The Superbundle™: Advancing Maternal Health Through Economic Security

The United States is facing a maternal health crisis. Nearly 1,000 women die each year from preventable pregnancy-related causes, with Black and Indigenous mothers experiencing mortality rates nearly three times higher than white mothers. These inequities are not driven by biology alone or even by healthcare quality. They reflect the broader economic and social conditions in which mothers live.

Decades of research show that roughly 80% of health outcomes are shaped by factors outside of the healthcare system—such as access to stable housing, livable wages, basic material needs, social support, and economic opportunity. For mothers, these conditions are deeply shaped by structural racism and economic inequality that accumulate across generations and directly affect health before, during, and after pregnancy.

The Superbundle™ is an integrated policy and program solution created to respond to this reality.

What Is the Superbundle™?

The Superbundle™ is an integrated, evidence-informed approach that addresses maternal health inequities by combining immediate support with strategies to address long-term economic security. The Superbundle brings together three proven and complementary strategies targeting the largest upstream drivers of inequities in maternal health:

Reducing Stress and Supporting Mental Health
- Meeting basic material needs, such as diapers, through partnerships with diaper banks
- Strengthening coping and mental health skills through the MOMS Partnership®, a brief, group-based, trauma-informed mental health program
Stabilizing Income During Critical Periods
- Providing direct cash transfers to help families navigate economic shocks during pregnancy and the postpartum period
Building Wealth for the Future
- Investing in Baby Bonds to support long-term asset building, economic mobility, and intergenerational financial security

Together, these strategies are designed to improve maternal and child health outcomes—not just in the moment, but across generations.

Why Economic Security Is Central to Maternal Health

Income matters for health—but wealth matters even more. Wealth provides stability, buffers families against economic shocks, and creates opportunities to invest in the future. It reduces chronic stress and supports long-term wellbeing across generations.

Programs like Baby Bonds represent a powerful wealth-building strategy with strong implications for maternal and child health. By providing a financial asset at birth that grows over time, Baby Bonds can interrupt what researchers call “economic weathering”—the cumulative health toll of prolonged exposure to poverty, instability, and limited opportunity. These disadvantages shape health well before pregnancy begins and often persist into the next generation.

Pregnancy, infancy, and adolescence are especially sensitive periods for brain development and lifelong health. Wealth-building strategies that begin early—particularly those enrolling pregnant people and infants—can promote healthier pregnancies, stronger early development, and improved outcomes across the life course.

But long-term solutions alone are not enough.

Mothers Need Support Now

While life-course approaches are essential, they do not address the immediate financial stress many families face during pregnancy and early parenthood. When mothers are asked, they regularly describe daily anxiety about paying bills, affording food and diapers, securing housing, and covering transportation to healthcare appointments. These pressures fuel chronic stress, social isolation, and poor mental health.

When families receive flexible cash assistance, they consistently use it to meet immediate needs—diapers, transportation, utilities, and other essentials that reduce stress and stabilize daily life.

Listening to mothers means addressing both the structural drivers of maternal health, like income and wealth, and the urgent, everyday needs that shape stress, mental health, and wellbeing during pregnancy and postpartum.

First Steps Forward: Vermont’s Superbundle Pilot

In Vermont, Elevate Policy Lab, the National Diaper Bank Network, Urban Institute and the Vermont State Treasurer’s Office are launching First Steps Forward, a three-year Superbundle™ pilot

Beginning in late 2026, the program will be implemented in three counties in Vermont’s rural Northeast Kingdom. The pilot responds directly to state data showing that poverty and mental health challenges are strongly linked to maternal mortality:

88% of mothers who died during pregnancy or the postpartum period were enrolled in Medicaid
69% were participating in WIC
Nearly 90% had a diagnosed mental health condition

The Urban Institute will evaluate the impact and effectiveness of First Steps Forward. Outcomes will include:

Maternal and infant mental health
Social isolation and stress
Employment and economic stability
Healthcare utilization
Longer-term economic and wealth-building outcomes

Beyond generating evidence, the pilot aims to raise public awareness and inform policy solutions that better support families during pregnancy and early parenthood.