As the government shutdown throttles federal SNAP benefits for an estimated 1.4 million Michiganders, Lee Roosevelt, a clinical associate professor at the University of Michigan School of Nursing, said her midwifery patients will be among the hardest hit.
Experts talk about the house of cards effect, or the cascade of challenges that happens when a person loses a benefit like SNAP. Can you discuss that as it relates to your midwifery patients?
When a pregnant patient loses SNAP, even briefly, food money must come from rent, utilities, transportation, meds or child care. Policy analysts have documented that a family losing even a few hundred dollars of SNAP benefits forces tradeoffs that directly hit health-critical expenses. That cascade shows up as a deterioration of diet, including less produce and protein sources, and a switch to cheaper, energy-dense foods that are linked to higher risks of gestational diabetes, hypertensive disorders and preterm birth.
All the science that we have shows that access to food assistance during pregnancy mitigates those risks. Additionally, we see people not show up for their prenatal visits because they are choosing food over bus fares or gas. Or, patients prioritizing gas and bus monies to visit sparsely located and often distant food banks in order to provide food for their family. This work, more often than not, lays on the backs of women, many of which are pregnant or breastfeeding.
What are the most serious pregnancy risks that your patients face when they lose their SNAP benefits?
Even temporary loss of benefits increases food insecurity. In pregnancy, that can mean days to weeks of skipped meals or low-nutrient substitutions that worsen glycemic control and blood pressure and provide inadequate nutrients for a growing pregnancy, resulting in preterm birth and low birth-weight babies. Studies show SNAP access before and during pregnancy improves maternal cardiometabolic health and birth weight distributions. Losing access means patients may prioritize the nutrition of their existing children over their own nutrition.
What is the connection between food insecurity and mental health and why is this important?
Food insecurity is consistently associated with higher rates of depression, anxiety and stress in parents. Stress then worsens glucose control, blood pressure, sleep and healthy behaviors. In pregnancy, that bidirectional loop contributes to adverse outcomes and can complicate lactation and postpartum recovery. Screening and addressing food need is therefore also a mental health intervention.
What is the relationship between SNAP and WIC and why is this important?
SNAP and WIC serve complementary but distinct roles in supporting nutritional health during pregnancy and early childhood. SNAP, a federal entitlement program, provides monthly benefits that households can use to purchase a wide variety of foods, making it a flexible tool for addressing general food insecurity. In contrast, WIC is a targeted program specifically designed for pregnant and postpartum people, infants and children under 5. It offers a prescribed food package focused on key nutrients, along with nutrition education, breastfeeding support and referrals to health care and social services.
While SNAP ensures broad food access, WIC ensures nutrient quality and education at critical developmental stages. Together, they help stabilize families' food security and improve maternal and infant health outcomes. So when patients lose access to either program, they lose not just calories but the nutritional and educational supports that protect perinatal well-being.
What are you hearing from your patients who are worried about or who have already lost their SNAP benefits?
Many of my patients who receive SNAP benefits are working families, often with one or two incomes, doing "everything right" by working full time yet still living on the edge of financial stability. For them, SNAP is the crucial support that keeps the household balanced. It's what allows the rent to be paid, the lights to stay on and the children to eat consistently. There is no cushion. Even the loss of a single month of SNAP benefits can send ripple effects through every part of their lives, leading to missed rent, job instability from missed shifts and worsening health complications. Patients describe impossible choices between buying groceries or paying for utilities, and many are afraid their electricity will be shut off as winter approaches.
In recent weeks, we've already seen a noticeable rise in OB triage visits from pregnant patients who fainted due to low blood sugar after rationing food bought weeks earlier, trying to stretch what little they had from October into November. One of my patients last week expressed incredible anger that while she was denying her kids seconds at dinner to ensure that she had enough food to send for their lunches the next day, politicians couldn't even be bothered to show up to work to come up with a compromise.
It is such an enormous violation of a cultural reverence for children and new life to watch politicians using the lives of children as a bargaining chip to force the hand of other politicians to cave to political pressure. There isn't a religion in the world whose tenets would support using the lives of the poor for personal and financial gain. It is the ultimate hypocrisy. From an ethical perspective, there is nothing "pro-life" about policies that withhold basic nutrition and threaten family stability and instead erode the conditions necessary for life. It is anti-family, anti-child and anti-life.
Regardless of what people think about the adults that receive SNAP benefits, the decisions that politicians are making impact babies and children who have no say in how food is acquired in their family. If these politicians were truly pro-life, they would ensure continuous access to food, health care and social support for pregnant people and young families, safeguarding the lives and well-being of both parents and children.
