In 2014, we carried out the first UK study to estimate the long-term costs of perinatal mental health problems for both mothers and children. By showing how costs fall on government, individuals, and society, the findings helped secure new investment in specialist services and shaped policy in other high-income countries.

Since then, we’ve worked with partners in Brazil, Pakistan, South Africa, and Thailand to adapt this approach and generate local cost estimates, even where data is limited.

To support wider use in low- and middle-income countries, we developed the Cost Calculator Tool that allows to:

• Estimate the long-term costs of perinatal mental health problems

• Draw on local data where available

• Test assumptions and update estimates as new evidence emerges

We take a participatory approach — collaborating with local experts and stakeholders to fill data gaps, reflect local context, and share findings in meaningful ways. This has proven effective across diverse settings.

At least 1 in 5 women worldwide experience mental health problems during the perinatal period, from pregnancy up to two years after birth. In some low- and middle-income countries, the rates are even higher, as many as 1 in 2 women may be affected, and rates will be even higher in regions and amongst groups affected by major environmental stresses such as conflict.

Without the right support, poor maternal mental health at this important time can have serious and lasting effects on both mothers and their children. Some of these impacts can also be measured in economic terms. Supporting perinatal mental health is now widely recognised as key to achieving global goals around maternal health, gender equality, child development, and economic growth.

Mental health and poverty are closely linked, particularly in resource-poor settings. Women in these contexts face a higher risk of perinatal mental health problems, often driven by gender-based violence, threats to livelihoods, and limited access to care. Around 1 in 10 women experience suicidal thoughts or attempt suicide during the perinatal period.

These challenges also affect children, increasing the risk of:

• Preterm birth

• Low birth weight

• Serious illnesses in infancy (e.g., diarrhoea, asthma, infections)

• Developmental delays (stunting, wasting)

• Mental health problems

Many of these issues carry significant economic consequences for governments, families, and society through healthcare costs, productivity losses, and reduced quality of life.

Cost evidence generated by the Cost Calculator Tool highlights the scale of these impacts. It shows how costs fall on governments, individuals, and communities, and how they relate to the wellbeing of mothers and children. By illustrating the cost of inaction and the potential savings from prevention and early treatment, these findings can be especially powerful in settings with limited investment.