New parents bringing home their bundle of joy often carry something else with them as they leave the hospital: medical debt.

That’s according to new research from Michigan Medicine that found postpartum women are more likely to have medical debt than those who are pregnant.

The researchers studied this by evaluating collections among a statewide, commercially insured cohort of more than 14,000 pregnant women and more than 12,000 postpartum women.

“Our findings suggest that current out-of-pocket costs before and after childbirth are objectively more than many commercially insured families can afford, leading to medical debt,” said lead author Dr. Michelle Moniz, an obstetrician/gynecologist at University of Michigan Health’s Von Voigtlander Women’s Hospital.

“Our study highlights the need to consider policies to reduce maternal-infant health care spending in order to ease financial hardship and distress and improve birth equity,” Moniz said in a Michigan Medicine news release.

People who were seven to 12 months past childbirth living in the lowest-income neighborhoods had the highest likelihood of having medical debt. After that group, those with the most debt were pregnant women in the lowest-income neighborhoods, followed by other postpartum and pregnant women.

“Having unpaid medical bills was not only significantly more common among postpartum individuals, but more common among the most socioeconomically vulnerable people,” Moniz said. “These results suggest that all postpartum individuals are at risk of economic strain related to out-of-pocket spending for medical care before and after childbirth, and that medical debt is most prevalent among postpartum individuals living in neighborhoods with the lowest median income.”

The findings were published Sept. 28 in the journal Obstetrics & Gynecology.

Moniz pointed to many factors that may explain why postpartum individuals may be at higher risk of medical debt.

Those factors include health care costs for pregnancy, birth, postpartum and newborn care, she said. Caregiving expenses may add to this. So, too, may potential reductions in earnings after childbirth.

The authors suggest that policymakers could consider efforts that reduce or eliminate maternal-infant out-of-pocket health care spending. This could include lowering deductibles for those with lower household income or pre-deductible coverage that prohibits out-of-pocket spending for services such as prenatal visits, ultrasounds, hospitalization for both parent and infant, and postpartum services.

“We know that financial hardship can negatively impact health — it is associated with delayed or deferred health care, mood disorders and mortality among adults. No one wants these outcomes for new parents and infants,” Moniz said.

“We need to pursue initiatives that help us identify and assist individuals with the lowest capacity to buffer against high health care bills or other expenses around the time of childbirth so that families can bring home a baby without a bundle of unpaid bills and financial distress,” she added.

More information

The nonprofit KFF has more on medical debt in the United States.

SOURCE: Michigan Medicine, news release, Sept. 28, 2023