Can Giving Families Money During Pregnancy Help Babies Get a Healthier, Safer Start?

What studies of Flint's Rx Kids program (Hanna 2025; Agarwal 2026) and Manitoba's Healthy Baby Prenatal Benefit (Enns 2025) tell us about cash, prenatal care, birth outcomes and child protection

Giving families money during pregnancy and a baby's first year, with no strings attached, may help in ways that can be measured. In Flint, Michigan, a program that paid every expectant mother was followed by better use of prenatal care and fewer child-protection investigations involving babies. In Manitoba, Canada, a small pregnancy payment that was never increased gradually lost its link with healthier births.

Why money matters around the time a baby arrives

Having a baby is joyful, but it is also expensive, and it often comes just as a parent has to cut back on work. Researchers who followed American households found that income stretches less far in the months around a birth, especially for single mothers living without other adults, and that government benefits soften this drop but do not prevent it [1]. Mothers are more likely to fall into poverty after giving birth [2]. For decades, people have wondered whether simply giving families money could protect babies' health. More than 140 countries now pay regular cash benefits for children, and the clearest health benefits seem to come when money reaches families during pregnancy and the first years of life [3]. A review of studies from around the world found that cash given without conditions tended to be linked with healthier birth weights and fewer infant deaths [4]. In the Canadian province of Manitoba, earlier research on a small monthly payment to low-income pregnant women found fewer babies born too small or too early among families who received it [5]. When a large American study called Baby's First Years gave low-income mothers either $333 or $20 a month starting only after birth, recruiting 1000 mothers from 12 hospitals in 4 US cities (New York, Omaha, New Orleans and Minneapolis–St Paul), it found no differences in how mothers rated their children's health, sleep or use of health care [6]. That raised a natural question: does it matter whether money arrives before the baby is born?

Two cash programs and three new studies

Three recent studies help answer that question. Two come from Flint, Michigan, a city where 34% of people lived in poverty in 2023 [7]. There, a program called Rx Kids started in January 2024. It gives every pregnant resident, whatever their income, $1500 during pregnancy and then $500 a month for the baby's first year, $7500 in all, and families can spend it however they need [8]. Signing up happens online, with a health provider confirming the pregnancy, and the money is treated as a gift that does not affect eligibility for most other benefits, such as Medicaid or food assistance [7]. Because enrollment was kept simple, almost every eligible family signed up, most of them during pregnancy [9].

The first Flint study looked at prenatal care, the check-ups a pregnant woman has with a doctor or midwife before birth [7]. The second, by the same research team, looked at child protection: how often a newborn became the subject of an investigation by Michigan's Children's Protective Services, the state agency that looks into reports that a child may be at risk of abuse or neglect [8]. Because no families were randomly picked to receive or not receive the money, both studies compared how things changed in Flint after Rx Kids began with how they changed over the same time in 21 similar Michigan cities without the program.

The third study comes from Manitoba, where the Healthy Baby Prenatal Benefit has been paid to low-income pregnant women since 2001 [10]. It is much smaller: at most 81.41 Canadian dollars a month during the second and third trimesters, a sum that was not raised for about 20 years. Women qualify if their annual income is 32 000 Canadian dollars or less, and each monthly check arrives with leaflets about healthy eating in pregnancy, breastfeeding and baby development. The researchers compared 17 970 mothers who received the benefit with 8301 similar low-income mothers who were eligible but did not apply, for babies born from 2003 to 2019.

What happened in Flint

Before Rx Kids, only about half of Flint births (50.5%) met a standard definition of adequate prenatal care, which looks at how early care started and how many visits took place. After the program began, that share rose by about 9 percentage points more than in the comparison cities, so roughly 9 more of every 100 pregnancies received adequate care [7]. Fewer women went without any prenatal care at all, more started care in the first three months of pregnancy, and women had nearly one more visit on average.

The child-protection findings were also striking. Before Rx Kids, about 22 of every 100 Flint babies (21.7%) were the subject of an investigation before they were 6 months old. Among babies born in 2024, that fell to about 15 or 16 of every 100 (15.5%), while the rate in comparison cities rose slightly [8]. After accounting for those trends, this was a drop of 7 percentage points, or about one-third. The researchers estimate that about 57 babies in Flint avoided contact with the child welfare system in that first year.

It is important to be precise about what this means. An investigation means that someone made a report and the agency looked into it; it does not mean abuse or neglect was proven. Cases where the agency confirmed a problem also went down, but that smaller change could have been due to chance. Investigations are common in the United States, where an estimated 37 in every 100 children are investigated at some point before age 18 [11], and they can be stressful for families even when nothing is found.

What happened in Manitoba

The Manitoba results tell a different and thought-provoking story. For babies born in 2003, mothers who received the benefit had fewer babies born too early or too small: about 3 fewer preterm births for every 100 mothers [10]. More of them started breastfeeding, and their children were less likely to struggle with language and communication skills in kindergarten. Year after year, however, these differences shrank, and by 2019 the differences in birth outcomes were too small to be distinguished from chance. Over the same years the payment was never increased, so rising prices steadily ate away at what it could buy; the researchers calculated that the 2001 amount would have needed to be about 113 Canadian dollars by 2019 just to keep up. Manitoba doubled the benefit in July 2024.

What these findings do and do not tell us

These studies are encouraging, but they cannot prove that the money itself caused the changes, because families were not randomly assigned. The Flint results cover only the program's first year or so, so we do not yet know whether the improvements will last. More babies were born in Flint in 2024 than expected, although the kinds of families having babies did not change noticeably, and the researchers' estimate for the number of investigations, not just the rate, also pointed to a fall. The comparison cities were somewhat better off than Flint, and the Flint studies come from one research team closely involved with Rx Kids, so studies by other groups and in other places will be valuable. The Flint papers did not report whether babies were born healthier, which is the question many families will care about most. Taken together, though, the studies suggest that the amount of money, when it arrives and whether every family can receive it may all matter.

What this means for families

If you are expecting a baby or caring for a newborn and money is tight, you are far from alone, and asking for help is a sensible part of preparing for your baby. Doctors, nurses and social workers in prenatal clinics and newborn units increasingly ask about finances because they know money worries affect health. It is worth telling them if you are struggling with rent, food or bills, and asking which benefits or programs you may qualify for. Other research from Rx Kids found that mothers who received the cash were less likely to face eviction and less likely to screen positive for depression after birth [12]. If you are feeling low after having a baby, our article on maternal depression and infant health explains why that matters and why support helps (https://inneosight.org/en-US/articles/perinatal-depression-infant-mortality-risk-2026). Researchers who study this field argue that pregnancy and children's health care settings are good places to connect families with cash support [13].

What researchers are working on next

Researchers want to know whether Flint's early improvements continue beyond the first year, whether Rx Kids also leads to healthier birth weights and fewer early births, and whether similar programs in other cities produce the same results. In Manitoba, the doubled benefit offers a chance to see whether the earlier advantages return when the payment is large enough. Researchers are also working out how big a payment needs to be, and how it should keep pace with rising prices, to make a lasting difference.

The bottom line

In Flint, giving every family cash during pregnancy and the baby's first year was linked to better prenatal care and fewer child-protection investigations of young babies [7][8]. In Manitoba, a small pregnancy payment whose value shrank over time gradually lost its link with healthier births [10]. Money is not a cure-all, but these studies suggest that steady, adequate support around the time of birth can make a real difference for families.

References

  1. Stanczyk AB. The Dynamics of U.S. Household Economic Circumstances Around a Birth. Demography. 2020;57(4):1271-1296. doi:10.1007/s13524-020-00897-1 ↩
  2. Hamilton C, Sariscsany L, Waldfogel J, Wimer C. Experiences of Poverty Around the Time of a Birth: A Research Note. Demography. 2023;60(4):965-976. doi:10.1215/00703370-10837403 ↩
  3. Shaefer HL, Hanna M, Harris D, Richardson D, Laker M. Protecting the health of children with universal child cash benefits. Lancet. 2024;404(10469):2380-2391. doi:10.1016/S0140-6736(24)02366-302366-3) ↩
  4. Siddiqi A, Rajaram A, Miller SP. Do cash transfer programmes yield better health in the first year of life? A systematic review linking low-income/middle-income and high-income contexts. Arch Dis Child. 2018;103(10):920-926. doi:10.1136/archdischild-2017-314301 ↩
  5. Brownell MD, Chartier MJ, Nickel NC, et al. Unconditional Prenatal Income Supplement and Birth Outcomes. Pediatrics. 2016;137(6):e20152992. doi:10.1542/peds.2015-2992 ↩
  6. Sperber JF, Gennetian LA, Hart ER, et al. Unconditional Cash Transfers and Maternal Assessments of Children's Health, Nutrition, and Sleep: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(9):e2335237. doi:10.1001/jamanetworkopen.2023.35237 ↩
  7. Hanna M, Agarwal S, Shaefer HL. Unconditional Cash Transfers and Prenatal Care Utilization in Flint, Michigan. JAMA Netw Open. 2025;8(10):e2538406. doi:10.1001/jamanetworkopen.2025.38406 ↩
  8. Agarwal S, Shaefer HL, Jubaed S, Schneider W, Finegood ED, Hanna M. Cash Transfers in the Perinatal Period and Investigations of Infant Maltreatment. JAMA Pediatr. 2026;180(8):876-883. doi:10.1001/jamapediatrics.2026.1602 ↩
  9. Zamani-Hank Y, Nothaft A, Shaefer HL, Hanna M. Lessons for Program Uptake: The 2024 Rx Kids Universal and Unconditional Cash Prescription Program in Flint, Michigan. Public Health Rep. 2026:333549251403346. doi:10.1177/00333549251403346 ↩
  10. Enns JE, Brownell M, Nickel NC, et al. Birth and Early Childhood Outcomes in Families Receiving an Unconditional Prenatal Cash Benefit. JAMA Netw Open. 2025;8(8):e2526996. doi:10.1001/jamanetworkopen.2025.26996 ↩
  11. Kim H, Wildeman C, Jonson-Reid M, Drake B. Lifetime Prevalence of Investigating Child Maltreatment Among US Children. Am J Public Health. 2017;107(2):274-280. doi:10.2105/AJPH.2016.303545 ↩
  12. Hanna M, Shaefer HL, Finegood E, Agarwal S, Zamani-Hank Y, LaChance J. Hardship and Hope: The Relationship Between Unconditional Prenatal and Infant Cash Transfers, Economic Stability, and Maternal Mental Health and Well-Being. Am J Public Health. 2025;115(12):2020-2029. doi:10.2105/AJPH.2025.308244 ↩
  13. McConnell M, Agarwal S, Hanson E, McCrady E, Parker MG, Bona K. Prescription for Cash? Cash Support to Low-Income Families in Maternal and Pediatric Health Care Settings. Milbank Q. 2024;102(1):64-82. doi:10.1111/1468-0009.12679 ↩