“No strings” prenatal income support improves birth outcomes

August 1, 2016

A study among low-income women receiving prenatal income support in the Canadian province of Manitoba found that this unique benefit-provided with no conditions-results in positive birth outcomes.

A study among low-income women receiving prenatal income support in the Canadian province of Manitoba found that this unique benefit-provided with no conditions-results in positive birth outcomes.

Investigators compared birth outcomes for infants of low-income women receiving welfare who were given the Healthy Baby Prenatal Benefit (HBPB) and those who were not given HBPB. The 14,591 study participants, like all pregnant women under Canada’s universal healthcare system, also received free prenatal care. The HBPB monthly payments of up to $81.41 Canadian were accompanied by pamphlets about the importance of good prenatal nutrition and information about breastfeeding and healthy infant development. However, recipients were free to spend the money as they wished.

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Receiving the HBPB was associated with reductions in low birth weight and preterm and small-for-gestational-age births. The HBPBs also were tied to increases in initiation of breastfeeding and large-for-gestational-age births, but not with 5-minute Apgar scores or neonatal hospital readmissions. For infants born vaginally, receiving the HBPB also was associated with shorter hospital stays (Brownell MD et al. Pediatrics. 2016;137[6]:e20152992).

Commentary: In US dollars, these payments were as much as about $63 per expectant mother per month. The savings associated with the changes noted by the researchers must certainly far exceed this cost. What is most interesting is that the payments were given with health information but without any associated responsibility or requirement, a benefit that required no enforcement or policing. This sounds like a winning proposition. -Michael G Burke, MD

Ms Freedman is a freelance medical editor and writer in New Jersey. Dr Burke, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.