Coping with the financial costs of pregnancy: What expectant parents should expect

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This story is part of PricedCNET’s coverage of how real people cope with the high cost of living in the United States.

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On a warm day last spring, Teja Smith, 31, went to Cedars-Sinai Hospital in Los Angeles to schedule her birth. Instead, at 36 weeks pregnant, she found out she had preeclampsia, a serious high blood pressure disorder that can occur during pregnancy, and had to induced Immediately. directly. Three days and an unscheduled C-section later, Smith left home with her newborn son and a $42,180 medical bill.

Although his insurance covered $40,000 of that bill, Smith was left with the balance. “I was even accused of skin-to-skin contact with my son and cutting my umbilical cord,” she said.

The Smith family

Teja Smith and family

Smith’s story is not unusual. this The cost of giving birth in the United States is higher Compared to any other state for parents with insurance, the average out-of-pocket cost of a natural birth is $2,854, compared to an average of $3,214 for a C-section like Smith’s. In accordance with Kaiser Family Foundation

If you don’t have insurance, the costs can add up quickly Tens of thousands of dollars. While there are resources to help reduce pregnancy-related costs, there are still gaps in access and large disparities in the cost of medical care for the uninsured and the insured.

Pregnant women are low-income, especially from black and Latino families Less likely to have health insuranceand these families spend on average Between 19 and 30 percent Their annual income from medical expenses related to pregnancy and childbirth. And that doesn’t include the hidden costs outside of labor that start in the family planning phase, or the costs that continue after childbirth.

“My biggest piece of advice is to never go into pregnancy without insurance, even if it’s Medicaid or something the government provides,” Smith said.

Pregnancy bills are heavy for everyone

Shilpa Nandwani, 30, a teacher in Austin, Texas, always knew she wanted children. After their marriage, in December 2021, Nandwani and her husband both decided to try in vitro fertilization, or IVF.

Nandavani and his partner

Shilpa Nandwani and her partner.

Non-disability insurance access to great grandparents, fertility benefits and family formation by the employer. She and her partner went through the egg retrieval process, which cost them both a total of $8,000 for everything, including a sperm donation, genetic testing of the embryos, and a frozen embryo transfer. Without Progyny’s help, their bill would have been $32,000.

Fertility treatments such as IVF and intrauterine insemination are becoming more common in the United States — some 33 percent of Americans According to a Pew Research Center study, you have turned to fertility treatments or know someone who has. But these treatments are expensive for those who do them.

He says: “The way to become a parent is not always as easy as what we have heard from movies and story books.” Janet Choi, reproductive endocrinologist and medical director of the CCRM Fertility Clinic in New York. Choi noted that one round of IVF with medication can cost more than $25,000 and often takes two to three cycles to be successful.

Dr. Choi

Dr. Janet Choi: “The road to parenthood is not always as easy as we’ve heard from movies and story books.”

According to Choi, an employer-sponsored fertility benefits program is crucial for those who must go this route. “This can not only offset the financial burden of fertility treatments, but also support the mental and emotional stress of going through the process,” she says.

Pregnancy costs can leave expectant parents with high medical costs even before the pregnancy begins. For many, the first expenses begin during pregnancy after finding out they are pregnant. Regular doctor’s appointments for examination, blood tests, ultrasound and other tests $100 to $200 per appointment (Most pregnant people attend 12 times during their pregnancy). Genetic carrier testing, which may be required to diagnose certain congenital disorders, is not always covered by insurance and can add an additional co-pay. 100 to 1000 dollars Out of pocket expenses

Then there are prenatal vitamins, Maternity clothes and pregnancy-safe skincare and makeup that are easy to pack. For example, Nandwani pays $50 for a two-month supply of prenatal vitamins—she estimates she spent $750 on supplements during her pregnancy and postpartum.

Childbirth is usually the most expensive, and if you choose non-traditional birthing methods, these costs may not be covered by your insurance. become more popular In the last five years

Nandwani and her husband are choosing to give birth outside the hospital. “We decided to get a doula and midwife because, as a queer couple, I didn’t want people to question our parenting titles and our relationship with our baby,” she says. The couple will pay $2,000 for a doula and $5,000 for midwifery services.

Health care coverage can reduce pregnancy costs

High doctor or hospital costs during pregnancy can lead to severe long-term consequences, including: Medical debt, bankruptcy and in some cases worsening health outcomes. Approximately 24% of pregnant or recently pregnant women report having unmet health needs that can lead to adverse birth outcomes and other risks. In accordance with A recent study in the Journal of the American Medical Association.

Considering that half of the country’s pregnancies are unplanned, families without insurance seek medical care. Although employer-sponsored health plans and the public health insurance marketplace may offer low-cost options, the small open enrollment window, typically between Nov. 1 and Jan. 15, can prevent parents-to-be from enrolling. Getting coverage outside of the open enrollment period requires a “qualifying life event” such as starting a new job, getting married or losing current coverage. Childbirth is considered a “qualifying life event,” but pregnancy is not. Depending on the timing, some expectant parents may not be able to sign up for coverage at all, while others may be able to sign up late in their pregnancy.

If health insurance is not an option, Medicaid may provide coverage. Low-income pregnant women who meet state income requirements can qualify for reduced or even free Medicaid coverage, but Still gaps in the system Preventing broader maternal and child health care coverage. And, Although most states have extended 12 months of coverage to postpartum women; in some states, Medicaid benefits end 60 days after delivery.

Further expanding Medicaid benefits to provide affordable coverage to more pregnant women could not only ease the financial burden of new parents, but also help reduce maternal mortality rates. It is higher in the United States More than any other developed country. In accordance with Georgetown University Health Policy Institute

Additional resources and support to help with pregnancy costs

Whether you’re insured or not, there are options to help lower your pregnancy costs.

In addition to her full-time job, Nandwani has also done contract work, a financial solution that works well for her family. Although this option may be practical for some, it may not be recommended for those with high-risk pregnancies. During her pregnancy, she worked more than 40 hours a week It is associated with serious health risksincluding miscarriage and preeclampsia.

If you can demonstrate financial need, you may be able to negotiate some of your medical expenses. “Some hospitals will allow you to submit your financial records if you are unable to pay certain fees or agree to a payment plan,” Smith said.

If you plan to pay for all or part of your pregnancy care out of pocket, tell your health care provider. He may be able to offer lower-cost care options or a discounted package rate, or if he can’t lower prices, he may be able to refer you to a more affordable clinic or doctor.

There are other programs and resources for uninsured expectant parents who do not qualify for Medicaid. Special supplemental nutrition program for women, infants and children, or WIC; Also known as Children’s Health Insurance Program chip; And Planned Parenthood All offer low-cost prenatal care. The US Department of Health and Human Services also has a references To help pregnant people access free or low-cost services.

Connecting with others in your community or across the country through Facebook groups and other online forums is a great way to share cost-cutting tips. Talking to other pregnant or new parents may help you better prepare for financial expectations, while offering solutions that others have implemented. Children’s Hospital of Pennsylvania Collection of Various groups that expectant parents can explore.

“Find support in any way you can,” Nandwani said. “Part of being supportive is talking about finances with your partner or family and understanding the potential costs.”

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