Postpartum medical utilization: The role of prenatal economic activity and living costs

Abstract

This study is the first to explore the extent to which prenatal economic fluctuations affect postpartum outpatient care utilization during three-month, six-month, and one-year postpartum periods in Taiwan and to document their counter-cyclical patterns for economic activity and pro-cyclical patterns for the CPI change rate. We present evidence that medical care utilization occurring during the postpartum period is sensitive to economic activity within the first trimester of pregnancy and the CPI change rate within the second trimester. The findings herein reveal that negative prenatal economic shocks lead to a higher probability of cesarean section, more outpatient visits for depressive disorders, hypertension, gestational diabetes, and anemia in the pregnancy period, and a lower number of prenatal care visits that could deteriorate postpartum maternal health. Moreover, our results are consistent with low-salary and private-sector-employed mothers who face credit constraints and experience the risk of losing their job, respectively, during a decline in economic activity and who subsequently suffer from nutritional deficits and maternal stress that lead to postpartum health deterioration. Conversely, high-salary mothers do not face credit constraints and have greater coping ability to deal with stress and nutritional problems, while public-sector-employed mothers are affected only by nutrition.