The prenatal period is a critical window for child development, where environmental conditions—such as income—can shape a child’s health, education, and well-being well into adulthood. Yet, despite growing international evidence supporting early financial support, cash payments during pregnancy remain uncommon in the United States.
A new policy brief, Starting Sooner: Should Cash Payments Begin During Pregnancy?, explores how investing in pregnancy through direct cash transfers can improve both birth outcomes and long-term child development. The report draws on global research to make the case for policy action that begins before birth.
Why Investing in Pregnancy Matters
Cash payments provided to pregnant individuals—such as nutritional support and income transfers—have been shown to produce causal impacts on outcomes from infancy through adulthood. These include:
- Healthier birth weights
- Lower rates of infant mortality
- Improved cognitive development
- Greater long-term earnings and well-being
The evidence affirms that pregnancy is a key period where environmental factors, including poverty and stress, can shape lifelong trajectories. Supporting families earlier can help reduce inequality and promote resilience from the very start.
A Global Standard—But Not in the U.S.
While cash payments during pregnancy are a common feature of family policy in many high-income countries, the United States stands out as an exception. The brief highlights how the lack of prenatal support reflects a missed opportunity for targeted policy that could deliver both immediate and generational returns.
About the Authors
Starting Sooner: Should Cash Payments Begin During Pregnancy? was co-authored by the Centre on Poverty and Social Policy at Columbia University, Barnard College, the Children’s Research and Education Institute, and the Learning for Well-being Institute.
