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.