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Pre-pregnancy costs can strain a family budget

Kelly Dilworth

Earlier this summer, I told my primary care physician that my husband and I are thinking about starting a family sometime in the next year.

I figured he’d tell me to start taking folic acid — which helps prevent birth defects — and send me on my way. Instead, to my surprise, my doctor recommended a battery of costly tests to make sure my body was prepared for the upheaval and promptly referred me to another specialist, presumably for further evaluation and testing.

Already, the co-pays are adding up — and we haven’t even started trying for a baby yet.

My case is somewhat unique (I had to go through a number of tests because of my personal and family health history). However, according to a recent article in the New York Times, my husband and I aren’t the only hopeful parents-to-be going through pre-baby sticker shock.Pre-pregnancy costs can strain a family budget

Over the weekend, a New York Times special report looked in depth at the high costs of giving birth in the United States.
The report, titled “The American Way of Birth: Costliest in the World,” looked hard at the financial realities of pregnancy and profiled several American women who struggled to make sense of their hospital bills and costs for care.

According to the article, many hospitals tack on inflated fees for extras big and small — ranging from elective epidurals to the disinfectant used to clean a baby’s leftover umbilical cord — and charge exorbitant prices for routine screenings and physician visits.

Some women, like me, are also urged by their doctors to get tested for a variety of conditions and possible outcomes. And because there’s no real way to compare costs or shop around for cheaper care, women just have to hope that the bills aren’t too high (and, if they have insurance, that the insurance will pay for it).

Speaking to the New York Times about why maternity care in the United States is so expensive, Johns Hopkins economist Gerard Anderson, who studies public health, commented: “It’s not primarily that we get a different bundle of services when we have a baby,” said Anderson. “It’s that we pay individually for each service and pay more for the services we receive.”

No kidding. Soon after the article was published, it began popping up regularly on my Facebook news feed as female friends of childbearing age commented on how nervous the report made them about giving birth.

One recently engaged friend who’s currently living abroad commented that the article made her dread getting pregnant at home in the U.S., since a complicated pregnancy could cause her to go broke before she even had a chance to buy baby food and supplies. How would she pay for all the tests and procedures that our country’s health care environment demanded?

My friends’ fears hit close to home. My husband and I are relatively careful spenders and are confident in our ability to accommodate an extra mouth to feed within our modest budget.

However, we hadn’t accounted for the extra bills that could pile up if something were to go wrong — and we also hadn’t factored in the small-dollar costs from routine screening and medical procedures that can easily balloon.

Already, I’m starting to wonder if we’re really as financially prepared for pregnancy as we thought. We’re lucky in that we have solid insurance with my husband’s employer — a key requirement since a complicated pregnancy could otherwise force us into bankruptcy.

However, it’s hard to tell what our insurance will really pay for, once do we cross that line. And like every hopeful parent-to-be, we’re acutely aware that we’ll be signing up for a major medical investment, without actually knowing the final costs.

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  • Scott

    Hi Kelly!
    I would recommend being pro-active and asking questions with your physician. Some good question would be:
    Why (or is) this necessary? (Wait for the response). If required, what would happen if it’s not done? What are the risks/benefits of the test?
    Approximately how much would it cost to perform the test?
    Also, it’s always good to seek a second opinion. Your library may have books about becoming pregnant and will explain what is neccessary.
    It seems some doctors like to order tests and test that aren’t necessary OR could be done for cheaper (a cheaper test).
    Angie’s List/ Yelp / Google Reviews are a good starting point to review your doctor.
    Also Bottom Health’s magazine and Consumer Reports health section seems to give good advice about medical issues.
    NB: I am a member of Angie’s List, Yelp, Bottom Health Line and Consumer Reports. I am not a sponsor and I’m not being paid, either.
    I just got the new consumer reports (the one with the technology cover). They had an article where a lady wanted to do cataract surgery and she was quoted an estimate of $10,000 without insurance (she didn’t have insurance). She inquired with the doctor that she wanted a discount because she had no insurance and would pay in cash. The doctor agreed to perform the procedure in a clinic setting (cheaper than a hospital setting) and all the fees of the surgery were approximately $1,300. Way more than the $10,000 she was quoted.
    I guess my point is we need to be informed consumers–ask questions, be willing to debate, and if we think something is too much, be willing to haggle. Being friendly yet firm and knowledgeable can be to our advantage and create a win-win situation with our doctors and our expenses.
    Medical experiences are way overpriced here, I agree!

  • Jayson Quilantan

    Could you do a story on the costs of giving birth at home naturally? The costs of midwives/doulas?