The Politics of Loving Kindness: Insights from a Birth Equity Initiative

What if we were explicit about caring for all people, more than corporations or profit?

The last 10 years of American politics seem uniquely horrible. We increasingly tolerate brutal policies that deny people basic dignity. Income inequity has risen beyond any imaginable logic, while policies that would feed and house all people are demonized as dangerous or risky. Political influence is being used to further hoard resources and advantages for billionaires, leaving more people to suffer than to benefit. By design, today’s politics are focused on turning people against one another to impede solidarity and maintain the status quo of a system that is massively widening inequality.

This raises a question: What might happen across our country if those working to make life better for our neighbors—policymakers, philanthropists, nonprofits, universities, thought leaders—embraced the politics of “loving kindness”? That is, what if they combated the fearmongering of manufactured scarcity with a vision that ensures all of us can thrive? What if we were explicit about caring for all people more than corporations or profit for a few?

In 2021, I led a team of researchers, advocates, and mothers to launch the Abundant Birth Project: a guaranteed-income program built to advance birth equity by providing unconditional monthly cash transfers to birth-givers facing the highest risk of adverse outcomes. Through this work, I have learned that loving kindness is foundational to birth equity because it centers care, respect, and human dignity; it expands our imagination for what’s possible by directly supporting population health and wellbeing. As I reflect on this work, it is clear that loving kindness is not only necessary for the welfare of new parents and babies, but also essential to building the conditions in which our communities can flourish.

Nearly half of US families do not earn enough income to meet their basic needs.

Here, I offer insights and a guiding framework to invite more people into a movement that starts and ends with something everyone finds irresistible: love. With loving kindness as our compass, we can collectively work to provide unconditional care for others while actively transforming the structures that drive inequity and suffering.

Income Inequality, Health Risk, and the Policies That Shape Them

Parents are increasingly bearing the hefty burdens imposed by our current regime of brutal policies. According to a 2024 report from the US Surgeon General, nearly 50 percent of parents say their stress is completely overwhelming on most days. This level of stress is partly driven by structural factors such as income inequality, which fuels adverse birth outcomes.

With loving kindness as our compass, we can collectively work to provide unconditional care for others while actively transforming the structures that drive inequity and suffering.

Raising a child is becoming overwhelmingly expensive in the United States, a primary reason many people are deciding not to have children. Nearly half of US families do not earn enough income to meet their basic needs. And as the various provisions of Trump’s so-called Big Beautiful Bill begin to take effect this year, families are experiencing even more pressure. This legislation calls for federal funding reductions, increased share of cost for states, and increased administrative hurdles for programs like Medicaid and SNAP food assistance. This will likely mean that states will drop optional Medicaid services, reduce access to food assistance, and cut other crucial services that have been keeping American families afloat.

The United States has by far the worst birth outcomes of all high-income countries and these policy shifts have a direct impact on mothers and their babies. Over the past 20 years, researchers have conclusively established a link between socioeconomic disadvantage and birth complications. As a pediatrician, I see firsthand what happens when mothers cannot afford fundamentals like rent, food, or utilities: Babies are born too small and too early, mothers feel the impact on their physical and mental health, and children don’t have what they need to grow up healthy.

Living in poverty disproportionately exposes pregnant people to stressors like housing insecurity, pollution, poor nutrition, and crime. The stress of these circumstances is toxic to pregnancies; chronic stress can lead to nearly twofold increased risk of delivering an infant with low birth weight.

Reimagining Birth Equity with Loving Kindness

After years of pediatric practice serving low-income communities, I found myself looking upstream in search of systemic solutions that would transform the circumstances for my patient families to support their wellbeing. This led to launching the Abundant Birth Project, where we worked to discover what providing recurring, unconditional cash to pregnant people during the critical period before and after birth could do. We sought to lead with a framework rooted in loving kindness, where our measures of success are health, happiness, and opportunity for the average family.

And, it turns out, big-hearted programs like these are not just ensuring that pregnant people and new babies have enough to eat. Investing in families with a monthly income boost also has significant health benefits for mothers and infants.

So far, studies have found cash supplements are associated with positive impacts on birth weight, fewer early-term births, fewer NICU admissions, a greater uptick of prenatal care for parents, improved maternal mental health, decreased food insecurity, and could produce millions in annual healthcare savings due to the reduction of premature and low–birth weight babies and maternal health complications. We’re also seeing indicators that money invested into the community has compounding economic returns. Recent data from a maternal guaranteed income program in Michigan show programs raising per capita income by more than double the program’s costs, meaning direct cash is not only investing in families with infants but also strengthening the local economy.

When we provide mothers with regular infusions of money, we are providing protection to two generations. Guaranteed income lets pregnant people breathe easier, knowing that they can afford the essentials. It provides flexibility that lets mothers decide how to best meet their family’s needs. And it provides pregnant people with dignity and autonomy during a high-stakes moment in their lives.

A Framework for Action: Four Principles Grounded in Loving Kindness

The Abundant Birth Project has now served over 1,000 mothers across California, distributing more than $11 million through public-private partnerships. What began as a pilot project in San Francisco has become a coalition of 30 programs, serving as a model for mother/infant cash programs across 20 states.

This level of progress would not be possible without being in deep community with—and led by—mothers who had experienced birth complications. Our work together made me want to be audacious, to be led by what was needed rather than what was feasible.

In retrospect, I can say that we held ourselves accountable to four principles, which I offer here with hope that they help guide the social sector for how we might show up for one another during this crucial moment in history.

Principle 1: Become stewards (instead of destroyers) of the future.

“Anticipating and collectively envisioning healthy futures takes time, care, and cooperation. We, individually and collectively, have to fall in love with the futures we want to emerge.” This statement comes from a recent report by the Robert Wood Johnson Foundation, based on convening over a dozen futurists, artists, and leaders, calling for love as a key tenet to bringing about a more sustainable future.

Our work to create conditions for all to thrive takes time, and when so much of the work in the social sector has become about responding to crises, the immediacy of that orientation leaves little room for anything but the problem right in front of us. Still, I encourage us all to stay the course.

The Abundant Birth Project was the culmination of a yearlong process during which we listened and learned from the people most impacted by the issue we want to resolve. We trained mothers to be community researchers, interviewed people who gave birth to understand what was needed for healthy pregnancies, and held design-thinking workshops with mothers as subject matter experts to guide the details of the program. Finally, we formed a community governance council to provide ongoing guidance and accountability during implementation.

Together, with the communities we serve, we can create healthier futures by investing in and building something new and lovable.

Questions to reflect on:

• What does a future you can fall in love with look like and what voices are helping to co-create this vision?
• In what ways are you laying the groundwork for that better future to emerge?
• How are you practicing accountability to future generations?

Principle 2: Trust people.

When the COVID-19 pandemic hit, US policymakers, funders, and nonprofits mobilized quickly to connect people with the resources needed to stay healthy, housed, and fed. People showed up for each other, and the government showed how possible it is to mobilize funds and advance policy change when the moment demands it.

For Medicaid, pandemic-era policy changes did more than stopgap emergencies; they improved care and protected state budgets. These improvements came down to whether states were required to regularly verify applicants’ eligibility. However, in 2023, the government decided to suspend the continuous eligibility policies that had improved user churn so significantly. This decision came at a tremendous cost. Uninterrupted insurance coverage is associated with fewer hospitalizations, fewer ER visits, and better outcomes. Data from the Commonwealth Fund estimate that, had continuous eligibility continued, people in the United States would have spent $1.8 billion less on healthcare in 2024. Further, analysis of government reports from 2023 found that fraudulently receiving Medicaid was a negligibly rare occurrence. Unfortunately, by the end of 2026, the Big Beautiful Bill will require even more frequent eligibility verifications, and not just for Medicaid but also for SNAP benefits.

This is a stark example of the tremendous progress that can be made when we trust the neighbors we are serving and work to remove barriers rather than uphold systemic practices that impede access to supports meant for their wellbeing.

Questions to reflect on:

• How are you trusting the people closest to the issues you work on to be decision-makers in your work?
• How might you operationalize trust internally and externally, throughout your work?

Principle 3: Put human outcomes over corporate outcomes.

“Forever chemicals,” or PFAS, are toxic, industrial chemicals that are used in a variety of consumer products. The health risks of these chemicals were first noted by the industries producing them more than 50 years ago, but they kept it secret. Despite having conclusive evidence about the harms of forever chemicals for more than 25 years, the EPA allowed companies to contaminate our water and soil for decades. Now half of all US residents have forever chemicals in their water. Why? Producing PFAS chemicals is cheap, but disposing of them properly is costly.

In 2024, after years of advocacy, the EPA finally adopted PFAS drinking water regulations to curtail the rampant dumping of these toxins into communities. But it shouldn’t have taken so long. And—one year later—in 2025, we’ve regressed, as the Trump administration’s EPA decided to weaken the 2024 PFAS drinking water protections, putting all our water at risk again for the sake of corporate profits.

Water is a basic human necessity and critical component of good health. Corporate priorities should not matter more than our collective safety.

Questions to reflect on:

• In your sector, how are corporate priorities harming our neighbors and our communities?
• In what ways are corporate interests diluting the impact of your work? How might you push back?

Principle 4: Nothing—and no one—is apolitical.

The American Medical Association (AMA)—a nearly two-century-old professional organization for physicians—has recently started standing up for science and taking a stance on vaccines, and speaking out on gun violence, racism, and reproductive healthcare access, among other politicized health topics.

The AMA is now facing blowback in Republican circles, where it once enjoyed special status. But the way forward is not to retreat. Instead, organizations in the social service sector should join them and become political together.

Choosing to be silent or apolitical in the face of violent and illogical policy decisions is in itself a political act, one which affirms those in power. In the face of bullying at school, we ask kids to join with other bystanders to show their disapproval. Organizations across the social sector can take this lesson. To overcome brutality and restore compassion, our organizations should become politically engaged.

Legal restrictions are often posed to scare organizations from political advocacy, so know this: It is legal for nonprofits to educate legislators and for their staff to educate the public on political topics, challenge unjust laws in court, register and mobilize voters, and take a position on proposed legislation. Bolder Advocacy is a wonderful resource to help 501c3s understand their rights and restrictions when it comes to political activity.

Questions to reflect on:

• Will the work you are doing now address the underlying systems and structures that are driving the adverse outcomes in our communities?
• Who benefits when social services are silent on political issues?
• Fifty years from now, when people are looking back at this period in history, what do you want to be able to say about how you responded?

From Abstraction to Actuality

The Seventh Generation Principle is a Haudenosaunee (Iroquois) philosophy that suggests, when making decisions, it is not enough to consider the impact on oneself, one’s family, or even one’s larger community—the impact on seven generations into the future must also be front of mind. Many dimensions of our government that we think of as essentially American were actually adopted from the Haudenosaunee’s Great Law of Peace. In fact, the Iroquois Confederacy influenced the US Constitution and Bill of Rights. In 1988, the US House passed a resolution to acknowledge the “Iroquois and other Indian nations [for their role] in the formation and development of the United States.”

However, it seems their Seventh Generation wisdom has been left behind. I urge us to return to this wisdom and steward a future where everyone—including      future generations—can thrive.

We can start the campaign for loving kindness now by reweaving the fabric of our society with compassion and gathering it close again. Philanthropy, nonprofits, universities, and advocates can align around these four big-hearted principles. We can determine how our organizations, together, can influence policy and take action.

It’s up to us to bring about change. The same alchemy is involved, whether birthing babies or kinder futures: When love is the seed, the blossom will inevitably be magnificent.