This paper incorporates fertility and altruism into the ``value of life'' framework. Two dimensions of fertility and altruism are important in evaluating life expectancy and health related gains. First, child mortality can be very important in determining welfare in a context where individuals choose the number of children they have. Second, if altruism motivates fertility, life expectancy gains have a twofold effect: they directly increase utility via increased survival probabilities, and they increase utility via increased welfare of the offspring. We develop a manageable way to deal with value of life valuations when fertility choices are endogenous and individuals are altruistic towards their offspring. Calculations using U.S. data between 1965 and 1995 show that altruism and fertility can easily double the value of mortality reductions obtained using the traditional framework.