Mothers need aftercare for their bodies, their babies, and their futures. This is what one mother shared about her birthing experience, describing how she felt forgotten after giving birth. She is not alone. Millions of women across the United States share this sentiment.
Expectant mothers do their best to maintain a healthy pregnancy, follow provider recommendations and attend their prenatal visits regularly. If they are struggling with a mental health or substance use issue, they seek help when needed. They give birth in hospitals where there are quality standards that must be followed, many undergoing complications or cesarean-births, and require treatment for conditions such as gestational diabetes and preeclampsia.
All of this is covered by Medicaid — providing an essential lifeline to pregnant mothers across the perinatal period and well into the postpartum period. Today, Medicaid covers half of all births in the U.S.
But after birth, the support system for many mothers begins to fade. While infants receive wellness visits and necessary services, mothers are expected to adjust to a new lifestyle — physically, emotionally, and socially — often without adequate care. Postpartum check-ups, mental health screenings, and recovery support are essential, yet too often overlooked. These are just a few of the critical ways that Medicaid helps mothers.
Potential cuts to Medicaid through pending budget legislation are estimated to be a staggering $1 trillion over five years. These cuts would endanger the lives of mothers across the country — especially low-income mothers from rural areas to urban centers — and have far-reaching consequences for entire communities.
Roughly half of U.S. states expanded Medicaid with the passage of the Affordable Care Act (ACA) in 2014. Today, with the exception of Wisconsin, Medicaid coverage has extended from 60 days to 12 months after childbirth. This extension ensures continuity of care and access to preventive services, including contraception and cancer screenings.
If mothers lose this support, much progress made in maternal health will be at risk, potentially adding to already alarmingly high maternal mortality and preterm births, especially among poor mothers. In Brooklyn, some estimates illustrate 13% of women who give birth prematurely (less than 37 weeks of gestation) live in high-poverty communities compared to a rate of 5.9% in low-poverty neighborhoods.
States that expanded Medicaid under the ACA saw 35% lower maternal mortality rates compared to non-expansion states between 2019 and 2023. Estimates suggests that 5.7 million women of reproductive age (18 to 49) are at risk of losing Medicaid coverage. It is alarming that such a reduction is even under consideration, especially given that the U.S. has the worst maternal health outcomes than other industrialized nations; in 2018, the U.S. maternal mortality rate was more than twice the rate in France.
In New York State, which has adopted the Medicaid postpartum coverage beyond 60 days, mothers have expanded access to prenatal and postpartum care, and new statewide coverage for doula services leading to potential improved birth outcomes. In states such as Georgia and Texas that were late in adopting the extended postpartum coverage to 12 months, women experience delayed or no prenatal care and face high rates of maternal mortality.
Postpartum depression, post-traumatic stress, and burnout are serious conditions that often affect new mothers. One of the leading non-medical risk factors for maternal mortality is suicide. Without Medicaid, mothers in crisis may not get the care they need during one of the most vulnerable periods of their lives. Additionally, a potential work requirement would place significant and undue burden, particularly on mothers who have children over the age of six.
If Medicaid is rolled back, hundreds of thousands of pregnant and postpartum women — especially in non-expansion states — could lose access to critical support.
In recent weeks, the importance of public health and advocacy has grown, highlighting the need to advocate for mothers. Now is the time to focus on a group that often goes unrecognized. We must amplify the voices of mothers and ensure that public health policies address their needs. We cannot turn our backs on mothers and must do everything possible to protect their right to care for themselves and their babies with dignity.
Williams is an associate professor in the Department of Population Health and Institute for Excellence in Health Equity at NYU Langone Health.
