State Policies to Promote Equity in Healthy Perinatal Outcomes: A Summary of the Evidence 

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Barriers to health care, high-quality health insurance, and parental leave work together to leave families and children vulnerable during the perinatal period. These barriers can shape life-long outcomes, particularly for children from historically marginalized groups. Most adverse perinatal health outcomes disproportionately affect families of color. For women in these families, systemic racism, combined with discrimination within health care delivery systems, drives poorer quality prenatal care and adverse birth outcomes.  

Rigorous research highlights the potential for state policy as an effective tool for reducing disparities in access to prenatal care services and healthy perinatal birth outcomes. The Prenatal-to-3 State Policy Roadmap identifies 12 effective policies that improve outcomes for children and their families during pregnancy and early childhood. Three of these evidence-based policies—expanded income eligibility for Medicaid, higher state minimum wages, and refundable state earned income tax credits—promote birth equity across different racial and ethnic groups. 

©May 2024, Prenatal-to-3 Policy Impact Center, All Rights Reserved. The Prenatal-to-3 Policy Impact Center at Peabody College of Education and Human Development, Vanderbilt University aims to accelerate states’ implementation of evidence-based policies that help all children thrive from the start.

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 Paid family and medical leave (PFML) is one of 12 evidence-based policies in our 2024 Prenatal-to-3 State Policy Roadmap, which details states’ progress toward adopting and implementing policies that effectively improve child and family wellbeing.
Community-based doulas are trained social service professionals who provide non-clinical emotional, physical, and informational support to expectant parents, starting during pregnancy and continuing throughout the postpartum period. Community-based doulas are one of 12 evidence-based policies
 A refundable state earned income tax credit (EITC) of at least 10 percent of the federal credit is one of 12 prenatal-to-3 policies included in our 2024 Prenatal-to-3 State Policy Roadmap, which details states’ progress