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DELIVERY COSTS

Mothers getting sick or dying in childbirth costs the US more than $30 billion a year

A newborn baby infected with COVID-19 receives oxygen at a maternity hospital
Reuters/Kirill Braga
A majority of maternal health costs are associated with children.
  • Annalisa Merelli
By Annalisa Merelli

Senior reporter

Published

The US is a dangerous place to give birth. The rate of maternal mortality—deaths resulting from pregnancy or delivery complications—and pregnancy-related illnesses are the highest of any rich country. American maternal health has declined dramatically since the 1990s, just as the rest of the world’s has improved dramatically.

The data are still incomplete, but in the US an estimated 17 to 26 women die of pregnancy-related causes for every 100,000 births. This ratio is far lower in comparable countries: In the UK and France, it’s about nine per 100,000, in Germany three per 100,000, and in New Zealand 1.7 per 100,000. Between 700 and 1,200 new mothers or pregnant women die in the US every year. Another 50,000 nearly die, and more than 100,000 experience severe illness.

The tragedy of maternal mortality and morbidity, which is especially high among Black women, doesn’t just have unspeakably high human costs: It is a huge financial burden for society.

The cost of maternal morbidity

The Commonwealth Fund, a foundation supporting independent research aimed at improving healthcare in the US and other industrialized countries, published a new report last week, calculating that poor maternal health costs the country more than $30 billion, which it called a very conservative estimate.

Through a literature review, the study—the most comprehensive so far on the economic burden of maternal mortality and morbidity—identified a list of conditions that can cause negative outcomes—including a loss of economic productivity and need for social assistance—for the mother and the child during pregnancy and after birth up to five years. It then quantified the economic cost of those outcomes for every year.

Maternal mental health issues have the biggest cost

Of the conditions identified in the study, maternal health issues were the ones linked with the highest costs. Psychiatric issues are the most common complications of pregnancy and childbirth, affecting at least one in seven mothers, and they cost $18 billion a year, of which $7 billion are medical cost and $11 billion are non-medical costs, such as lost productivity. Hypertension ($7.5 billion in overall costs) and gestational diabetes ($5 billion) were the second and third most expensive conditions.

When it comes to outcomes, loss of productivity was by far the costliest for mothers ($6.6 billion). The most expensive outcomes for children were preterm birth, associated with a cost of $13.7 billion, and developmental issues ($6.5 billion).

A partial estimate

Since the study was only able to calculate the costs of conditions linked to specific outcomes, the estimate is to be considered partial, says So O’Neil, a senior researcher at Mathematica, a policy research organization, and the study’s lead author. Out of 31 conditions that were identified as affecting maternal health, only nine could be connected to quantifiable outcomes, which leaves more than 20 conditions that likely have an economic impact (including cardiovascular conditions, or blood clot disorders) but couldn’t be quantified based on the available literature.

“This speaks to the need for better quantification,” says O’Neil. While she doesn’t feel comfortable trying to guess how much of the costs weren’t captured by this research, she says it is a significant amount. “[The cost] could rival some of the most burdensome chronic conditions, she says.

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