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Having a child and early childhood for low-income families

I wish I had [support] when I was pregnant, in order to understand what all the programs mean. I still don’t know all the things that are available to me.

— Mom

Where we are

For parents of all income levels, carrying and delivering a child is one of the most significant experiences of their life — but the stresses and burdens are greater for low-income families.

Many eligible low-income families are not enrolled in the combination of supports that exist to help them thrive after a baby is born. Too often, the difficulty of knowing what programs exist and navigating siloed, complicated application processes results in critical benefits (such as health care, food, affordable childcare, and early childhood programs) not reaching the families who need them most.

 

1 in 3 births in the U.S. were on covered by Medicaid in 2020. 42 percent of these were covered by Medicaid.1

1 Source: National Center for Health Statistics

Challenge
How might we help families of young children become more aware of existing programs and improve access to supports for eligible people?


Our approach

To start, we listened to people’s stories.

The Life Experience research team spoke with people nationwide about this moment in their lives and where the government process could have been simpler and more helpful. The listening sessions captured honest conversations about peoples' experiences, candid feedback on what could have worked better, and what really made a difference for them. Their stories have been combined and are represented here through illustrations. The quotes are real, but names have been changed.


Kailee
Looking for employment and childcare
Single mom
First-time parent

Rosa
Health Home Aid
Mother of two
Spanish speaking

Haleemah
On-leave from work
Mother of two
Has childbirth health complications
Moves to a new state


Kailee
Looking for employment
Single mom
First-time parent
Pregnancy and birth:
Kailee receives pamphlets about benefits programs during a doctor’s visit but finds the information overwhelming. On top of this, her doctor is dismissive of her needs.
Post-partum: After giving birth, Kailee receives a substantial medical bill. Distressed, she asks her church for advice. Her pastor informs her that she's likely eligible for Medicaid, WIC, and SNAP. To apply, she must travel to offices on separate sides of town. With no means of personal transportation, she has to take two buses. This process takes her all day, losing a day of work, and the cost cuts into her weekly grocery budget.
Early childhood: As Kailee waits for benefits to kick in, she struggles to cover the cost of baby essentials.
“I was depleted in funds and I'm losing my mind like 'I can't buy diapers. I can't get any formula.'”
Pain Point
Lack of access to physical resources
The process of applying for benefits is time-consuming and complicated. The burdensome process can disadvantage families balancing needs, including getting essential supplies.

Rosa
Health Home Aid
Mother of two
Spanish speaking
Pregnancy and birth:
In the delivery room, Rosa is never asked if she wants a professional interpreter, limiting her ability to express her needs to the care team. After delivering her baby, she signs paperwork she does not understand.
Post-partum: After giving birth, Rosa wants to return to work full-time. She knows about support programs but assumes she will have to repay the government for any benefits she receives, so she decides to reduce her hours instead and rely on her neighbors for help.
Early childhood: When her baby turns one, Rosa receives an application to renew her Medicaid. The application is in Spanish, but it is too difficult for her to understand. Unsure of what to do next, Rosa gives up.
“Not all the questions were clear enough. You can make mistakes, and they don’t tell you ‘there’s a mistake in your form, please correct this question', or 'if you have questions, contact us' [until the application has been processed].”
Pain Point
Barriers to apply
The process of applying for benefits is time-consuming and complicated, making it unclear if the costs of applying are outweighed by what it's worth.

Haleemah
On-leave from work
Mother of two
Has childbirth health complications
Moves to a new state
Pregnancy and birth:
Haleemah experiences health complications after giving birth. Fortunately, she has short-term disability coverage through her job and had to move to a neighboring state to be closer to her family, who can help her recover.
Post-partum: Haleemah tries to transfer her benefits to her new state but cannot seem to reach a benefits worker, despite spending multiple hours a day calling. Desperate, she drains her budget to drive to her former state to visit each benefits office in person.
Early childhood: Haleemah feels healthy enough to return to work after six months. Still, there is a year-long waitlist for Head Start, so she must rely on her family for childcare in the meantime. She felt guilty that her child wasn't receiving early childhood education from professionals.
“It's all about jumping through hoops and staying on top of people to make sure the application is moving, but you can't stay on hold on the phone for 6 hours if you work.”
Pain Point
Benefits are burdensome to maintain
Families face barriers to maintaining benefits as they juggle the responsibilities of parenthood.

 

This research took place virtually and in-person, in English and in Spanish. 121 people, from 10 states, participated in the research. This group included single parents, people facing housing insecurity and homelessness, people who are justice-involved, and people with disabilities.

The team spoke with:

  • 32 members of the public
  • 12 frontline staff
  • 13 state/program administrators
  • 64 subject-matter experts

Discovery insights

Framing for collective thinking about customer pain points

How might we factor in the physical goods that families need in the first year after childbirth to help people start their journey with essentials in hand?

How might we empower organizations and staff in local communities to help families have greater awareness and streamlined access to available benefits?

How might we help people have the right information at the right time about enrolling in benefits and the process to renew them as needed?

Next steps

Teams are currently working on identifying and scoping projects to move into the design phase. Please check back on this page in the coming months for updates.

Project Documentation

Agency collaborators

  • General Services Administration
  • Department of Labor
  • Department of Housing and Urban Development
  • Department of Agriculture
  • Office of Management and Budget
  • Department of Education
  • Department of Health & Human Services