The Financial Impact of Pregnancy and Childbirth Among Louisiana Medicaid Beneficiaries.

OBJECTIVE

To measure the impact of pregnancy and childbirth on debt and personal credit scores by race, ethnicity, and geography.

STUDY SETTING AND

DESIGN

We used Medicaid claims data, credit report data, and the Callaway Sant'Anna difference-in-differences method to compare relative changes in credit score, medical debt, and nonmedical debt between women moving through their pregnancies and women who weren't pregnant.

DATA SOURCES AND ANALYTIC SAMPLE: Louisiana Medicaid claims data (January 2017 to December 2020).

PRINCIPAL FINDINGS: While outcomes were not adversely impacted for non-Hispanic White women, non-Hispanic Black women experienced worsening financial measures following their pregnancies: credit scores decreased from Month 4 to 14 (4 points, 95% CI: -5.65 to -1.81, p < 0.01), medical debt increased from Month 8 to 12 ($41, 95% CI: $6-$75, p = 0.02), and nonmedical debt increased from Month 2 to 21 ($44, 95% CI: $15-$74, p < 0.01).

CONCLUSIONS

Pregnancy and childbirth were associated with worsening financial outcomes among low-income Medicaid-enrolled mothers, particularly among non-Hispanic Black women. These findings highlight the importance of broader economic supports to reduce financial disruption associated with pregnancy and childbirth among low-income families and address disparities in maternal and child well-being.