Postpartum Depression Risk Following Exposure to Universal and Unconditional Perinatal Cash Transfers

Purpose. Postpartum depression (PPD) disproportionately affects women experiencing socioeconomic hardship. We examined the association between exposure to Rx Kids, the nation’s first universal and unconditional perinatal cash transfer program, and PPD risk among mothers of one-month-old infants. Methods. This study used Edinburgh Postnatal Depression Scale (EPDS) data collected from electronic health records of 815 one-month well-child visits between 2022 and 2025, spanning two years before and after Rx Kids implementation. Difference-in-differences analyses compared changes in depression screening outcomes among mothers residing in Flint, Michigan, where Rx Kids was implemented, with changes among mothers residing outside Flint. Results. In the two years before Rx Kids, the prevalence of high risk PPD scores > 13 was 8.7% in Flint and 6.2% outside Flint; two years after, the prevalence was 3.3% in Flint and 10.4% outside Flint. Rx Kids exposure was associated with a 9.8-percentage-point reduction in high risk PPD scores (95% CI, -16.8 to -2.8, p = 0.006), reversing the preexisting geographic disparity. Reductions were also observed in moderate PPD risk and mean EPDS scores.Conclusions. Findings suggest that universal and unconditional perinatal cash support may be an effective upstream strategy for preventing PPD, improving maternal mental health, and reducing place-based disparities.