Exploring heterogeneous effects of the Health in Pregnancy Grant on birth outcomes and maternal mental health

Early life experiences play a critical role in shaping long-term health and socio-economic outcomes. The period of pregnancy and early childhood is a time of rapid development, where factors such as nutrition, stress, and socio-economic conditions can have lasting effects on a child’s well-being. Providing adequate support during this critical window can improve health, cognitive development, and future life chances. Recognising the importance of early life, many governments have implemented cash transfer programs (such as child benefits) to offer financial support to families during the postnatal period and throughout childhood. These programmes aim to reduce child poverty, improve health and development outcomes, and strengthen household financial stability. However, cash transfers during pregnancy remain less common, despite their potential to influence child development at an even earlier and potentially more impactful stage. As a result, there is limited evidence on the effects of providing cash support during pregnancy.

The United Kingdom has previously run a cash transfer programme for pregnant women called the Health in Pregnancy Grant (HPG). Introduced in 2009, the grant aimed to improve the health of pregnant women and their babies. It was a one-off payment of £190 (equal to £302 in April 2025), available to all pregnant women with an expected due date on or after 6 April 2009 [1]. To receive the grant, women needed to attend an antenatal appointment after the 25th week of pregnancy. The programme was discontinued due to concern about value for money, ending for women reaching their 25th week of pregnancy on or after 1 January 2011 [2].

Previous research has examined whether the HPG led to improvements in infant health outcomes such as birthweight, length of pregnancy, and risk of premature birth, which are key indicators of a baby’s early health. One study using Scottish data found that when the HPG was available, pregnant women booked their first antenatal appointment earlier on average, and the odds of booking before 25 weeks gestation increased by 10% [3]. It found no statistically significant effect on birthweight. A national study of England found that HPG increased birthweight by 8-12 grams on average, reduced low birth weight (<2,500g) by 3-6 percent, and decreased prematurity by 9-11 percent [4]. However, because those studies relied on administrative data like hospital and birth records, they had limited ways of exploring how the grant may have influenced behaviour during pregnancy or which groups of women benefitted the most. As a result, there is limited understanding of the pathways through which cash support during pregnancy might affect outcomes, and which women benefit the most. This study proposes to use data from the Born in Bradford survey to explore whether the HPG had a positive effect on maternal mental wellbeing, and whether the HPG had a more beneficial effect on outcomes for cohort members in lower-income households. The timing of the grant means that it was only available to women in the second half of the Born in Bradford cohort. This allows us to use statistical methods to compare outcomes between women who were eligible for the grant and those who were not. We will examine whether receiving the grant had a positive effect on mental wellbeing during pregnancy, using information collected directly from participants at the time. We will also explore whether the grant had a greater impact on mental wellbeing or birthweight for women living in lower-income households, by drawing on data about household income and benefits.