway for LGBTQ+ parents, individuals facing infertility, cancer survivors who have lost reproductive function, and families who cannot safely carry a pregnancy for medical reasons.
For families in Louisiana, however, navigating these options can be especially challenging. The state’s limited healthcare resources and low pediatrician availability create additional barriers for expecting or growing families, whether through natural conception or through surrogacy. In addition, Louisiana’s legal landscape around assisted reproduction can be more restrictive than in many other states, prompting some residents to seek services across state lines.
As fertility continues to decline nationwide, states with strong healthcare systems, supportive surrogacy frameworks, and higher educational outcomes are increasingly better positioned to attract new families. Louisiana’s placement in the bottom ten suggests that many prospective parents may feel the state does not yet offer the security, opportunity, or healthcare foundation needed to support raising a child.
The Bigger Picture
The study paints a sobering portrait of what it means to start a family in the United States today. The best states for raising children tend to be those with lower crime, strong schools, higher life expectancy, and robust access to healthcare. The worst states tend to struggle with high mortality rates, educational gaps, and shortages in key medical services.
Louisiana’s ranking as the No. 8 worst place to start a family signals the ongoing challenges the state faces in becoming a place where young parents feel confident about the future. Until major improvements are made in healthcare access, public safety, and education, the state may continue to see families delaying parenthood, relocating, or seeking alternative paths such as surrogacy to achieve their dreams of building a family.
