The Rising Cost of Pregnancy: What Can Parents Do About It?

this story is part We lowered the priceCNET’s coverage of how real people are coping with the high cost of living in the US.

Brandon Douglas/CNET

On a warm day last spring, 31-year-old Teja Smith visited Cedars-Sinai Hospital in Los Angeles to find out about birth planning. Instead, she learned that just past 36 weeks of pregnancy, she had pre-eclampsia, a serious high blood pressure disorder that can occur during pregnancy. It had to be provoked immediately. Three days after her unplanned caesarean section, Smith left home with her newborn son and her $42,180 medical bills.

Her insurance covered the bill for $40,000, but Smith was left with the balance. “I was charged with skin-to-skin contact with her son and cutting the umbilical cord,” she said.

Teja Smith and family.

Smith’s story is not uncommon. Childbirth costs in the United States are higher than in any other country. For an insured parent, the average out-of-pocket cost for a conventional birth is her $2,854, according to the Kaiser Family Foundation, while a C-section like Smith’s averages $3,214.

Without insurance, the cost can quickly add up to tens of thousands of dollars. While there are resources available to reduce pregnancy-related costs, there are still gaps in accessibility and wide disparities in health care costs among the uninsured or underinsured.

Low-income pregnant people, especially black and Latino families, are less likely to have health insurance, and these families spend an average of 19% to 30% of their annual income on pregnancy and childbirth-related medical expenses. I’m here. This does not include hidden non-labor costs that begin at the family planning stage or continue after childbirth.

“My biggest piece of advice is to never get pregnant without insurance, even if it’s Medicaid or what the state provides.

Pregnancy bills are expensive for everyone

Shilpa Nandwani, 30, a teacher in Austin, Texas, has always wanted children. After her marriage, in December 2021, Nandwani and her partner decided to try IVF, or IVF, on her.

Nandwani and her partner

Shilpa Nandwani and her partner.

Nandwani’s insurance provided access to Progyny, an employer-sponsored fertility and family-building benefit. She and her partner went through the process of egg retrieval, which all cost $8,000 in total, including sperm donation, embryo genetic testing, and both frozen embryo transfers.Without Progyny’s help, what their bill would have been. would have been her $32,000.

Fertility treatments such as in vitro fertilization and intrauterine insemination are becoming more popular in the United States. About 33% of Americans are undergoing or know someone who is undergoing fertility treatment, according to a Pew Research Center survey. However, these treatments come at a huge cost to those who perform them.

“The road to parenthood is not as easy as it sounds in movies and fairy tales,” says Janet Choi, a reproductive endocrinologist and medical director of the CCRM Fertility Clinic in New York City. Choi notes that her one session of in vitro fertilization with medication can cost her more than $25,000, and she often needs two to three cycles to be successful. Did.

Dr. Choi

Dr. Janet Choi: “Parenthood is not as easy as it sounds in movies and fairy tales.”

Employer-sponsored fertility benefit programs are important for those who need to go down this path, Choi said. It can also support mental and emotional strain.

Conception costs can leave prospective parents with high medical bills, even before the pregnancy begins. For many, the first costs begin in the prenatal period, after pregnancy is known. Ranging from $100 to $200 (most expectant mothers attend 12 appointments during their pregnancy). Gene carrier testing, which may be required to detect certain birth defects, is not always covered by insurance and may add an additional $100 to $1,000 to your out-of-pocket costs. .

Then there are prenatal vitamins, maternity clothes, and pregnancy-safe skincare and makeup that you can easily add. I’m here. She estimates that during her pregnancy and postpartum, she spent $750 on her supplements alone.

Childbirth is generally the most expensive, and if you choose a non-traditional birth method that has become more popular over the last five years, these costs may not be covered by your insurance.

Nandwani and her partner have chosen to give birth outside the hospital. “As a queer couple, we didn’t want people to question our parental titles or our relationship with our baby, so we decided to go down the path of getting a doula and a midwife,” she said. The couple will pay the doula her $2,000 and her $5,000 for midwifery services.

Health care coverage can reduce pregnancy costs

High bills to doctors and hospitals during pregnancy can lead to serious long-term consequences, including medical debt, bankruptcy and, in some cases, poor health.Published in the Journal of the American Medical Association A recent study found that 24% of pregnant or recently pregnant women report unmet health care needs, which can lead to poor birth outcomes and other risks.

Given that half of all pregnancies in the country are unplanned, uninsured households are left scrambling to seek medical care. Employer-sponsored health insurance and the public health insurance market may offer lower-cost options, but the small open enrollment window, usually from November 1 to January 15, is a great option for expectant parents. may prevent you from enrolling. To obtain insurance outside the open enrollment period, you must have a “qualifying life event” such as starting a new job, getting married, or losing existing insurance. Birth is considered a “qualifying life event”, but pregnancy is not. Depending on the timing, the expectant parent may not be able to purchase insurance at all, or towards the end of the pregnancy.

Medicaid may provide coverage if health insurance is not an option. Low-income expectant mothers who meet state income requirements may be eligible for reduced or no Medicaid coverage, but there are still gaps in the program and broader maternal and child health insurance coverage. hinders its application. And while most states have extended coverage to a postpartum woman for her 12 months, some states end Medicaid benefits 60 days after giving birth.

Further expanding Medicaid benefits to provide affordable coverage to more pregnant people would not only ease the financial burden on new parents, but also increase the cost of pregnancy for pregnant women in the United States, which is higher than in any other developed country. It also helps reduce mortality. University Institute of Health Policy.

Additional resources and support to help with pregnancy costs

Whether you have insurance or not, there are options available to reduce your out-of-pocket pregnancy costs.

Nandwani has taken on contract work in addition to her full-time job. This is a financial solution that has worked well for her family. While this option may be practical for some, it is not recommended for those with high-risk pregnancies. associated with significant health risks.

You may also be able to negotiate some of your medical costs if you can demonstrate financial need. “Some hospitals allow you to submit financial records if you can’t pay certain costs or agree on a payment plan,” Smith said.

Let your healthcare provider know if you plan to pay for all or part of your care during your pregnancy out of pocket. We may be able to offer low-cost care options or discounted package rates. And if we can’t lower our prices, we may be able to refer you to a more affordable clinic or doctor.

There are other programs and resources for uninsured parents who are not eligible for Medicaid. Special Nutritional Assistance Programs, or WICs, for Women, Infants, and Children. Children’s health insurance program, also known as CHIP. All Planned Parenthood offer low cost pregnancy care services. The U.S. Department of Health and Human Services also has a list of resources to help pregnant individuals find access to 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-saving tips. Talking to other pregnant women and new parents may help you prepare for financial expectations while offering solutions that others have implemented. There is a collection of different groups that parents can explore.

“Find as much support as you can,” Nandwani said. “Part of the support is talking with your partner and family about finances and understanding potential costs.

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