The Financial and Human Cost of Untreated Maternal Mental Health Conditions in Texas

Addressing inequities such as untreated maternal mental health is not only the right thing to do; it is costly not to

Published March 8, 2021

Healthy women are a cornerstone of healthy families, communities, and economies. That’s why investing in women and girls is a key part of our strategy to advance health equity in Central Texas.

The United States has the highest maternal mortality rate of any developed country, and Texas’ high uninsured rate further exacerbates maternal health challenges. So, while we believe women’s health encompasses more than childbirth and postpartum, we see addressing and improving maternal health outcomes—especially for women of color—as an imperative.

In fact, in 2018, we launched Focus on the Fourth, an initiative that supports maternal health during what’s known as the “fourth trimester,” or the year after childbirth. Each year, thousands of women suffer injuries, complications of childbirth, or risk death, with women of color impacted at double the rate as their white counterparts.

A new report released by Mathematica and published in collaboration with St. David’s Foundation and Texans Care for Children examines a crucial part of postpartum health—maternal mental health conditions (MMHCs), and their economic and human costs. These conditions are among the most common complications of pregnancy and childbirth and can have a devastating impact on mothers and children, yet they often go minimized, undiagnosed, and untreated.

In Texas, maternal mental health conditions affect more than 1 in 8 pregnant and postpartum women. In this newly issued report, Mathematica estimated the total monetary cost of untreated maternal mental health conditions in Texas is $2.2 billion.

The largest costs are productivity losses ($610 million), child behavioral and developmental disorders ($556 million), maternal health expenditures ($445 million), and preterm births ($372 million). With many of these costs resulting from untreated conditions, extending coverage to uninsured or underinsured mothers from 60 days to a year after childbirth could be one step to lowering this cost.

But the $2.2 billion doesn’t include the societal cost. When mothers suffer, we all do.

“The human cost, beyond the financial impact quantified in the analysis, ripples across generations. Every year in Texas, untreated MMHCs lead to an additional 7,472 babies being born preterm, 61 cases of SIDS, and nearly 7,000 children growing up with health, emotional, or behavioral challenges. Similarly, untreated MMHCs by definition hurt the mental well-being of moms, in addition to placing them at a higher risk of suicide and health challenges – which impact their families and extended community.” Lourdes Rodriguez, DrPH, Senior Program Officer at St. David’s Foundation

Untreated maternal mental health conditions are common and costly among families of all backgrounds. However, the report shows that families of color—especially Black families—are disproportionately impacted, affecting an estimated 19% of Black mothers in Texas, compared to 15% of Hispanic mothers and 12% of White mothers.

We know that some of the factors contributing to such disparities in maternal health outcomes include implicit bias in the health care system; chronic stress, including the physical toll of stress related to structural racism; social determinants of health, such as housing, food scarcity, and education; and a disproportionate lack of access to health insurance. (Interested? Read more here).

With all this in mind, one thing is clear—for the well-being of mothers, children, and the community, addressing maternal mental health during the postpartum period is crucial. Not only would it save financial costs, but it would also improve and save lives, for generations to come.

“We approach birth equity from an understanding that structural barriers including systemic racism and institutional bias lead to the stark health disparities we see in our community. This research demonstrates that addressing inequities such as untreated maternal mental health is not only the right thing to do, but it is costly not to.” Lourdes Rodriguez, DrPH, Senior Program Officer.

To learn more and review the findings, you can download the issue brief here: Untreated Maternal Mental Health Conditions in Texas: Costs to Society and Medicaid