{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:42:42Z","timestamp":1792482162890,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000905","name":"Commonwealth Fund","doi-asserted-by":"publisher","award":["#24\u201024156"],"award-info":[{"award-number":["#24\u201024156"]}],"id":[{"id":"10.13039\/100000905","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To measure the impact of pregnancy and childbirth on debt and personal credit scores by race, ethnicity, and geography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Setting and Design<\/jats:title>\n                    <jats:p>We used Medicaid claims data, credit report data, and the Callaway Sant'Anna difference\u2010in\u2010differences 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Analytic Sample<\/jats:title>\n                    <jats:p>Louisiana Medicaid claims data (January 2017 to December 2020).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>\n                      While outcomes were not adversely impacted for non\u2010Hispanic White women, non\u2010Hispanic Black women experienced worsening financial measures following their pregnancies: credit scores decreased from Month 4 to 14 (4 points, 95% CI: \u22125.65 to \u22121.81,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), medical debt increased from Month 8 to 12 ($41, 95% CI: $6\u2013$75,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), and nonmedical debt increased from Month 2 to 21 ($44, 95% CI: $15\u2013$74,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pregnancy and childbirth were associated with worsening financial outcomes among low\u2010income Medicaid\u2010enrolled mothers, particularly among non\u2010Hispanic Black women. These findings highlight the importance of broader economic supports to reduce financial disruption associated with pregnancy and childbirth among low\u2010income families and address disparities in maternal and child well\u2010being.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1475-6773.70166","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T09:12:42Z","timestamp":1789636362000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Financial Impact of Pregnancy and Childbirth Among Louisiana Medicaid Beneficiaries"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5617-577X","authenticated-orcid":false,"given":"Brigham","family":"Walker","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management Tulane University  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2997-6456","authenticated-orcid":false,"given":"Ethan","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Tulane University  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8562-7694","authenticated-orcid":false,"given":"Andrew","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7669-9482","authenticated-orcid":false,"given":"Melissa","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Social, Behavioral, and Population Science Tulane University  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4181-7407","authenticated-orcid":false,"given":"Kevin","family":"Callison","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Tulane University  New Orleans Louisiana USA"},{"name":"The Murphy Institute Tulane University  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13524\u2010020\u201000897\u20101"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0038-4941.2005.00340.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010023\u201008214\u20103"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1468\u20100009.12721"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.32103"},{"key":"e_1_2_10_7_1","unstructured":"U.Ranji A.Slaganicoff J.Tolbert B.Fredericksen andI.Gomez \u201c5 Key Facts About Medicaid and Pregnancy \u201dKaiser Family Foundation accessed June 9 2025 https:\/\/www.kff.org\/medicaid\/issue\u2010brief\/5\u2010key\u2010facts\u2010about\u2010medicaid\u2010and\u2010pregnancy\/#:~:text=1.Medicaid%20finances%20over%20four 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