Associations Between Unconditional Cash Transfers and Postpartum Outcomes in the United States : A Systematic Review

Area of Science:

• Public Health
• Health Services Research
• Maternal and Child Health

Background:

• Unconditional cash transfers (UCTs) and direct cash transfers (DCTs) are social program strategies that may mitigate factors contributing to pregnancy-related health issues.
• Evidence on the impact of UCTs on postpartum outcomes in the U.S. requires comprehensive summarization.

Purpose of the Study:

• To systematically review and synthesize existing evidence on the effects of unconditional cash transfers (UCTs) on postpartum outcomes within the United States.

Main Methods:

• Searched major databases (PubMed, Embase, Web of Science, SSRN) and performed internet searches up to January 2025.
• Included primary research on UCTs and postpartum outcomes (0-2 years post-delivery) in the U.S.
• Assessed study quality using Cochrane Risk of Bias 2 and ROBINS-I, and strength of evidence (SOE) with GRADE.

Main Results:

• Analyzed 11 reports from 6 studies (4 quasi-experimental, 2 RCTs).
• Found high SOE for increased breastfeeding with UCTs (2 RCTs, 2 QE studies).
• Found high SOE for little or no difference in postpartum mood (1 RCT, 2 QE studies); low SOE or insufficient evidence for other outcomes.

Conclusions:

• UCTs effectively increase breastfeeding across diverse populations and settings.
• UCTs demonstrate minimal impact on postpartum mood, particularly in low-income populations.
• Further research is crucial to understand UCT associations with critical maternal health outcomes like morbidity and mortality.