Kids are expensive – they just keep eating and growing out of their clothes and needing more diapers! But that’s not the only bill you’ll need to think about as you prepare to welcome a new little one into your family. There’s also the cost of pregnancy, labor, and delivery. Medical care is notoriously expensive and opaque, so it’s tough to know what to expect. What’s the cost of having a baby?
Cost Of Prenatal Care
Before we can tally up a total, we need to know what we’re being charged for. First, you’ll have prenatal care. If your pregnancy is routine, that may include:
- doctor’s visits – up to once a month for the first few months, twice a month for the next few months, and weekly for the last month
- lab tests (like urine tests and blood work)
The pricing for all of this care will vary by location and provider. Nationwide, the average is about $2,000. However, your costs may end up being far higher or lower than that, depending on where you get your care. For example, the average cost of an ultrasound in Dayton, Ohio is about $270. The average cost of the same procedure in New York City is about $340. Even within the same city, costs can vary widely between different providers.
If your pregnancy isn’t routine or if you’re overweight, over the age of 40, or have certain health problems, you may need more extensive prenatal care. That may involve more testing, more frequent visits with your doctor, and other types of treatment. It also involves more costs, which will depend on the specific kind of extra care you need.
Cost Of Having A Baby
Once it’s time to actually deliver, you’re facing a different set of costs altogether. The cost of having a baby depends on where you deliver, whether there are any complications, and your health care provider.
In A Hospital
The average cost in the US for a vaginal delivery without complications is $2,600 and the average cost for a c-section is $4,500. Vaginal deliveries with complications that require surgical intervention are by far the most expensive, costing an average of $6,900.
That said, the cost of having a baby varies widely depending on your provider. One study found that the average price tag for an uncomplicated vaginal delivery ranges from $2,000 to a whopping $12,000 in the US. A study from UC San Francisco found that in California, the cost of an uncomplicated vaginal delivery can be as low as $3,000 and as high as $37,000. The same study found a range of $8,000 – $71,000 for a c-section.
In other words, it’s tough to pin down what exactly the cost of having a baby will be. And what exactly are you paying for? The costs of an uncomplicated hospital delivery may include:
- use of a delivery room
- bed and board at the hospital
- cost of medical supplies
- your OB/GYN
- an anesthesiologist
- pain medication
- other fees
A complicated delivery may also include costs related to a c-section, blood transfusions, surgeons, the use of a surgical suite, and others.
In A Birthing Center
Of course, not everyone wants to deliver in a hospital. What about birthing centers? There, your costs are typically much more transparent than at a hospital and they’ll tell you what you’ll be paying up front. Birthing centers also typically bundle the costs of their services together, so your room, midwife, and other expenses are all covered at the same time. The average cost to have a baby at a birthing center is about $3,000. However, like hospital expenses, these prices vary significantly by provider.
For example, we contacted birthing centers in four different cities around the country to ask about their pricing. At the centers we spoke to in Omaha, Orlando, and Portland, the price of prenatal care and delivery was around $6500. At the center we spoke to in Albuquerque, the price was just $3500. All of the centers we spoke to offered discounts for pre-paying, and several offered discounts for those without insurance. In addition, they all noted that they were willing to work with a patient who could not manage the costs.
Note that if you decide to use a birthing center but experience complications, you may need to be transferred to a hospital. In that case, you’ll also be responsible for those costs.
The cost of giving birth at home – you guessed it – varies widely. You won’t have to pay facility fees like you would at a hospital or birthing center, but you will need to hire a midwife or a doula. Their fees range from $1,000 to $5,000. As with a birthing center, you may need to be transferred to a hospital in case of complications, which means you’ll have extra expenses.
Where Does Insurance Come In?
All of the prices above are cash prices, but what if you have insurance? That will depend on your specific coverage and where you want to deliver. If you’re pregnant or trying to become pregnant, take a look at your insurance right away. Contact them and ask what they cover and whether you need to use specific providers or hospitals. Ask them about what their requirements are for coverage – some plans require you to get pre-authorization or to notify them when you go into labor or they’ll deny your claim. Home births are typically not covered and only some plans will cover birthing centers.
As far as hospital deliveries go, it gets a little trickier. Hospital pricing systems are notoriously opaque and complex and the cost of having a baby is no exception. As you decide where to deliver, you’ll need to keep in contact with your insurer and any hospitals you’re considering to make sure they’re in network. You should also ask about your OB/GYN and your anesthesiologist, because they frequently bill separately from the hospital itself and may actually be out of your network. Even among hospitals within your network, the costs can vary significantly. Hospitals decide what they want to charge for rooms, procedures, and tests, so two different facilities just a few blocks apart may have final price tags tens of thousands of dollars apart. In other words, you’ll need to do your homework in advance to keep the costs down. Even during delivery, your doctor may want to do extra tests, all of which can cost you. Ask if the tests are medically necessary and whether they’re likely to be covered by insurance.
When you’re dealing with insurance, the trick is to keep careful track of every bill and everything you spend. Remember that you won’t get just one bill from the hospital. You’ll get separate bills for separate parts of your services and from different providers – you may receive completely separate invoices for your doctor, your room and board, your anesthesiologist, your medications, and more. An estimated 30-40% of medical bills have errors in them, meaning many people overpay without knowing it, so it’s worthwhile to check through every one that you receive. Verify the services you received and the things you’re being billed for with your care provider and challenge anything that doesn’t look right. As your insurance comes through, check to make sure they’re covering everything they said they would cover. The cost of having a baby is already high enough – you don’t want to get stuck paying extra!
How To Figure Out Your Costs
Ok, so what are you actually going to pay? If you have insurance, the first step is to call them and ask about your maternity coverage. If you have a group plan and your employer has more than 15 employees, your insurance must cover maternity care by law. Plans purchased through the Affordable Care Act are also required to provide maternity coverage, even if you got the plan after you were already pregnant. Private insurance plans, on the other hand, are only required to provide maternity care in a few states. Some allow you to purchase additional coverage specifically for maternity care, but it’s usually expensive and may have a waiting period of up to 2 years before you can actually use it. If you do have coverage, you’ll have to pay up to your deductible and potentially a portion of the costs (“co-insurance”) after your deductible is met. You may be able to keep your costs down by keeping your entire pregnancy within insurance year so that your prenatal and delivery costs all go toward your deductible and you don’t have to hit the deductible twice. With insurance, you may end up paying anywhere from a few dollars to several thousand – it all depends.
If you don’t have insurance, note that Medicaid has higher income limits for pregnant women in many states, so you may qualify for coverage. Medicaid often covers a large chunk of the costs, so that’s an option worth considering. You can also sign up for coverage under the Affordable Care Act, because insurers can no longer treat pregnancy as a preexisting condition and deny you care. They also can’t charge more simply because you’re pregnant.
If you don’t have insurance and want to deliver at a birthing center or at home, you can simply call your local birthing centers and midwives/doulas and ask them what they charge. They’re typically very transparent about pricing and willing to work with you on a payment plan or other accommodation if the costs are a problem for you. However, you should still look into the pricing of local hospitals in case of emergencies – better to choose one in advance than get stuck with a huge surprise bill. As far as hospitals go, it’s all about doing your homework. As we’ve mentioned before, the costs of hospitals and doctors differ significantly even in the same area. Don’t forget to ask about the individual costs for the OB/GYN, anesthesiologist, and medications, all of which may be billed separately. Having a baby without insurance at a hospital can be very pricey, so you may consider using a birthing center or having a home birth.
As you consider the cost of having a baby, you should also ask about the cost of care for your newborn. You may end up with a different doctor doing the first checkup for your little one, which may be a separate charge. And if your baby is premature or has other health problems that will also be an additional expense. Some hospitals contract out their newborn intensive care units (NICUs), so that care may be out of network even if the rest of your delivery is in network.
The Bottom Line
At the end of the day, the cost of having a baby is a surprisingly complicated matter. The best thing you can do for your budget is start to address the costs as early as possible. If you have insurance, get in touch with them right away to start working out the most cost-effective plan. If you don’t, you may want to look into enrolling in either Medicaid or an ACA plan, or you may want to start researching hospitals, birthing centers, and midwives near you to find the best option. You’re already going to have your hands full with your new little one, and surprise medical bills are the last thing you need to deal with.
How did you handle the cost of having a baby? Do have tips for keeping the bills low? Let us know in the comments!