What to Expect: Hospital Birth Costs

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.

An image of a newborn baby in the hospital.
Photo: Getty Images.

News flash: Having a baby is expensive. And not just the price of raising the child. The costs of the actual prenatal care, birth, and postpartum care add up quickly, too. In fact, typically, it's the most costly health event families are likely to experience during their childbearing years. A study published in Health Affairs by the University of Michigan found that in 2015, the average cost of giving birth was $4,500—even with insurance. That's including pregnancy, labor and delivery, and three months of postpartum care.

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's a breakdown of what to expect from hospital bills—and how to safely lower them—when you're expecting.

Type of Birth

Whether you deliver your baby vaginally or via C-section will have a significant impact on the cost. It also depends on what state you live in. You can get an estimate of what childbirth costs are in your state with or without insurance through Fair Health's free healthcare expenses tool.

Vaginal birth

Vaginal deliveries account for about 7 in 10 childbirths, and C-sections for about 3 in 10. High-risk pregnancies result in even higher rates of C-sections than average, according to the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project.

According to data collected by Fair Health, the average cost of having a vaginal delivery is between $5,000 and $11,000 in most states. Your personal health insurance coverage, including deductibles, cost sharing, co-pays, and other variables, as well as which doctor and hospital you go to will also adjust your costs up or down.

C-section birth

C-section births tend to be even more expensive, with prices ranging from $7,500 to $14,500. A C-section costs more because it 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 factors mean more resources used—and more dollars spent.

Premature birth

Premature birth is one of the biggest game-changers in terms of medical costs. This complication occurs in about 1 of 9 pregnancies. Average healthcare costs for premature/low birth weight infants are over 10 times more costly than for newborns without complications, according to data collected for the March of Dimes.

However, knowing the symptoms of preterm labor and avoiding particular risk factors, such as excessive exercise, recreational drug use, smoking, and drinking alcohol, can lower your chance of going into premature labor. If you are pregnant or trying to become pregnant, talk to your OG-GYN about what you can do to help prevent premature delivery.

According to the American College of Obstetrians and Gynecologists, if you do go into premature labor, your doctor may use medications to halt uterine contractions—but those necessary meds will add to your hospital bill. And if they cause additional maternal complications, they are unfortunately going to cost you even more.

Other birth complications

Complications during childbirth can further increase the overall cost. For a vaginal delivery with complications requiring an operating room procedure, the cost is an average of $10,700—nearly double the average cost of a vaginal delivery without complications, according to a report by Premier on maternal and infant health trends.

People with high risk pregnancies and/or preexisting conditions like obestity and diabetes are more likely to experience complications during delivery. Advanced maternal age (over 35) may also up your odds of needing interventions during your birth. People carrying multiples are also likely to end up with higher hospital bills.

Parent'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. Labor that does not progress is one of the most frequent complications, and needing to be induced can up your costs.

According to the National Institutes of Health, other 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.

Many of these complications are out of your hands, but you can help to make sure they are treated as quickly and easily as possible by getting prenatal care, Dr. Stern says. You want your health care 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 doctor will treat you on the big day. Talk, talk, talk with your OB-GYN during your prenatal checkups and on the big day. During the deliver, they can read your tests, but not your mind—and as you'll be in labor, you may not remember to tell them all the pertinant details.

Be aware that certain health conditions can also increase your risk of complications and delivery costs. Premier's analysis found that pregnant people with conditions like diabetes, obesity, or chronic pain had deliveries that were $1,000 to $2,200 more expensive on average compared to those with uncomplicated deliveries.

Essentially, the better health you are in, the better your chances of paying less for your baby's delivering.

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.

Thanks to the Affordable Care Act (ACA), pregnancy is no longer considered a pre-existing condition and must be covered in all individual and small group insurance policies. If you apply for coverage while pregnant—individual or through your employer—health plans cannot deny you coverage. If your plan covers maternity care, you are entitled to a minimum of 48 hours of hospital stay after a vaginal delivery, and 96 hours after a C-section, according to the Healthcare.gov. You also don't need to be preauthorized from your insurance plan for the minimum hospital stay to be covered.

Does your health insurance cover these costs?

Make sure your insurance covers childbirth costs, including the 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. Once again, the details of what your plan covers will vary by where you live and the type of plan you have, so carefully read the summary of benefits to fully understand your coverage.

Do you need health insurance?

Programs such as Woman, Infants, and Children (WIC) and Children's Health Insurance Program (CHIP) may help you find low-cost coverage if you're not eligible for Medicaid. According to the American Community Survey, over 15% of people between the ages of 19 and 34 are uninsured in the U.S. If you're in need of health insurance, the U.S. Department of Health and Human Services provides information to help connect people with health assistance resources.

Updated by Dina Roth Port and Hiranmayi Srinivasan
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