Untreated Mental Health Challenges of Pregnant and Postpartum Vermonters Cost $48 Million

Newly published findings from Mathematica and the Vermont Department of Health estimated that the societal costs of untreated perinatal mood and anxiety disorders (PMADs) among birthing parents in Vermont reached $48 million. Investing in the prevention and treatment of mental health conditions in pregnant and postpartum people could go a long way toward decreasing that burden.

PMADs are mental health conditions that develop during pregnancy and the year after delivery. They are the most common complication of pregnancy and childbirth and include diagnoses such as depression and obsessive-compulsive disorder.

In Vermont alone, PMADs increased from about 20 percent in 2014 to 25 percent in 2020, according to the report. The total societal cost of untreated PMADs in Vermont—which include direct costs, such as medical costs, and indirect costs, such as lost work time—reached $48 million for all births when following the parent–child pair from pregnancy through five years postpartum. This amounts to $35,910 in excess costs per birthing parent with an untreated PMAD and their child. The largest cost drivers include preterm birth ($13.1 million), productivity loss ($12.5 million), non-obstetric health expenditures ($9.4 million), and child behavioral or developmental disorders ($6.1 million).

“All Vermonters bear the cost of PMADs, treated or untreated,” said Isabel Platt, researcher at Mathematica. “Investing in the mental health of pregnant and postpartum Vermonters through prevention and effective treatment can improve the quality of life for birthing parents and their children while significantly reducing costs to the state.”

Nationally, half of all people in the perinatal period with a diagnosis of depression do not receive the treatment they need. Many parents with untreated PMADs work fewer hours, experience higher rates of absenteeism, and run a greater risk of developing preeclampsia or other pregnancy complications. Their children are at a higher risk of having behavioral or developmental disorders, of being born prematurely, or of developing chronic conditions such as asthma and obesity. These factors lead to increased health care costs, greater use of social services, income loss, and reduced economic output, all of which result in higher costs to the state, individuals, and their families.

“These data spotlight the importance of providing perinatal mental health screening, treatment, and prevention services for pregnant and postpartum people in Vermont,” said Laura Pentenrieder, program manager for Screening, Treatment & Access for Mothers and Perinatal Partners at the Vermont Department of Health, Family and Child Health Division. “In recognition of how critical this work is, Vermont is committed to continuing its economic analysis by exploring the impact of expanding PMAD treatment services in support of the well-being and mental health of pregnant and postpartum parents.”

Making the investments that promote wellness and support the mental health of pregnant and postpartum people can improve health outcomes for them and their children and reduce the economic burden of PMADs on individuals, families, employers, and states.

To conduct this study, Mathematica and the Family and Child Health Division constructed a model composed of the most recent peer-reviewed literature and secondary data sources to quantify the societal costs of not treating PMADs in Vermont. The study authors averaged the data over several years to account for changes in incidence of PMADs and record keeping during the COVID-19 pandemic.