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A U.S. analysis of commercial insurance claims found that the share of women starting a GLP-1 medication within six months of delivery rose from 0.08% in early 2018 to 1.9% by early 2025. In the second half of 2024, only 18.3% of initiators had type 2 diabetes, while safety evidence for postpartum use, including during breastfeeding, remains limited.
A U.S. analysis of insurance claims found that the share of women who started a GLP-1 medication within six months of giving birth climbed from 0.08% in early 2018 to 1.9% by early 2025. The increase was sharpest among women with type 2 diabetes, but by the second half of 2024, most new users did not have that diagnosis, raising questions about prescribing patterns and the limited evidence on postpartum use.
The research letter, published in JAMA, was led by Sih-Ting Cai, PhD, of the University of Southern California’s Schaeffer Center for Health Policy & Economics, and colleagues. The researchers analyzed commercial insurance claims for 911,908 women and 1,104,417 deliveries from January 1, 2018, through March 31, 2025. They counted a postpartum start when a woman had at least one pharmacy claim for a GLP-1 medication within six months after delivery.
Among women with type 2 diabetes, the share starting a GLP-1 rose from 2.3% to 16.9% over the period. Yet the profile of initiators shifted: in the second half of 2024, 40.4% had overweight or obesity, 20.7% had no qualifying diagnosis recorded before delivery, 20.6% had gestational diabetes, and 18.3% had type 2 diabetes. These percentages describe the diagnoses among initiators in that period, not the likelihood of treatment within each group.
Use most often began several months after birth. Across the study, 61.6% of initiators started three to six months postpartum. Median time to a first fill was 95 days for women with type 2 diabetes and 117 days for those without a relevant recorded diagnosis. Among initiators without a qualifying pre-delivery diagnosis, 55.2% had a diagnosis recorded between delivery and their first fill, most commonly overweight or obesity.
Postpartum Prescribing Moves Beyond Diabetes
The findings document a change in who is starting these drugs after childbirth. GLP-1 medications are used for conditions including type 2 diabetes and, for some products, weight management. The fact that most initiators in late 2024 were outside the type 2 diabetes group makes the trend relevant to postpartum care, where weight, metabolic risk and recovery can intersect.
But the claims data do not establish why a medication was prescribed, whether it was clinically appropriate for an individual, or what outcomes followed. The authors said postpartum treatment may have a role for persistent metabolic risk, while also emphasizing that safety evidence has not kept pace with use. Patients and clinicians need better information, particularly for people who are breastfeeding or considering another pregnancy.
GLP-1 medication for postpartum weight management
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How Researchers Counted New Starts
The researchers used Merative MarketScan Commercial claims and diagnosis codes to identify live births. Eligible women were ages 18 to 49 and had continuous commercial insurance coverage from six months before through six months after delivery. The analysis excluded women with type 1 diabetes and those with a GLP-1 fill in the 180 days before delivery; diagnoses were assessed using claims from as far as 12 months before birth.
A Danish study published in JAMA the previous year also reported increased postpartum prescriptions after semaglutide was approved for weight loss. Cai described the U.S. findings as a benchmark comparable to the Danish trend, despite differences between the countries’ health systems. Separately, reviews of GLP-1 use around pregnancy have not found an apparent increase in adverse maternal or perinatal outcomes, but researchers and experts cited in the report urged caution because the evidence remains limited.
“Postpartum GLP-1 use is likely rising even faster than our numbers show, while the safety evidence hasn’t kept pace.”
— Sih-Ting Cai, lead researcher, speaking to MedPage Today
Safety and Prescribing Reasons Remain Unknown
The study measured pharmacy claims, not whether women took the medication, their clinical outcomes, or the reasons clinicians prescribed it. Claims-based diagnoses may be incomplete or misclassified; the authors said that a diagnosis first recorded after delivery could reflect new risk, newly documented risk or gaps in earlier records. The study also could not identify breastfeeding status, and some prior users may have been misclassified if their last fill fell outside the 180-day exclusion window.
Because the sample included only women with commercial insurance, the results may not represent people with public coverage or those paying out of pocket. The analysis also does not quantify use through cash-pay telehealth or compounded formulations obtained outside traditional insurance channels. It cannot show whether postpartum GLP-1 use affects breastfeeding, mental health, weight change, or later development of type 2 diabetes after gestational diabetes.
Research Needs to Track Use and Outcomes
Cai said future work should examine what is driving prescriptions in the group without a documented pre-delivery diagnosis and track use through cash-pay telehealth and compounded products. Researchers also need data that can distinguish medication indications, breastfeeding status, actual use and health outcomes over time. The study does not announce a planned follow-up or a specific publication date for further results.
For now, the reported trend is a measure of recorded starts among commercially insured patients, not proof of benefit or harm. Further evidence will be needed to guide decisions about postpartum treatment, including for people with gestational diabetes or other metabolic risks.
Key Questions
How much did postpartum GLP-1 use increase?
The share of women with a recorded GLP-1 start within six months of delivery rose from 0.08% in early 2018 to 1.9% by early 2025 in the commercial claims analysis. The figures describe the study population and period, not all U.S. postpartum patients.
Did most new users have type 2 diabetes?
No. In the second half of 2024, 18.3% of initiators had type 2 diabetes. Other recorded groups included women with overweight or obesity, gestational diabetes, or no qualifying pre-delivery diagnosis.
Does the study show that postpartum GLP-1 use is safe?
No. The analysis tracked insurance claims and diagnoses; it did not measure safety outcomes or breastfeeding status. The researchers and an outside obstetrician-gynecologist cited in the report said more evidence is needed, especially for use during breastfeeding.
Who was included in the analysis?
The study included women ages 18 to 49 with continuous commercial insurance coverage around delivery, using claims for births from January 2018 through March 2025. Its findings may not apply to people with other types of coverage or to all forms of out-of-pocket prescribing.
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