Many low-income pregnant women don't have enough to eat, despite food programs

Last Halloween, I met Lynn in front of her apartment building in Brownsville, a neighborhood in Brooklyn that has one of the highest crime and poverty rates in New York City. Lynn had agreed to be part of a randomized controlled trial that measures the impact of an antipoverty program called Room to Grow. She’s eight months pregnant and supports herself and two kids on an annual income of just $10,000.

As she ushers us inside with several grocery bags in each hand, she explains that her SNAP benefit, also known as food stamps, just came in and she wanted to make sure there was food in the house before her kids got home, especially since it’s a holiday. In the cramped kitchen, she unpacks the goods into sparse cabinets and a refrigerator that holds some leftover mashed potatoes but not much else. Before I can start our interview, Lynn empties a carton of eggs into a bowl, pulls out a tray of small paints and begins brushing color onto each dimple of the carton. “I’m going to strap this to my belly and be a gumball machine for Halloween,” she explains.  

As we get to talking, a familiar pattern of food scarcity emerges. While there’s not much national data on how many pregnant women experience food insecurity, we know that households with children are much more likely to run out of food. Nationally, 17 percent of households with children are food insecure, compared to 11 percent of households without children. And though safety net programs such as SNAP and the Women, Infants and Children (WIC) federal nutrition program are essential to alleviating hunger and poverty, it’s often not enough. According to the latest USDA report, approximately half of households that receive SNAP, and 4 in 10 households that receive WIC, report food insecurity.

The majority of the mothers we talk to consistently either worry about not having enough food or repeatedly run out of food.

The mothers I interview are, if anything, worse off. Our study is an evaluation of a program called Room to Grow, which combines social and material support (books, toys, clothing and equipment) for mothers and babies in the first three years of life. Two-thirds of the pregnant women in this trial receive both WIC and SNAP, but even with both of these benefits, many moms aren’t getting the food they need. Data from our evaluation show that only 28 percent of respondents who received WIC and SNAP say they never experienced food hardship, while 41 percent reported moderate level of hardship and 31 percent severe food hardship.

These numbers are striking. Taken together, this means the majority of the mothers we talk to consistently either worry about not having enough food or repeatedly run out of food.

SNAP and WIC, are two of the biggest programs providing food assistance to low-income pregnant mothers. SNAP works like a debit card: based on a family’s income level, a monthly allowance is loaded onto a card that can be used to purchase groceries. While a pregnant woman’s caloric intake needs to increase, pregnancy does not affect SNAP benefits — the baby is not counted as a member of the household until birth. Similarly, WIC provides food vouchers to supplement the nutritional needs of women and children. The most recent national data analyzed by the Center on Poverty and Social Policy at Columbia University shows that roughly four in 10 low-income mothers with an infant are recipients of WIC and SNAP. Because poor and low-income pregnant women qualify for both, they are arguably the most “covered” when it comes to food scarcity.

But as Lynn’s story illustrates, even this dual coverage often fails to fill the gap. Like many expectant mothers, Lynn oscillated between the nausea of morning sickness and the hunger pangs of an increased appetite. In some ways, the nausea was easier to manage because it required fewer resources, while the appetite demanded food, and there was never enough. It’s not uncommon to hear that parents in poor households will skip a meal so that their children can have a full plate, but that calculation gets trickier when the parent is pregnant. While the common saying goes “You’re eating for two,” that’s a bit of an exaggeration — the recommendation is for pregnant women to eat about an extra 300 calories a day. These extra calories are critical to the pipeline of nutrition that the fetus receives as it develops; in many ways, the mother’s health is the blueprint for the baby.

We know that a lack of nutritious food is physically and psychologically damaging to pregnant women and children. For pregnant women, food insecurity has been linked with gestational diabetes, iron deficiency, low birth weight and maternal depression. Infants who experience food hardship are later more likely to have insecure relationships, and to perform worse on tests of cognitive development. Children in food insecure households have higher rates of hospitalization, iron deficiency anemia, and chronic health conditions; they show smaller gains in math and reading achievement between kindergarten and third grade. The latest research shows that even “marginal” food insecurity is associated with poor health and developmental outcomes.

In May, the House failed to advance its version of the farm bill, which included a controversial proposal to impose work requirements on SNAP recipients. Those tougher requirements ultimately helped sink the bill. The action now moves to the Senate, which is expected to produce a more bipartisan bill. Even so, the Trump administration’s agenda for cutting the safety net is clear. As someone who sees the plight of these families firsthand on a daily basis, I find this deeply troubling, especially since families like Lynn’s are already struggling to meet their basic nutritional needs.

In the face of the current political climate, it’s important to tell the stories of those who rely on SNAP and WIC and also to improve our understanding of how these programs can better serve low-income mothers and children. No pregnant mother should have to choose whether she feeds herself or her two young children who come running through the door after school, ready for dinner.

Tonya Pavlenko is a research analyst at the Center on Poverty and Social Policy at Columbia University.