Objectives <p>This study aimed to investigate the cost-effectiveness of a Mindfulness-Based Childbirth and Parenting (MBCP) program compared with treatment as usual in the Spanish National Health System.</p> Method <p>A multicenter randomized controlled trial was conducted in Valladolid, Spain, from October 2017 to April 2019. Participants were pregnant women (<i>n</i> = 104). They were assigned to either (1) an MBCP course adapted to the Spanish National Health System together with treatment as usual (TAU) or (2) TAU only. The evaluated outcomes included maternal depression symptoms, measured using the Edinburgh Postnatal Depression Scale, and healthcare costs, assessed using an adaptation of the Client Service Receipt Inventory (CSRI).</p> Results <p>The incremental cost-effectiveness ratio (ICER) analysis revealed an incremental cost of €19.15 and an incremental effectiveness of 0.06 points in maternal depression symptoms, resulting in €319.17 per point gained, suggesting the intervention is potentially cost-effective with moderate costs for mental health benefits. The incremental cost-utility ratio (ICUR), supported by bootstrap simulations, indicated that the intervention was dominant in a substantial proportion of scenarios, generating both cost savings and QALY gains. For the ICER, results from the uncertainty analysis ranged from dominance to €3900 per Edinburgh Postnatal Depression Scale (EPDS) point gained, providing consistent evidence of the intervention’s economic viability.</p> Conclusions <p>Findings indicated that MBCP is a cost-effective intervention compared to TAU, demonstrating economic viability through reduced costs and enhanced quality-adjusted life years.&#xa0;</p> Preregistration&#xa0; <p>ClinicalTrials. Gov (NCT03247491)</p>