Giving birth doesn't come cheap. From prenatal care and epidurals to pre-term deliveries and hospital stays, here's the bottom line on hospital births.

By K. Aleisha Fetters
February 13, 2011

News flash: Having a baby is expensive. It's the most costly health event families are likely to experience during their childbearing years. On average, U.S. hospital deliveries cost $3,500 per stay, according to the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Add in prenatal, delivery-related and post-partum healthcare, and you're looking at an $8,802 tab, according to a Thomson Healthcare study for March of Dimes.

But a lot of factors can move your bottom line, says Aleksandr M. Fuks, M.D., Director of the Department of Obstetrics and Gynecology at Queens Hospital Center. Here, we break down what to expect from hospital bills -- and how to safely lower them -- when you're expecting.

Type of Birth

Vaginal delivery or cesarean section -- that is the question. The answer could mean an average difference of $1,900 to $2,600 in your hospital bill. Vaginal births, on average, cost $2,600 without complications, and C-sections cost $4,500, according to the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Vaginal deliveries account for about 7 in 10 childbirths, and C-sections for about 3 in 10, according to the Project.

A C-section is a major operation that involves anesthesia, longer hospital stays, and higher instances of morbidity and mortality, says Toni Stern, M.D., Chair of Obstetrics and Gynecology at Coney Island Hospital. All of these mean more resources used -- and more dollars spent.

However, vaginal delivery with complications requiring an operating room procedure has the highest average price tag of any type of birth, costing parents (and their insurance companies) an average of $6,900, nearly double the average cost per stay for all types of delivery, according to the Project.

Mom's and Baby's Health

Happy and healthy -- that's all that matters, right? Although that wish has nothing to do with hospital costs, complications can really increase them.

Some common (and costly, but not-so-common) delivery complications include premature rupture of the amniotic sac, abnormal presentation, dangerous umbilical cord positioning, difficulty breathing, amniotic fluid embolisms, irregular blood pressure, postpartum hemorrhage, bleeding in the brain, fluid accumulation in the brain, neurological problems, intestinal problems, jaundice and anemia, according to the Mayo Foundation for Medical Education and Research.

Many of these complications are out of your hands, but you can help to make sure they are treated as quickly and easily by getting good old-fashioned prenatal care, Dr. Stern says. You want your healthcare team to know your and your baby's chart backward and forward, including all of your medications, allergies, health conditions and any problems experienced during pregnancy, as all of these can affect how your doc should treat you on the big day. Talk, talk, talk with your ob-gyn during your prenatal checkups and on the day. She can read your tests, but not your mind.

Be aware that any health condition can increase complications and delivery costs. For example, a delivery stay costs an average of 55 percent more ($5,900) for a woman with diabetes, according to the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project.

Premature birth is one of the largest game-changers in terms of medical costs, occurring in about 1 of 8 pregnancies. Average healthcare for premature/low birth weight infants is nearly 11 times more costly than that for newborns without complications, according to a Thomson Reuters study for March of Dimes.

However, knowing the symptoms and avoiding particular risk factors can lower your chance of going into premature labor. If you are pregnant or trying to become pregnant, talk to your ob-gyn about what you can do to help prevent premature delivery. If you do go into premature labor, your doctor may use medications to halt uterine contractions, according to Mayo Clinic-- but those meds are going to cost you. And if they cause additional maternal complications, they are going to cost you even more.

Health Insurance Coverage

You've probably given a lot of thought to your health insurance coverage and costs. But if you don't know your maternity coverage, it's time to take another look. Health insurance is vital to obtaining maternity care services -- and being able to afford them, according to the March of Dimes.

Make sure your insurance covers childbirth costs, including baby's nursery care. Depending on your birth plan, you may also want birth setting and labor support options included in your provider's plan. Pay attention to your co-pay, deductible and what percentage is covered after your deductible is met.

If you decide to change health insurance plans, you may wish to do so before becoming pregnant. The federal government prohibits group health insurance plans from treating pregnancy as a pre-existing condition, but individual health insurance plans can legally treat pregnancy as a pre-existing condition, effectively denying you maternity coverage, according to the U.S. Department of Labor.

Some companies also require you to "pre-authorize" coverage for your baby, and some require that you call them when you arrive at the hospital to deliver-- if you forget, you could be refused coverage.

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