Abstract
INTRODUCTION: Hypertensive disorders in pregnancy, including chronic and pregnancy-induced hypertension, pose significant risks to maternal health. This study evaluated the association of New York State (NYS)'s Paid Family Leave (PFL) law, implemented in 2018, with postpartum healthcare utilization among women with hypertensive disorders in pregnancy. METHODS: Using commercial claims data (2017-2022) for 312 470 employed women aged 15-45 years with live births, we assessed postpartum outpatient visits, hospital admissions, and medication adherence. RESULTS: The PFL law was associated with a 3.7%-point increase in outpatient visits within 7 days postpartum for women with chronic hypertension (from 25.9% to 29.6% in NYS, P < 0.001) and an 8.6%-point increase for women with pregnancy-induced hypertension (from 26.3% to 35.0%) in NYS, P < 0.001). The PFL law was associated with a 1.5%-point reduction in inpatient admissions for women with chronic hypertension (from 3.6% to 2.1% in NYS, P < 0.001), and a 7.1%-point improvement in antihypertensive medication adherence for women with chronic hypertension (from 26.6% to 33.8% in NYS, P < 0.001). CONCLUSION: Study findings suggest that PFL laws may enhance postpartum hypertension management, providing useful insights for policymakers aiming to improve maternal health outcomes through workplace policies.