Abstract: Fostering Joy: Pathways from Guaranteed Income to Improved Perinatal Mental Health (Society for Social Work and Research 29th Annual Conference)

Schedule:

Thursday, January 16, 2025

Ballard, Level 3 (Sheraton Grand Seattle)

* noted as presenting author

Anu Manchikanti Gomez, PhD, Associate Professor, University of California, Berkeley, Berkeley, CA

Stephanie Arteaga, MPH, Project Director, University of California, Berkeley, CA

Erin Hubbard, MPH, Senior Research Coordinator, University of California, Berkeley, Berkeley, CA

Monica De La Cruz, MPH, Doctoral Candidate, University of California, Berkeley, CA

Sabra Bell, Community Researcher, University of California, Berkeley, CA

Maile Chand, BA, Community Researcher, University of California, Berkeley, CA

Anjeanette Coats, Community Researcher, University of California, Berkeley, CA

Breezy Powell, Community Researcher, University of California, Berkeley, CA

Tiffany Sagote, Community Researcher, University of California, Berkeley, CA

Aresha Auzenne, Community Researcher, University of California, Davis, CA

Troy Roberts, Senior Abundance Coach, Expecting Justice, CA

Michaela Taylor, MPH, Senior Program Manager, Expecting Justice, San Francisco, CA

Zea Malawa, MD, MPH, Physician Director, Expecting Justice, CA

Deborah Karasek, PhD, MPH, Assistant Professor, Oregon Health Sciences University, Portland, OR

Brittany Chambers, PhD, MPH, Assistant Professor, University of California, Davis, CA

Background: Economic volatility is common during pregnancy and can worsen perinatal mental health through material deprivation, acute worry, and anticipatory stress. These outcomes are intensified by structural racism, which is a driver of economic insecurity and also impacts birth outcomes. This qualitative study explores how unconditional income supplementation during pregnancy may affect perinatal mental health, drawing on data from the evaluation of the Abundant Birth Project (ABP) San Francisco Pilot, the first guaranteed income program for pregnant people in the U.S. ABP provided $1000 monthly income supplements during and after pregnancy and optional individualized coaching and linkage to resources.

Methods: We interviewed 40 Black- and Pacific Islander-identified women during the third trimester of pregnancy in 2022-23. Half received income supplements through ABP, while 20 were control group participants from neighboring counties that did not receive supplements. We utilized an innovative collaborative reflexive thematic analytic approach to explore the impact of ABP. The analytic team, including investigators, research staff, and community researchers, met regularly for joint coding sessions in which smaller groups collectively open-coded transcripts while listening to interview audio. This collaborative approach facilitated the representation of multiple, diverse perspectives throughout the analysis process.

Results: Preliminary analyses highlight the self-defined joys of pregnancy, including increased social connections, excitement about the new baby, and increased intentionality about self-care. Yet across both groups, participants faced limitations in actualizing joy due to structural factors like financial and housing insecurity, which increased stress and negatively impacted their mental health. Many described having to work later in their pregnancies than desired to make ends meet and scrambling to find stable housing before their new baby arrived. Importantly, ABP recipients described how the extra monthly income decreased their stress and anxiety and increased their peace of mind, allowing them to work less and spend more time doing the things that brought them joy. The income supplements permitted recipients to spend more time with their families, foster their mental and physical well-being through increased exercise and rest, and mentally and materially prepare for their baby’s arrival. Recipients noted increased ability to practice self care in the form of accessing personal care services, like getting prenatal massages, and to care for their families by participating in recreational activities outside of the home. Recipients also described increased ability to choose what they purchased for their families, like better-quality foods and toys, as a source of joy. Lastly, recipients described increased access to supportive resources through assistance from program coaches.

Conclusions: Unconditional income supplementation during pregnancy may improve perinatal mental health via pathways of increased joy and reduced stress, making it a promising intervention for promoting birth equity in the United States. Future research should explore whether impacts continue into the postpartum period, as well as the potential to expand unconditional income supplementation as an evidence-based perinatal health intervention.