California: Healthy Babies, Healthy Mothers
In California, low-income women who are pregnant for the first time can't receive federal TANF assistance—known as CalWORKs—until they are in their third trimester. When CalWORKs began twenty-five years ago, there was a strong state General Assistance (GA) program to help very poor, childless pregnant women during their first two trimesters until TANF kicked in. But as in most states in the country, California's GA program has deteriorated significantly, so that now many pregnant women face the prospect of zero income during their second trimester.
We now know from research just how important the second trimester is in terms of fetal development, and that proper care at this stage can prevent preterm births and future developmental disabilities—both of which are expensive. In fact, according to the Institute of Medicine and March of Dimes, the average first-year medical costs—including inpatient and outpatient care—are about ten times greater for preterm infants ($32,325) than for term infants ($3,325).