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The Cost of Untreated Maternal Mental Health

Untreated maternal mental health conditions cost Texas over $2 billion


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

Impact: Legislative Update

The launch of this research corresponded to the vote on TX House Bill 133, which originally recommended extending healthcare coverage from 2 to 12 months postpartum for new moms covered by Medicaid, it was later negotiated down to 6 months. Due in large part to the leadership and partnership with Texans Care for Children, the key findings from the study were cited during the legislative hearing in support of extended postpartum coverage and improvement of access to medical and mental health care. In the final days of the 2021 Legislative Session, TX House Bill 133 passed and the Texas Healthcare Transformation and Quality Improvement Program (THTQIP) waiver amendment is now pending federal approval.

The Foundation supports extended Medicaid eligibility because of the positive effects on healthy pregnancies, births and Texas families and continues to urge the Centers for Medicare & Medicaid Services (CMS), HHSC, and the Texas Legislature to explore options to extend Medicaid coverage for new mothers to one year postpartum, as proposed by most states and as recommended by Texas’ Maternal Mortality & Morbidity Review Committee.

The Issue:

Maternal mental health conditions are among the most common complications of pregnancy and childbirth and often go under-diagnosed and untreated despite the availability of effective screening and treatment tools. Untreated maternal mental health conditions have multigenerational consequences and are linked to negative outcomes in the mother and child from pregnancy and through the child’s life.

This report was developed by Mathematica and in partnership with Texans Care for Children through funding from St. David’s Foundation’s Evaluation and Strategic Learning department. It supports the goal of the Healthy Women and Girls priority area, to ensure that girls and women are supported with the resources, respect, and conditions vital for equitable health and well-being.

The Findings:

Excerpted from the full study, the graphics below illustrate key findings. This research continues to inform decision makers at a national scale, and was published in the open access journal BMC Pregnancy and Childbirth.

A graphic with a figure of a mother holding a baby and the outline of the state of Texas that reads: "Untreated maternal mental health conditions are costly and have multigenerational consequences. Maternal mental health conditions account for an estimate $2.2 billion in societal costs for all births in 2019, from conception through five years post-delivery." A graphic with 8 figures of women, 7 of which are blue and 1 of which is red, that reads "Maternal mental health conditions are among the most common complications of pregnancy and childbirth. In Texas, maternal mental health conditions affect more than 1 in 8 pregnant and postpartum women. At least 49,816 of the 377,397 Texas mothers who gave birth in 2019 had a maternal mental health condition."

A table with data titled "Figure 4. Estimates of societal costs of MMHCs and impacts for 2019 births in Texas, from child's conception to fifth birthday."

A report by Mathematica examines the societal cost of untreated maternal mental health conditions in Texas from conception through the child’s fifth birthday. The report shows that our whole community — kids, schools, local businesses, the health care system, and beyond — are all impacted by the fragmented system of care for women in Texas. Addressing mental health is a key aspect of improving maternal health.

Meet our Contributors


Lourdes Rodriguez, DrPH

Former Senior Program Officer


Ellie Haggerty Coplin, MPH

Director of Learning and Evaluation