One of the most common pushbacks we hear—especially from HR teams and payors—is this: “Why invest in postpartum? Isn’t the bulk of the cost during delivery?”

On paper, yes. Most of the claims dollars hit during pregnancy and the day of birth. But that’s not where the real financial volatility lives—and it’s definitely not where the lives are lost.

To unpack this, we asked two of our co-founders—Dr. Ilana Jerud, a neonatologist, and Bryan Smith, a data scientist and operator—to walk through the numbers, the risks, and the truth behind why postpartum care looks cheap—until it explodes.

Bryan Smith (Phia Co-Founder):
This question comes up in almost every employer pitch: “We already spend on pregnancy—why should we spend more on postpartum?”
And the short answer is: you’re right. The majority of the medical claims hit before or during birth.

Ilana Jerud, MD (Phia Co-Founder, Neonatologist):
Right. The data’s pretty clear: if you look at large employer claims from 2018–2020, about 60% of the cost is the delivery itself, 25% is prenatal, and only 15% is postpartum. That’s from Health Care Cost Institute and Kaiser Family Foundation datasets.

Bryan:
So if you’re building a model just off raw claims volume, postpartum looks small. But that’s the wrong lens. Because postpartum is where all the volatility lives. The danger. The high-cost, low-frequency outliers that explode a budget. It’s not about average spend. It’s about variance.

Ilana:
Exactly. One in three severe maternal morbidity (SMM) events happen after discharge. Over half of pregnancy-related deaths happen between 7 and 365 days postpartum. Those are catastrophic claims—$20,000+ events that don’t show up in prenatal bundles. And from a care delivery standpoint, this is also where follow-up collapses. Only 60% of commercially insured moms even make it to a postpartum visit. That’s a wide open risk window.

Bryan:
So while prenatal and delivery are “known spend”—DRG-coded, bundled, forecastable—the postpartum window is full of unpriced risk. From a financial modeling standpoint, prenatal and delivery are like buying a plane ticket. Expensive, yes, but predictable. Postpartum is like lightning strikes—rare, random, expensive, and usually untracked until it’s too late.

Ilana:
And those “strikes” hit real outcomes. We see:

• Readmissions for bleeding, preeclampsia, feeding failure

• Emergency psych admits from undiagnosed PMADs

• Neonatal bounce-backs because mom couldn’t get support in time

• Mortality cases that every health system then has to explain

None of that is visible from the routine claim stream. But every one of them is felt at the stop-loss level, in HR absence data, or in neonatal ICU spikes.

Bryan:
We tell employers: you already padded the front nine with pregnancy perks. We caddie the back nine, where the real financial and clinical collapse happens. And our model’s not bloated—we don’t ask you to PMPM every employee. We don’t reinvent maternity benefits. We price per episode, post-delivery, with a very clear ROI: lower readmissions, faster escalations, reduced total cost of complications.

Ilana:
What’s wild is that even with just 15% of claims landing postpartum, two-thirds of the total maternal morbidity cost in the U.S. occurs in the first year after birth.

So yes—delivery is the biggest line item on the claim. But postpartum is where budgets quietly break.

Final note from the team:

We don’t sell “postpartum is the highest spend.” We sell it as the highest-leverage risk zone—the part of care where traditional coverage ends, outcomes fall apart, and costs become unpredictable. Phia exists to make that risk visible, predictable, and preventable.