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This paper argues that the social organization of care work shapes economic inequalities across families and uses the rising costs of childcare as a case study. Rising childcare costs have the potential to exacerbate employment inequalities after childbirth between women with high- and low- earnings potential, and to aggravate economic inequality as a result. We investigate this hypothesis using the Survey of Income and Program Participation (SIPP) panel data from 1984 to 2014 and state-level measures of childcare costs. Our analysis is the first to show that births substantially increase inequality across families; the size effect equates to a third of the increase in family inequality 1970-2005. We also show that childcare costs are key drivers of this increase in inequality: results show that childcare costs widen post-birth employment gaps among women and that this polarization in women’s employment is responsible for 60% of the increase in economic inequality among first-time parents.