The birthweight effects of universal child benefits in pregnancy: quasi-experimental evidence from England and Wales

Over a decade ago, in April 2009, the UK Labour government introduced the Health in Pregnancy Grant (HPG), a cash transfer of the equivalent of child benefit over the third trimester (£190) as a lump sum to all pregnant women in the United Kingdom. As a labelled, universal and unconditional cash transfer with near-universal take-up, the HPG remains the only international example of paying the equivalent of child benefit during pregnancy to improve health outcomes at birth. The grant was designed to improve birthweight by helping mothers afford high-quality nutrition and reducing stress in the prenatal phase. In January 2011, the HPG was abolished by the Conservative-Liberal Democrat Coalition on grounds, in part, that it was a "gimmick" with little evidence of impact on birthweight. This CASEpaper quantitatively evaluates the impact of the HPG on birthweight in England and Wales. Using administrative birth registrations data, I implement a quasi-experimental regression discontinuity (RD) design based on an arbitrary eligibility rule for the HPG. I find that the HPG was responsible for an increase of 11g in birthweight on average and that effects were concentrated on the smallest babies. Increases in birthweight were largest for younger mothers aged 25 and under (29g average increase) and mothers living in areas with high levels of deprivation (20g average increase). While younger mothers experienced a reduction in the probability of low birthweight by 0.9 percentage points (12 percent in relative terms), low birthweight did not fall for the population as a whole. My findings suggest that paying the equivalent of universal child benefits in pregnancy as a labelled lump sum can disproportionately benefit disadvantaged groups such as younger mothers and lead to effect sizes that are larger than would be expected of more general windfall increases in income.