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Extending Medicaid coverage to 12 months after childbirth increased postpartum health care utilization among women with pregnancy complications such as diabetes and hypertension, according to a new study at Columbia University Mailman School of Public Health. The findings suggest that expanded postpartum Medicaid coverage can be leveraged to improve access to preventive care and reduce both immediate postpartum complications and long-term maternal health risks.

The study is among the first to examine whether expanded postpartum Medicaid coverage translates into greater use of recommended postpartum screenings and outpatient care among women at high risk for maternal morbidity and chronic disease. The results are published in the journal Health Affairs Scholar.

"Postpartum health care plays a key role for women with pregnancy complications such as diabetes or hypertension," said Teresa Janevic, Ph.D., associate professor of epidemiology and corresponding author.

"Screening for unresolved conditions, monitoring for emerging chronic disease and establishing ongoing preventive care are all critical during this period. Additionally, connecting women to primary care can have lasting benefits for their health."

Women who experience diabetes in pregnancy (DIP) or hypertensive disorders of pregnancy (HDP) face elevated risks of postpartum emergency department visits, severe maternal morbidity, pregnancy-related death and the later development of diabetes and cardiovascular disease.

Yet postpartum follow-up remains persistently low, in part because many women historically lost Medicaid coverage just 60 days after giving birth.

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