Giving birth costs about $3,000 more with insurance, a new study says

This article was originally published by The 19th on July 13, 2022.

The out-of-pocket cost, with insurance, is $2,854, on the new analysis released Wednesday by the nonpartisan Kaiser Family Foundation (KFF).

The analysis comes on the heels of The Supreme Court’s landmark decision in Roe v. Wade, a 1973 case that legalized abortion. The June 24 decision gave states the power to block the process. In the past two and a half weeks, eight countries have begun banning abortion altogether. Three other countries strictly prohibit the procedure for people who are more than six weeks pregnant.

Childbirth is only the first investment – raising a child brings its own financial challenges, and previous research has shown that people who are denied abortion face serious financial problems. The work known as The Turnaway Study found that 72 percent of people who were unable to have an abortion lived in poverty, compared to 55 percent of people who were able to have an abortion.

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KFF’s analysis builds on that understanding, revealing one of the most expensive considerations in reproduction. It provides an overview of the financial burdens associated with pregnancy, and emphasizes that many Americans cannot afford childbearing.

“There have been many women who have given birth to term because they have not been able to have an abortion in time or have an abortion. And what that can mean is that they have more money,” said Cynthia Cox, vice president at KFF and author of the study. “This is the first tree they get, the tree of birth. But it’s true that there are other costs—the cost of infant health care and the care and support of their children for many years afterward.”

Out-of-pocket costs represent insurance-related liabilities related to pregnancy, labor and delivery, and postnatal care. The researchers analyzed health insurance data from 2018 to 2020, comparing women between the ages of 15 and 49 who had given birth to those who had never given birth. The data in this category does not include people who have children or who may have given birth.

In total, pregnancy and childbirth for someone with private insurance costs an average of $18,865. Most of them are covered by the insurance plan but can result in more insurance costs down the line. So although the amount of $2,853 is only a fraction of the total cost, it represents the amount that new parents have to pay for themselves for the birth of one child.

By comparing the amount of medical expenses for women who gave birth to those who did not give birth, the study clearly showed how expensive childbirth can be. Out-of-pocket expenses included mental health care, antenatal visits and other medical care that cannot be called “birth-related” but that are directly related to the pregnancy and carrying the pregnancy to term. In general, cost-of-birth analysis only considers the cost of labor and delivery.

But if anything, the paper lowers the average price, Cox said. The group of people who have not given birth are people who have been pregnant for some time but either miscarried or had an abortion. This means that they spent some of the money related to the pregnancy but not all of it.

The study looked only at people insured through large employer-sponsored health plans. About half of all births are covered by private insurance — many others are insured through the state’s Medicaid program, which covers low-income people and has low out-of-pocket costs.

For private plans, large employer-sponsored plans are often the most generous. People who have other private plans — small employer-sponsored insurance, or plans purchased in the individual marketplace — may face higher medical costs during childbirth, Cox said.

The findings underscore that, while millions of Americans have lost their access to abortion, childbearing is still out of reach for most Americans. A previous analysis of KFF found that 45 percent of single-person households do not have more than $2,000 in medical bills. About one-third of households with multiple members lack sufficient income to cover pregnancy and childbirth costs.

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“These costs are more than most families can afford,” the report said.

High-risk pregnancies, which often result in cesarean sections, also result in higher out-of-pocket costs, according to the paper. Cox noted that this could be especially important in a post-Roe world. Banning abortions could result in many high-risk pregnancies being delivered – forcing patients to endure, potentially putting their lives at risk medically and financially.

And, the analysis says, out-of-pocket medical expenses are just one issue. Because KFF’s analysis looks at health insurance information, it does not account for the costs patients may spend on uninsured prescription drugs such as prenatal vitamins.

And there are more costs than medical expenses that a pregnant woman faces. When giving birth, people can give up pay if their job doesn’t offer paid parental leave. Caring for a new baby can mean new expenses such as medical care for the baby and new non-medical expenses. The loss of income, along with new financial problems, increases the risk of new parents incurring medical debt. Modern parents too possibly have medical debt.

“This is probably the cheapest,” Cox said. “It’s the first of many.”