Four Philly moms explain how cash for expecting parents could be transformative in America’s poorest big city

Buy diapers or pay the bills?

Spend money you don’t have for a babysitter so you can attend a job interview, or grind on at a job that barely pays enough?

New and expecting parents struggling financially face impossible choices. Money worries even play a role in whether a baby thrives or dies, since mental wellbeing affects infant mortality. Philly, the poorest big city in the nation, has the highest rate of infant mortality among America’s 10 largest cities, according to the Philadelphia Department of Public Health.

It’s a crisis the department now wants to address through a $6 million pilot program called the Philly Joy Bank that aims to give cash to pregnant people, no strings attached. The city is contributing $750,000 over three years, but the program will largely depend on grant funding, including about $3 million recently committed by the William Penn Foundation and Spring Point Partners.

By next year, city officials and partners from the Philadelphia Community Action Network expect to give 250 pregnant women $1,000 a month for 18 months, covering part of their pregnancy and the first year of their child’s life.

The Joy Bank will benefit parents in Strawberry Mansion, Cobbs Creek, and Nicetown-Tioga. Those neighborhoods were chosen because they have the city’s highest rates of very low birth weight, an indicator of premature births, said Stacey Kallem, director of the health department’s division of maternal, child, and family health.

The income limit for participation in the pilot program is $100,000, Kallem said, but she anticipated the people most likely to participate will earn much less than that. The average annual household income in the program’s target neighborhoods ranges from $20,000 to $30,000, she said.

They’re also majority Black communities and the city wants to use this program to address racial disparities in birth outcomes. Black babies die four times more frequently than white babies, a grim reality rooted in social inequities and racism.

“There’s not a biological reason why a Black woman is more likely to have a baby die,” Kallem said.

» READ MORE: New moms keep dying in the weeks after birth, and the risk remains highest among Black women

Stipends for pregnant parents have shown results elsewhere. A Mississippi program that gave Black mothers $1,000 a month for a year found participants were better able to afford basic needs, could be more supportive of their children, and felt more hopeful about their family’s future. If the Philadelphia pilot has a demonstrable affect on babies’ health, Kallem said, it could spur policy changes to give new parents more financial stability. Changes could include distributing the earned income tax credit in monthly payments, rather than one lump sum, Kallem said, or loosening restrictions around some forms of public assistance that currently prevent funds from being used as guaranteed income.

Below, four mothers whose incomes would make them eligible for the Joy Bank stipend describe how $1,000 a month would’ve made all the difference in their birthing stories.

I have a 16-year-old, an 11-year-old, a six-year-old, and a one-year-old. Everybody’s five years apart and it’s busy in my house.

My youngest son was three months early from stress factors that I was dealing with. He was only four pounds, 4.4 ounces.

With my 11 year old, there was no maternity leave. I tried to apply for workman’s comp, I tried to apply for unemployment, and the job … denied my unemployment, they denied my workman’s comp. I wound up having to do little side jobs … but it wasn’t enough. I wound up getting evicted.

So first, $1,000 a month would have definitely helped me out a whole lot. I wouldn’t have had to worry as much about the bills. It would have been extra for me to be able to buy clothes for the baby and make sure that I have diapers so I don’t have to go steal them from the store. I was able to go back to work but it was a very, very traumatic experience.

So when I found out I was pregnant, I started doing my own research and saw the statistics around Black maternal mortality and morbidity. I heard and read about Beyonce and Serena [Williams], and I was shocked because they were celebrities and they could afford the care they needed. And I was surprised to learn that they both almost died in childbirth.

When I was about maybe 30-something weeks, I decided to interview midwives.

» READ MORE: Philadelphia to pilot a guaranteed income program to reduce rates of infant mortality

My doula wasn’t covered by insurance at all. But I guess because my midwife has an NPI code and she said, because I have that, you know, insurance will reimburse you, but my doula did not have that. So for the home birth insurance only covered half. For me, out of pocket, $2,600.

$1,000 would have definitely helped to pay for the home birth.

That $1,000 would have gave me a lot of security through a toxic situation I was going through when I lived with Aila’s father.

I was going through a lot of anxiety and stress, especially with the toxic situation that was happening in the relationship.

I would have been saving up when I was pregnant with that $1,000 a month. I would have left and got my apartment and moved on with my life.

This is emotional for me because when my daughter was born, I was doing everything for her. It transformed me because I didn’t have no choice but to be the best mother that I wanted to be. I had to step up.

$1,000 a month is everything to a mother. A true mother, a real mother, that really cares about their child and their wellbeing, would spend that money wisely.

[About a year after her daughter was born, Ferguson did move out on her own, and two years later still lives alone.]

I have two [kids]. My youngest is 25 months.

When I became pregnant, I knew that I wanted additional support other than just my partner. I learned so much, that a doula is way more than just support. They’re a great resource of information. And they are someone that could speak up for me in a vulnerable situation such as birth.

Health insurance doesn’t really cover doulas. And if they do, they went through hell and high water to be covered by insurance.

After having my second child, I knew I needed a therapist. But finding a therapist that would take my state insurance was very far and few in between. I feel like having that resource, I would have been able to pay for one out of out of pocket.