Making an invisible burden visible: Quantifying the hidden economic impact of birth trauma in Australia

Birth Trauma Australia (BTA) sought to address a longstanding gap in Australia’s healthcare and policy systems: the under-recognition of the economic burden associated with birth injuries and ongoing conditions after childbirth. While these experiences can have profound physical, psychological, social and financial consequences, they have often remained hidden in clinical data, fragmented across care pathways and poorly reflected in policy and funding decisions.

The scale of the issue was substantial. In FY23–24, an estimated 1.1 million women+ in Australia, or more, were affected by birth injuries and ongoing conditions. But many conditions remained underdiagnosed, underreported or poorly understood. Limited data on prevalence, diagnosis, treatment, care pathways and long-term outcomes made it difficult for advocates, clinicians and policy makers to describe the full impact of birth-related trauma, let alone make the case for coordinated reform.

Without a credible national evidence base, birth-related trauma risked being treated as a niche women’s health issue rather than a system-wide challenge affecting healthcare costs, workforce participation, household finances, mental health, relationships, parenting and quality of life. Birth Trauma Australia needed robust, defensible analysis of economic impacts to support advocacy, inform public debate, and strengthen the case for investment in prevention, treatment, and maternity care reform.

After being engaged by Birth Trauma Australia, we set about undertaking the country’s first comprehensive national assessment of the economic impact of birth injuries and ongoing conditions. The work was designed to do more than produce a headline figure. It needed to capture the breadth of impacts across people’s lives, show where costs were falling across the system, and make visible the consequences that conventional datasets often miss.

"Until now, birth trauma has been viewed as an individual experience for women to manage,” says Nous Director Joshua Sidgwick. “But the report shows it is a social and economic issue of national significance with potentially lifelong impacts on women+, their partners and children, and on labour and productivity."

We began by developing an economic model that quantified impacts across four domains: health system costs, labour market impacts, household financial costs, and burden of disease and wellbeing loss. This framework enabled the analysis to recognise both direct costs, such as treatment and service use, and broader costs associated with reduced workforce participation, out-of-pocket expenses, pain, distress and diminished wellbeing.

The analysis drew on national health datasets, Australian and international literature, survey data from Birth Trauma Australia, and targeted consultations with women+ with lived experience, clinicians, researchers, advocates, and system stakeholders. This mixed evidence base was critical. It allowed us to triangulate quantitative findings with clinical knowledge and lived experience, test assumptions, identify data gaps and avoid overstating results where evidence was incomplete.

"We deliberately took a conservative approach, drawing on national data and validating our findings against international evidence and lived experience,” says Senior Consultant Isobel Barry. “Even then, the annual cost of birth injury runs into the billions, and that's likely an underestimate.”

We also adopted a life-course perspective. Many birth-related injuries do not end with the immediate postnatal period. Some emerge, persist or worsen months and years after childbirth, affecting people’s health, confidence, relationships and ability to work. Recognising this longer time horizon helped the model reflect the true nature of the issue: birth-related trauma is not a single moment that happens then ends, but a set of conditions and consequences that can shape lives well beyond birth.

The analysis found that birth injuries and ongoing conditions generated an estimated economic impact of $17.5 billion in FY23–24. This included $1.4 billion in health system costs, $8.8 billion in labour market impacts, $792 million in household costs, and $6.5 billion in burden of disease and wellbeing losses.

These findings gave Birth Trauma Australia a credible, nationally relevant evidence base to support advocacy and policy engagement. They demonstrated that the effects of birth injuries and ongoing conditions extend far beyond immediate clinical outcomes. The impacts are felt across health services, workplaces, families and communities, with consequences for productivity, financial security, mental health, parenting and quality of life.

The report also made clear that the true economic burden is likely higher than the estimate suggests because of limitations in available data. This was an important finding in itself. The analysis showed how gaps in diagnosis, coding, data collection and follow-up can obscure the scale of birth-related harm, reinforcing the need for stronger national data infrastructure, universal screening and more consistent treatment pathways.

The project highlighted the policy power of making invisible impacts measurable. For many women+ and families, birth-related trauma is experienced as a deeply personal and isolating event. By quantifying its economic, social and wellbeing impacts, Nous helped reframe the issue as a matter of system performance and public investment.

The work also showed that better evidence is not only about better numbers. It is about making data meaningful to decision makers while keeping lived experience at the centre. The strongest case for reform came from combining economic modelling, clinical evidence and personal accounts into a coherent narrative: prevention, earlier diagnosis and better care are not optional improvements, but investments that can reduce avoidable harm and long-term costs.

"The report provides an important first step in making this burden visible,” says Director Olivia Mallet. “We hope it provides a foundation for policy makers and health professionals alike to galvanise action to reduce birth trauma."

For Birth Trauma Australia, the study provides a platform for future advocacy, research and partnership. For the broader maternity system, it offers a clear message: when conditions are under-recognised in data, they are under-recognised in policy. Making birth injuries and ongoing conditions visible is a necessary step toward coordinated national action, more consistent care and better outcomes for women+, babies, and families.