Modern H/HS Policy

Pregnancy and Poverty: Forging a Path Forward for Families

By Madison Doser    September 26, 2022


Pregnancy, even in the 21st century, is an incredibly burdensome undertaking. Childbearing people experiencing poverty must take on additional expenses to bring about the healthy birth of a child, including medications, doctor visits, and proper nutrition. Pregnancy can, then, force poverty or deepen conditions of poverty on expectant parents who are underprepared or lack the necessary support to afford the costs associated with having children. Children raised in poverty experience worsened health outcomes, both physical and mental that they carry into adulthood. Poverty, which causes 4.5 percent of annual U.S. deaths, harms childbirth, childhood development, and educational opportunities, necessitating changes in the social structures contributing to maternal and childhood poverty.

Pregnancy Exacerbates Impoverished Conditions

Childbearing populations experiencing poverty during pregnancy are at risk of multiple health issues. Malnutrition during pregnancy has the potential to lead to later health disparities in children, such as obesity, diabetes, and heart disease. Furthermore, mothers experiencing poverty tend to have a diet lacking fruits and vegetables, which provide necessary micronutrients for fetal development. Deficiencies in their intake are linked to neural tube defects in children. Childbearing people living in poverty also tend to experience increased levels of stress as a result of inconsistent income, reliance on government programs, housing, food insecurity, and worries about paying bills. Increased stress leads to increased levels of cortisol which triggers the fight or flight response. Those experiencing higher cortisol levels consistently can trigger pre-term birth, which is correlated with low birth weight. High cortisol levels can also damage a fetus’ cortisol-regulation system, making them more vulnerable to toxic stress behaviors later in life.

Children from infancy to adolescence will also experience numerous effects of poverty during pregnancy and early life. Early exposure to poverty can contribute to health disparities with long-lasting impacts. Behavioral issues are strongly associated with maternal poverty, as are delayed cognitive development and poor school performance. Considering the impact that education has on future employment prospects, delayed cognitive development leading to poor educational attainment contributes to continued poverty after childhood and continues the cycle of generational poverty.

Importance of Addressing Maternal and Childhood Poverty

Today, poverty affects more than 1 in 5 children and is a reinforcing factor in the accumulation of Adverse Childhood Experiences (ACEs). Exposure to childhood adversity leads to increased stress levels that behave as toxins in the developing child’s brain. In the absence of protective factors against toxic stress, which are common in households experiencing impoverished conditions, toxic stress may alter “a child’s neural architecture and result in emotional disorders and cognitive deficits.” Chronic exposure to stress hormones can also affect energy metabolism. The importance of addressing childhood poverty cannot be understated as living without essentials during pivotal developmental periods can cause irreparable damage in both the long and short term.

Poverty is heavily correlated with increased rates of unintended or teenage pregnancies and being a single mother. Considering the significant cost of giving birth—an average of nearly $11,000 for a vaginal birth and $20,000 for a cesarean section, not including prenatal or postnatal care—it is not surprising that pregnancy contributes to the cycle of poverty. As abortion access is uncertain in multiple states, following the overturn of Roe v. Wade (1973) and Planned Parenthood of Southeastern Pennsylvania v. Casey (1992), women experiencing unintended or teenage pregnancies will more often have to bear the costs associated with pregnancy, further exacerbating the risks to maternal health, nutrition, mental health, and fetal development, among others.

Families that feel incapable of raising a child in poverty may put their child up for adoption, or the child may be forced into the foster care system due to the inability of the parents to provide proper care or supervision. On any given day, there are nearly 424,000 children in the foster care system in the United States, and in 2019 over 672,000 children spent time in the foster care system. In 2019, over 20,000 children aged out of the foster care system without finding any form of permanency. Because approximately one-third of children entering the foster care system are children of color, the impacts of childhood poverty disproportionately affect people of color, making them more likely to experience homelessness, unemployment, and incarceration as adults. The issue is also not strictly present in the U.S. foster care system. Adoption rates following the COVID-19 pandemic are decreasing, leaving more children without families and without proper support to develop life skills necessary for future success. Adoption or foster care is not an adequate solution for families experiencing poverty, necessitating a reevaluation of social supports currently in place.

Current Barriers to Alleviating Poverty

The United States is one of the only industrialized countries without mandatory paid maternity leave. Furthermore, the United States ranks number 33 out of 38 in infant mortality amongst other Organization for Economic Co-operation and Development (OECD) countries. Childbearing populations in low-wage jobs tend to lack the schedule flexibility for health care and are not offered paid sick or maternity leave. Without these options, families experiencing poverty lack the ability to spend time with newborn children to develop close familial relationships pivotal to childhood development, cannot afford medical care and are forced to seek out child care. On average, child care costs approximately $20,000 or more annually per child, depending on region and time spent in care. Child care costs are an extreme economic burden for families or completely unattainable for parents who work nontraditional or overnight shifts. Oftentimes, families must decide between paying for necessary child care, rent, food, or medical costs. Without the support of paid leave or affordable child care, families experiencing poverty face extreme barriers in raising children.

Policy Recommendations

Implementing mandatory paid maternity and paternity leave in the United States is necessary to help alleviate the burdens of childbirth on families experiencing poverty. When parents are granted the ability to leave their jobs to raise their newborn child in the early points of their development, with guaranteed job security, a significant stressor is lifted. Many people cannot afford to take unpaid leave after the birth of a child, and approximately 44 percent of people do not qualify for benefits through the Family and Medical Leave Act (FMLA) because it excludes part-time employees and small businesses. Paid parental leave contributes to reduced financial stress, increased parental bonding time with newborn children, and an increase in gender equality as fathers are granted opportunities to take on parental duties. Maternity leave also contributes to better health for women, and research shows a 51 percent decrease in the risk of maternal rehospitalization following childbirth. Paid parental leave is necessary for all workers to positively impact childhood development and reduce risk of job loss or financial insecurity.

Once families must return to work, they face the insurmountable costs of child care. Expanding access to affordable child care for families in need would provide them with the opportunity to return to a consistent work schedule and afford other basic life necessities. For families living in poverty, child care can cost upwards of 52 percent of their annual wage. With much of a family’s household income being dedicated to child care, they are left with difficult decisions to make regarding their spending and must sacrifice medical care, food, rent, or utility bill payments as a result. Furthermore, children being exposed to substandard and unregulated child care may face developmental issues and other deleterious effects. Other effects include lost productivity for employers as a result of parents missing work to handle gaps in child care, loss of retirement benefits for parents, and loss of extra income to promote college savings or other forms of educational attainment. The egregious prices of child care and their effects on families experiencing poverty require the implementation of universal child care to both remove the financial burden and allow families to have consistent care for their children to ensure that they can work steady hours to afford other basic necessities and establish financial security.

Overall, maternal and childhood poverty can have major impacts on childhood development and lead to various health and wellness issues. Poverty harms mental and physical health, educational attainment, job opportunities, can lead to abuse and neglect, and increase parental incarceration rates. Families experiencing poverty require social support in order to provide an adequate lifestyle for their children and adequately provide for themselves. Provision of universal child care and paid family leave are necessary stepping stones to help alleviate the burden that poverty presents to new and existing families as well as the economic mobility and well-being of all communities across the nation.

About the Author

Madison Doser (full bio)

Policy Intern for Child Welfare and Family Well-Being
American Public Human Services Association


Pregnancy and Poverty: The Impacts of Bringing Life into an Under-resourced System

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