The heterogeneous associations of universal cash-payouts with breastfeeding initiation and continuation.

Existing health literature documents the benefits of breastfeeding for the first six months of life. Prior research on barriers to breastfeeding has focused on the role of hospital initiatives, return to work, and individual mothers' characteristics. This study uses data from Alaska's Pregnancy Risk Assessment Monitoring System and the Alaska Permanent Fund Dividend, to investigate whether universal income support shapes mothers' breastfeeding behaviors. We find that payouts are associated with increases in breastfeeding initiation and short-term continuation (three months) among a sample of urban Alaskan mothers. These associations differ across mothers' socioeconomic and demographic characteristics (i.e., education, economic status, race, marital status). We contend that this type of income intervention may complement existing efforts to promote breastfeeding by removing financial barriers to breastfeeding.

Pregnancy intentions' relationship with infant, pregnancy, maternal, and early childhood outcomes: Evidence from births in Alaska, Missouri, and Oklahoma.

OBJECTIVES: Much of reproductive health care policy in the United States focuses on enabling women to have intended pregnancies. Investigating whether the association between pregnancy intention and adverse outcomes for mothers and children in the immediate and longer term is due to intention or a mother's demographics provides valuable context for policy makers aiming to improve maternal and child outcomes. METHODS: We investigated relationships between pregnancy intention and pregnancy, infant, early childhood, and maternal outcomes using data from the Pregnancy Risk Assessment Monitoring System survey, conducted 2-8 months after the child's birth, and follow-up surveys from three states (Alaska, Missouri, and Oklahoma), administered at age 2-3 years old. We used logistic regressions with inverse propensity weights to measure associations, accounting for potential confounding factors. RESULTS: After inverse propensity weighting, pregnancy intention was associated with adverse maternal pregnancy behaviors but not most infant outcomes. Mothers who reported an unwanted pregnancy were associated with increased odds of the child receiving a developmental delay diagnosis. Among those who did not report depression prior to pregnancy, mothers with unwanted pregnancies were more likely to experience persistent depression, and mothers with pregnancies mistimed by two or more years had a higher likelihood of experiencing depression postpartum or in the follow up period. CONCLUSIONS: Our findings suggest that pregnancy intention is less consequential for maternal and child well-being than socio-economic disadvantage, suggesting that re-orienting policy toward social conditions and reproductive autonomy will serve better individual and population health.