By now, there’s little question that a maternal health crisis is rocking the Black community. The data tells the story: Black moms are dying during childbirth at three times the rate of white moms, a disproportionately high percentage of Black children are born prematurely, and Black infants are about twice as likely to die as white infants in states like Louisiana.
But new data from a handful of pilot projects also suggests a potential solution that could significantly improve outcomes for Black mothers and their babies: cash payments, no strings attached.
Studies show the unrestricted money led to fewer preterm births, higher newborn birth weights, and fewer critical-care infant hospitalizations. It also reduced stress among new moms who would otherwise struggle to attend prenatal check-ups, pay for food and formula, or keep a roof over their heads.
“This makes so much sense to me,” says Tamara Mason, an official with the nonprofit March of Dimes who worked on an Atlanta project distributing money to low-income pregnant women. “Why isn’t everyone doing this?”
Sen. Cory Booker, a New Jersey Democrat, is among several sponsors of legislation that would provide direct financial aid to new mothers, similar to the expanded child tax credit in 2021. The credit sent monthly payments of up to $300 per child straight to most families’ bank accounts; experts credit it with lifting millions of children out of poverty.
When it expired, child poverty rose again.
“I believe that we need to, for moms, flood resources to them through things like the child tax credit,” Booker said during an August press briefing on the Black Maternal Health Momnibus Act. “We were able to cut child poverty virtually in half for our communities, and that actually does affect child outcomes.”
Those positive outcomes in part spurred the March of Dimes to launch trial programs providing universal basic income, or UBI, to pregnant women and new moms in two cities: Atlanta, which Bloomberg ranked as the most economically unequal large city in the country, and New Orleans, which March of Dimes gave an F grade.
No strings attached
In Atlanta, the Guaranteed Basic Income Program gave each participant $1,000 a month during pregnancy and her baby’s first year. Women most likely to live in poverty in that city are Black women of reproductive age; 25 pregnant women in two of the area’s highest-need ZIP codes received the cash.
March of Dimes ran the pilot through an Atlanta collective-impact partnership known as the collaborative. It is modeled on San Francisco’s Abundant Birth Project and, organizers say, rooted in an idea the Rev. Martin Luther King Jr. championed decades ago.
Funders Skeptical at First—Then All In
Mason said she spent months pitching foundations on the idea, which some considered outside her organization’s lane.
“I was honestly surprised that a couple of foundations,” Mason says. “Funders were like, ‘Why is March of Dimes in this space? You all are the birth defects people. You’re the preterm birth people.’”
The Community Foundation for Greater Atlanta signed on as the primary funder. The Liz Blake Giving Fund and the Jesse Parker Williams Foundation funded data gathering and evaluation Emory University conducted.
The nonprofit Center for Black Women’s Wellness handled recruitment, and more than 110 women applied for the 25 spots, Mason said. Applicants had to live in one of the two ZIP codes, earn no more than 200% of the federal poverty level, and be 12 to 28 weeks pregnant.
Cash, Diapers and a Network
Stipends were paid through a prepaid card, letting evaluators track spending without restricting it. Helping Mamas, a nonprofit focused on diaper insecurity, supplied 300 diapers and eight packs of wipes a month, plus a car seat and other essentials. The Georgia Black Doula Network encouraged, but didn’t require, participants to hire doulas.
Early results from Emory’s evaluation, as described by Mason, show a 20% decrease in financial stress and a 66% decrease in hopelessness, a figure she called striking. Prenatal outcomes trended better than average.
Mason was careful not to oversell what $1,000 a month can fix. Several participants lost housing; one or two dealt with domestic violence.
Even though GBI reduced financial stress, “it still is one piece of the puzzle,” Mason said.
New Orleans: Overcoming Crisis
March of Dimes runs a similar program in New Orleans, GBI Rx, offering pregnant patients in their first or second trimester $12,000, as a lump sum or $1,000 a month. Two partner medical clinics enroll patients for healthcare, and the payment card blocks cash withdrawals and spending on liquor and gambling.
In Louisiana, “we have a maternal and infant health crisis — specifically, a Black maternal and infant health crisis,” said Robin Gruenfeld, director of collective impact for March of Dimes in New Orleans. ”And it’s been that way for a long time.”
Black infants there died at about twice the rate of white infants from 2021 to 2023. Gruenfeld said Orleans Parish has the state’s lowest prenatal care utilization rate.
Gruenfeld said the program’s city seed money, federal pandemic relief funds, and foundation funding were “zeroed out” without notice. Most funds were later restored at a lower level, forcing organizers to scale down to 94 participants instead of the 100 planned. They also enrolled on a first-come, first-served basis.
Recipients spent lump sums on housing, cars and insurance. But spending priorities for the participants changed when the federal government stopped paying out SNAP food benefits during last fall’s federal shutdown.
“During that time, more than a quarter of the funds that we gave folks was going to groceries,” Gruenfeld said.
Several New Orleans city government officials are now weighing a program modeled on Michigan’s Rx Kids, which a study credits with nearly halving neonatal deaths in Flint, one of the poorest cities in the state.
“We are seeing policies pushed by the political will of predominantly Black women come into effect, and then also the backlash,” says Danielle Atkinson of Mothering Justice Action Fund, a nonprofit advocacy organization. “In Michigan, we have Rx Kids, which is extremely popular [and] the data on the impact is undeniable.”
But recent changes are endangering the success of such programs, particularly amid President Donald Trump’s hostility towards programs focused on diversity, equity and inclusion.
“We’re getting this pushback around identifying race and parental status as systemic areas of oppression,” Atkinson says. It remains to be seen, she says, “whether or not we are going to be able to prevail with the political power and the popular will of these issues, or the rhetoric and the history of racism in our country.”
Washington Looks Elsewhere
That includes the Republican-controlled Congress, which has shown little appetite for cash aid tied to pregnancy.
The Black Maternal Health Momnibus Act, which Booker reintroduced along with Democratic Reps. Lauren Underwood of Illinois and Alma Adams of North Carolina, bundles 14 bills on housing, nutrition, WIC and the perinatal workforce, but not direct cash.
Still, signs suggest the issue — providing cash aid to low-income mothers and their babies — may stay on the front burner as the midterm elections approach in November.
This month, former Vice President Kamala Harris and Michigan Senate nominee Abdul El-Sayed, both Democrats, hosted a Black maternal health roundtable in Detroit. Danielle Atkinson of Mothering Justice took part.
“Black mamas deserve access to quality healthcare that sees us, listens to us, and understands us at every step of the way,” Atkinson said afterward. “The responsibilities we carry do not end at pregnancy, nor do they disappear when we give birth and want to spend time with our newborn. They stay with us throughout all that we experience.”
