Economic insecurity during pregnancy is a critical social determinant of maternal and infant health, and traditional public assistance programs often fail to meet the needs of marginalized communities, particularly Black and Pacific Islander pregnant women and people.
The California Abundant Birth Project (ABP), an initiative of Heluna Health partner, Expecting Justice, was founded with the mission to change that.
Their San Francisco pilot was the first guaranteed income program in the U.S. designed specifically to address economic insecurity during pregnancy, with the goal of disrupting birth inequities. Now, a new study in BMC Public Health offers compelling evidence that it’s earning the trust of the communities it serves.
Through the pilot program, ABP provided $1,000 per month, no strings attached, for up to 14 months to 151 Black and Pacific Islander (Pasifika) pregnant individuals in San Francisco between 2021 and 2024. Of that 151, 120 (79.5%) consented to participating in the evaluation study, assessing their satisfaction with the program and. Nearly all participants, 95.7%, reported that they were very satisfied with the program and felt respected by ABP staff. A strong majority, 77.5%, trust ABP to act in their best interest, compared to just 9% who said the same about government programs.
That gap in trust points to something deeper than satisfaction scores. Participants trust ABP because of its community-centered approach and genuine care for them. The program’s emphasis on dignity, responsiveness, and cultural alignment helped participants feel seen and supported, and challenged dominant narratives about who deserves support and under what conditions. Rather than placing burdens of proof or compliance on participants, ABP extends trust from the start. And the data shows that trust is returned. As one participant shares, “It feels so good to be supported. [ABP has] done a lot to make sure that we’re cared about in a non-invasive way. I’ve felt a lot more connected to my experience as a Black mom.”
That unconditional support makes a tangible difference. When cash comes without conditions, mothers and pregnant people can use it for what they need, whether that’s baby supplies, groceries, or rent, but also for the kind of stability that opens longer-term doors. Participants have used ABP funds to go back to school, pursue new job opportunities, and build toward a more secure future for their families. As one participant put it, “There’s going to be a next phase in my life. So, [ABP] is definitely a stepping stool. My plans are just to continue to work towards my [career and educational] goals that the Abundant Birth Project has helped me feel closer to.”
To date, ABP has distributed 11.8M in no-strings-attached assistance, served 1,013 pregnant people, and supported 720 births. Heluna Health is proud to serve as a partner supporting the Abundant Birth Project and the important work it represents. We believe that lasting health equity requires approaches built with communities, not just for them. We congratulate the ABP team, their research partners, and every participant who contributed to this groundbreaking work, and we look forward to seeing its impact continue to grow.
Click here to read the full study.
