Background: The effects of poverty in the United States are growing, and the impacts are most severe for the already vulnerable populations. This analysis looks at the cost of doing nothing for at-risk pregnant women in one county in NE Ohio. Most of these women are living at or below the poverty level, lack safe, affordable, and stable housing, and often do not receive recommended levels of prenatal care. This examination uses data from Mahoning County, Ohio, where one program has provided wrap-around support for any at-risk pregnant mother since 2016. Objective: Examine the cost/savings of providing wrap-around support services to at-risk pregnant women. Methods: Data was provided by the Mahoning County Pathway HUB (MCPH) regarding all births since its 2016 inception. Data was extracted from the Ohio Department of Health, the CDC, and other sources regarding the cost of births and specifically premature births. These sources of data were analyzed using causal-comparative methods, in order to understand the frequency of premature births, with, and without the support services provided by the MCPH. Conclusion: The results of these causal-comparative analyses suggest that the cost of doing nothing for at-risk pregnant women is substantial for all stakeholders. Results demonstrate a savings of 2.45 million dollars for the five years included in the analysis. Because most of the services provided by the MCPH are billable to public health insurance, this model of supporting pregnant mothers who are at risk is important. The cost of doing nothing can lead to a lifetime of avoidable suffering and financial hardship for the women and infants who are born premature. The results from the MCPH suggest that this model of support and service delivery is making a difference, based on the lower-than-expected pre-term births over their tenure of operation.