When childbirth becomes a financial stress

On December 31, 2011 right before midnight, I took the test of excitement and new beginnings and found out that I was pregnant. While this news was joyous in nature, it was soon marred by uncertainty and harsh reality.

After my test, I followed up with a doctor’s visit a month later, as was expected, and soon learned that the cost for this bundle of joy would be around $12,000 to $15,000 plus. My husband was a student in school and while I did have insurance, I did not understand the terminology behind it.

Speaking to Jill, the financial advisor lady, I was told, “Since you have such a high deductible you will need to pay $450 a month for just the doctor’s visits and care, then once you meet your deductible you will owe a co-insurance portion owing up to $8,000 to $10,000 for the hospital room and delivery.”

I was at a loss. I had no idea what a deductible, co-insurance or an out-of-pocket max was and even still I would have still owed a total of $8,000 until I would have hit my out-of-pocket maximum, which I didn’t realize until after giving birth.

After attending that one doctor’s appointment, I did not go back simply because I knew with my $37,500/year salary that there was no way I would be able to afford this birth. I didn’t go to the doctor for another 6 months. I was ashamed and felt like a horrible mother because I knew with these birthing bills alone I could not afford this child. What made things worse was that when people found out that I was not going to the doctor they would question my decisions and add to my guilt.

After my boss found out that I was not going to the doctor, I began doing my research on doctors and hospitals to find which one would be the most cost effective one for me. I still had no idea what a deductible and co-insurance was and this lack of knowledge of terminology added to my frustration since the only thing I seemed to hear from doctors’ offices was that I owed $3,000 to $4,000 upfront for just the doctor’s fees. I was beginning to think I should have this baby at Walmart like Natalie Portman in Where the Heart Is.

I finally Googled natural birth centers since I already knew that I did not want an epidural or C-section or anything extra just because I was scared to add costs to the already high cost of me doing most of the work and pushing a baby out of my body. I even joked in seriousness to my friends and husband, “If I start screaming for an epidural just tell me it’ll be $10,000 and I will shut-up.”

So I called birthing centers and learned that for the doctor’s visits and birth I would owe only $900. This is because it was a very minimalist birth, me, the midwife, her assistant and then the baby. Granted there was no medication and I left the birthing center within 4 hours of birth, but now I can wear a t-shirt saying “I Survived Child Birth” and I ended up owing a lot less money for the birth allowing me more money to spend on diapers, clothes and toys.

A year later, I read an article about Kate Middleton who gave birth and it only cost her about $15,000 and this was with all the stops being pulled. This made me wonder why our health care system is so dysfunctional that something so miraculous as childbirth becomes another stress for American parents-to-be.

Ashley Lane was a runner-up, 2013 Costs of Care Essay Contest.

When childbirth becomes a financial stress

This post originally appeared on the Costs of Care Blog. Costs of Care is a 501c3 nonprofit that is transforming American health care delivery by empowering patients and their caregivers to deflate medical bills. Follow us on Twitter @costsofcare.

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  • doc99

    Healthcare is the only American enterprise which claims to save money by increasing the number of middlemen.

  • Patient Kit

    Ashley, first, I’m glad you ultimately found a way to give birth with a midwife at a birthing center and I hope you and your baby are both healthy and happy. Hubby too. ;-)

    You’re not alone. There are plenty of Americans with similar salaries, $37,000 (gross, not net) who can’t afford to use their high deductible, high co-pay insurance. The result: Many people don’t go to the doctor when they should; they go only when absolutely necessary; and way too often they go when it’s too late. But, apparently, we need that “skin in the game” to deter us from going to doctors and hospitals too often. Like going to the doctor for unnecessary care is every American’s favorite pastime.

    Finally, it never ceases to amaze me how many Americans who do have health insurance, don’t actually know how their plan works or what it covers. And then they find out, when they try to use it for the first time, what it doesn’t cover, how it doesn’t work and just how underinsured they are. I imagine this is more often true of people with employer provided insurance than those who actually shopped and carefully chose their plan. Again, you’re not alone in not understanding how things work. In fact, a doctor recently wrote a main post here about how hard it was to help her father, who has cancer, navigate our healthcare system financially.The doctor didn’t know how things worked either. And she’s a doctor.

    But still. The bottom line is that insurance is useless unless we can afford to use it.

  • querywoman

    You were probably eligible for Medicaid. I used to put pregnant working women on Medicaid all the time in Texas, even those with insurance.
    The income limits for pregnancy Medicaid are raised all the time, and Texas is the chinchiest state.
    You should have been told to apply.
    When you have private insurance, you should choose a doctor who takes your insurance and Medicaid. Medicaid covers the parts insurance does not cover, like copayments and deductibles.
    Because birth is a fairly high ticket “procedure,” many obstetricians do take Medicaid.

    • B Viner

      I wouldn’t call it exactly high ticket. Medicaid in Kentucky paid nearly $1900 for all the prenatal visits, delivery care and postpartum visits. Subtract the cost of liability insurance and it’s not that great unless you do a high volume. But that’s not ideal either because you’re treating people like cattle.

      • querywoman

        It beats about $25 or whatever for one office visit for sickness for which there will never be a need for surgery, hospitalization, or other costly procedures.
        That’s what I mean by, “high ticket.”

    • SarahJ89

      No way would someone with that high an income be eligible in my state. And Medicaid would only cover a pregnancy if it ended in a viable infant. God forbid the pregnancy end badly because then the state would be off the hook as the retroactive coverage only begins at birth. The mother would not be covered unless permanently and totally disabled and of far, far lower income.

      • querywoman

        You should call your state and check it this stuff out. It’s federal minimum coverage. Lots of people don’t know what’s available.
        Medicaid covers a pregnancy for nine and a half months, and then allows the mother two months of coverage after the birth for checkups.
        An infant born to a mother on Medicaid should automatically get Medicaid for a year.
        Texas is always at the absolute bottom barrel of social services. 185% of the Federal Poverty Level. Some states are more generous.
        A married couple with a pregnant wife counts as a household of three people. If she is expecting twins, that’s a family of four.
        I just checked the limits. This is public information, freely available on the internet.
        Currently, $3,050.96 monthly is 185% of the FPL, and $36,611.50 annually is 185% of the FPL.
        If a pregnant woman has both Medicaid and private insurance, a doctor who accepts them both will get paid from both sources. Private insurance pays first, then Medicaid pays for what it doesn’t cover.

        • SarahJ89

          They have changed it then since I worked for the state. Thank god. Left to its own devices my state would provide no coverage to anyone. Local control really isn’t always the best thing. Thanks for the info.

          • querywoman

            You had left out before that you are a former state employee. Never assume anything about the government: look it up. Stuff changes all the time.
            I hated that I could put healthy pregnant women on Medicaid but not put really sick adults on Medicaid.

  • Lisa

    Personally, I think the only reason to circumcise your baby is if you are practicing Jew. When my son was born, the American Academy of Pediatrics recommended against routine circumcision. Now, they have softened their recommendation stating that health benefits of newborn male circumcision outweigh the risks, but the benefits are not great enough to recommend universal newborn circumcision. Their policy, published on 8/12, says the “final decision should be still be left to the parents to make in the context of their religious, ethical and cultural beliefs.” Perhaps they should add another statement about the parents ability to pay for the circumcision.

  • Lisa

    And when they can’t pay the bill, I am sure they would prefer the input to be monetary, not your
    good advice.

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