The effect of welfare reform on prenatal care and birth weight.

Welfare reform has resulted in a dramatic decline in welfare caseloads and some have claimed that a significant number of low-income women may be without health insurance as a result. The loss of insurance may reduce low-income, pregnant women's health care utilization, and this may adversely affect infant health. Welfare reform also may affect healthcare utilization and health of pregnant women and infants because of welfare-induced changes in family disposable income, time available for health investments, and levels of stress. In this paper we examine the effect of welfare reform on prenatal care utilization and birth weight of low-educated women and their infants. We find that a 50% reduction in the caseload, which is similar to that which occurred in the 1990s, is associated with a zero to seven percent decrease in first trimester prenatal care; a zero to five percent decrease in the number of prenatal care visits; and a zero to 10% increase in low birth weight. Since welfare reform was responsible for only part of the decline in the caseload, welfare reform per se had even smaller effects. Copyright 2004 John Wiley & Sons, Ltd