Estimating the Effect of a Universal Cash Transfer on Birth Outcomes

By: Kiara Wyndham-Douds, and Sarah K. Cowan

Published in: American Sociological Review 89 (5), 789-819

Babies in the United States fare worse than their peers in other high-income countries, and their well-being is starkly unequal along socioeconomic and racialized lines. Newborn health predicts adult well-being, making these inequalities consequential. Policymakers and scholars seeking to improve newborn health and reduce inequality have recently looked to direct cash transfers as a viable intervention. We examine the only unconditional cash transfer in the United States, the Alaska Permanent Fund Dividend (PFD), to learn if giving pregnant people money improves their newborns’ health. Alaska has paid its residents a significant dividend annually since 1982. The dividend’s size varies yearly and is exogenous to Alaskans and the local economy, permitting us to make causal claims. After accounting for fertility selection, we find that receiving cash during pregnancy has no meaningful effect on newborn health. Current theory focuses on purchasing power and status mechanisms to delineate how money translates into health. It cannot illuminate this null finding. This case illustrates a weakness with current theory: it does not provide clear expectations for interventions. We propose four components that must be considered in tandem to predict whether proposed interventions will work.

Do Pregnancy Intentions Matter? Revisiting Relationships With Pregnancy, Birth, and Maternal Outcomes

By: Nicholas Mark, & Sarah K. Cowan

Published in: Demography (2022) 59 (1): 37–49.

Preventing unplanned or unintended pregnancies continues to be a cornerstone of American reproductive health policy and infrastructure, but the evidence that these pregnancies cause adverse maternal and child outcomes is limited. We test these relationships on recent large-scale data using inverse propensity weights estimated from generalized boosted models. Consistent with prior research, we find that pregnancy timing is related to maternal experience during pregnancy, but not to infant outcomes at birth. In an addition to the literature, we find evidence that pregnancy timing is relevant for a number of maternal outcomes, such as the onset of depression and intimate partner violence, changes in smoking behavior, and receipt of medical care. These findings suggest that policy intended to improve infant welfare by preventing unintended pregnancies has little empirical support, but that policy focused on increasing reproductive autonomy and maternal well-being has the potential to improve outcomes.