Moving Upstream: Perinatal Cash Transfers as a Tool to Address Inequities in Birth Outcomes

The United States has an exceptionally high preterm birth rate, which features inequities that impact many Black, Indigenous, and Pacific Islander families. Unconditional perinatal cash transfers, which offer cash assistance to pregnant and postpartum women with no strings attached, are a promising tool to address disparate birth outcomes. Canada and the United States both have an emerging evidence base that supports the impact of perinatal cash transfers on birth outcomes for all groups, but especially for those who are from under-resourced communities. We review the evidence supporting the use of perinatal cash transfers in Canada and the United States, discuss the distinct advantages of perinatal cash transfers, and highlight examples of growing momentum and support for this type of intervention. Although there are still challenges to their widespread expansion and adoption, we argue that perinatal cash transfers should be included as an essential tool in the US public health toolbox to advance health and financial equity while optimizing dignity, autonomy, and flexibility for families in a changing policy landscape.