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Unconditional Cash: A Bold New Pilot for Pregnant Women

Lived Experience

Sabra Bell remembers what it was like to be pregnant and low on funds. 鈥淓xtra cash would have been useful,鈥 she says. 鈥淚 would have paid off my debts and bought a nice stroller, crib, breast pump, baby clothes and more.鈥

Today, Bell and other mothers are drawing on their personal experience in their work as researchers on the Abundant Birth Project, an ambitious pilot seeking to reduce the incidence of premature birth in San Francisco.

Starting in 2021, the program will distribute a monthly income supplement of $1,000-$1,500 per month to 100 low-income black and Pacific Islander pregnant women. Payments will continue for the duration of a woman鈥檚 pregnancy and then for the first two months of the baby鈥檚 life.

Kara Dukakis, an early childhood development senior program officer at , which is one of the pilot鈥檚 funders, champions the Abundant Birth Project for the way it explicitly acknowledges racism as a factor in these women鈥檚 lives. “An incredibly important part of the pilot is that women of color are hired to be the researchers,鈥 she says. 鈥淏ecause they have lived the experience, they can truly empathize with the women the project supports.”

Maile Chand, another researcher who has 鈥渂een there鈥 herself, adds, 鈥淣ot only will this financial opportunity help San Francisco black and Pacific Islander families better provide for their children, but it will also transform the emotional and physical state mothers are in going into their birth.鈥

The Science Behind the Project

The Abundant Birth Project is grounded in both science and respect for moms. Thanks to advances in medical science, premature babies have a far greater chance to survive and thrive than ever before, but it鈥檚 still ideal for a pregnancy to last 40 weeks, or close to it. Cognitive deficits and physical disabilities frequently accompany preterm births, and black women give birth prematurely, as white women.

“The strain of ongoing financial insecurity,鈥 says Dr. Zea Malawa, director of Expecting Justice, 鈥渃ontributes to chronic stress and is associated with premature birth. Although San Francisco has programs to address poverty, they are not enough to close the gaps. The high rates of preterm birth experienced by the black and Pacific Islander community require a more urgent and upstream intervention.”

The Abundant Birth Project builds on of Jackson, Mississippi, which distributed $1,000 monthly for 12 months to 20 women. , was found to help women to improve their nutrition, prepare for baby and engage in self-care to moderate the effect of stressful life events. Reduced incidence of low-birth-weight infants and pre-term birth also resulted.

Free Money? What鈥檚 the Catch?

There is no catch.

Unlike conditional cash transfer programs, which distribute money only when subjects adhere to certain behaviors (for example, attending school or visiting the doctor), the program commits to awarding stipends without stipulation.

鈥淢ost public assistance programs have complicated eligibility requirements,鈥 says Deborah Karasek, a researcher with the at the University of California, San Francisco, which is partnering with on the Abundant Birth Project. 鈥淗owever well intentioned, these requirements often prevent black and Pacific Islander pregnant women from obtaining the resources they need鈥攁nd they tend to exacerbate mistrust in the system.鈥

The Abundant Birth Project, in contrast, provides direct, unconditional cash aid鈥攔eturning to women the power to make their own decisions.

Partners in the Abundant Birth Project, an Initiative of Expecting Justice
San Francisco Department of Public Health
The University of California, San Francisco
University of California, Berkeley
The Federal Reserve Bank of San Francisco
The San Francisco Human Rights Commission
The San Francisco Human Services Agency
The San Francisco Treasurer鈥檚 Office
First 5 San Francisco
The San Francisco Department of Children, Youth, and Families
San Francisco Unified School District
The Bayview YMCA
Office of the District 5 Supervisor
The National Health Law Program
Tipping Point Community

Pregnancy can simultaneously bring great joy and acute stress. Even for mothers with a steady partner, financial resources and robust social networks, this time can be overwhelming, even traumatic. Pregnant women without these assets are susceptible to mental and physical health threats鈥攁nd this is before a new person suddenly enters the picture, demanding food, attention and medical care.

The Abundant Birth Project won鈥檛 make everything right for the moms and babies it touches鈥攂ut it鈥檚 a start.

This story originally published on Early Learning Nation and is now archived on 蜜桃影视. Learn more here.

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