How does the average American afford to have babies?

b_girl

My husband and I were invited to a wedding in Syracuse, NY on November 2 - I'll be 8 months pregnant by then so figured it would be best to look into what our insurance will cover and such prior to rsvp'ing.

Between the two insurance companies we have through our employers, we were essentially told that in the last 8 weeks of my pregnancy I'm covered for absolutely nothing in regards to pregnancy emergencies or giving birth while in the States.

That prompted me to look into how much that would cost, should we go and I end up going into labour (and for whatever reason couldn't make it back over the border in time). I was absolutely astounded by the costs I had found! If it happens that early, the baby would be premature and I figure that would complicate matters and so the cost would likely increase as well.

I came across this website in my research, showing the 2008 - 2010 average costs to give birth in the state of New York... Is this really what you end up paying? How can the average person afford costs like this? I'm assuming that a lot of people have some soft of insurance that'll cover it and all, but what do those people do who don't have coverage??

http://transform.childbirthconnection.org/wp-content/uploads/2012/05/New-York.pdf

Needless to say, although the chances of me giving birth at that time are slim, we can't afford to pay for it if it did happen and therefore aren't going to take the risk.

PS. I mistakenly found out yesterday that we're having a boy - we didn't want to find out, but I was being nosy at the dr's office and have now ruined the surprise for myself!

goofyboy · Posted: Sep 25, 2013 7:47 am Post subject:

Average American's have health insurance and that covers a large portion of the cost. Even with my insurance, we were still out $3500 or so.

That said, people without insurance can have kids without it costing them a thing. I'm not sure what all they have to go through, but it happens. My step sister did it 3 times. Evil or Very Mad

vette74 · Posted: Sep 25, 2013 7:54 am Post subject:

You negotiate with the Dr and pay before hand I believe it was $5-6k when my daughter was born. Congrats on the Boy!

Okie Boarder · Ladies Man Joined: 03 Mar 2008 Posts: 10056 City: Edmond

I know with us, we paid a minimal amount...somewhere less than $500, because of insurance coverage. The chart you showed is higher than costs when our kids were born, but that was over 10 years ago.

ohsix · Posted: Sep 25, 2013 7:57 am Post subject:

I think mine cost around $3500 with insurance as well.

Hospital billing rates are probably a bigger mystery than airline ticket pricing.

weatherford · Soul Rider Joined: 14 May 2008 Posts: 471 City: Seattle

One thing I am happy for with the Military...insurance.

b_girl · Posted: Sep 25, 2013 8:09 am Post subject:

Well, glad to hear that you're not all dishing out $10k+ to have kids then.

If I had more than 8 weeks remaining for that wedding, then our insurance would have covered us 100%, so we would have gone for sure. Stupid insurance!

vette74, thanks. I was really hoping for a girl 1st time around, but after all we went through to get to this stage, I'm happy with either... just want it to be healthy!

eich82 · Addict Joined: 13 Jan 2003 Posts: 860 City: MTP

It's quite simple, you have the majority of the population that has insurance which at the very least will pay the lion's share of the costs.

Those who are not insured, typically pay nothing. Hospitals can't turn you away because you don't have insurance. Hell a lot of the uninsured pregnant women in the US will just use the ER as their OB and use the ambulance as a shuttle service to the hospital, regardless of whether or not they actually have an emergency. My wife has even had several patients (during her residency) request that the ambulance come back and take them home after being released.

It's ironic that those who are uninsured or on Medicaid pay nothing for their healthcare, while those who are insured usually pay a significant amount out of pocket (not a large portion relative to the whole bill but a significant amount).

RampageWake · Posted: Sep 25, 2013 8:37 am Post subject:

Go in and say "Yo soy embarrasada" and it will be free.

jgriffith · Posted: Sep 25, 2013 8:47 am Post subject:

Ours cost about $1,000 total, that includes dozens of trips to high risk doctors. We had very good insurance at the time though.

Affordable good insurance will soon be a thing of the past though...

Broccoli B · Posted: Sep 25, 2013 8:53 am Post subject:

The people that don't have insurance some are covered by Medicaid. They get billed for some services but most already have horrible credit so they never end up paying anything.

Bethany · Posted: Sep 25, 2013 9:06 am Post subject:

We paid about $3k after our excellent insurance for an extremely low risk (boring) pregnancy and unmedicated delivery. Ugh! Rolling Eyes

b_girl · Posted: Sep 25, 2013 10:01 am Post subject:

vette74 · Posted: Sep 25, 2013 10:12 am Post subject:

b_girl, They will bill you but most people with a 515 credit score will throw the bill in the trash. Kind of like a credit card. You don't HAVE to pay your credit card bill. That is how people get free insurance unless you are a Mexican then it is free because well I don't know ask Chavez. Laughing

chavez · RIP MHL 04/25/1958 - 01/11/2006

b_girl, the people who don't pay also have (or will soon) terrible credit.

We paid $0 out of pocket, but our portion of our health insurance premiums run over $12k per year. My wife's employer also kicks in a fair amount. It is what I would consider the most "cadillac" of plans, covering pretty much everything with little to no out of pocket. Considering how high our premiums are, it better....

chavez · RIP MHL 04/25/1958 - 01/11/2006

vette74, viva Mexico!

And 515? That's a good score for my peoples! Laughing

/racism

b_girl · Posted: Sep 25, 2013 10:41 am Post subject:

vette74 & chavez, that makes a ton more sense, thanks!

brew · Posted: Sep 25, 2013 10:50 am Post subject:

Total cost on my first was about $22k, but there were some complications and we were in the hospital a couple extra days. Second one was a scheduled C section and it was about $9,000 total. We paid about $2,500 on both.

goofyboy · Posted: Sep 25, 2013 11:35 am Post subject:

Oh, our total cost was around $12,000 i think. our portion was $3500.

I'm now in a high deductible HSA insurance plan. Our next kid (assuming we have another) will probably be a little more out of pocket. That said, I ask many more questions about where my money is going. I want itemized bills. I will question charges now as well. You can get money cut off of bills if you ask and argue why.

Okie Boarder · Ladies Man Joined: 03 Mar 2008 Posts: 10056 City: Edmond

goofyboy, you could go the midwife route, too.

RampageWake · Posted: Sep 25, 2013 12:07 pm Post subject:

brew · Posted: Sep 25, 2013 12:17 pm Post subject:

Bethany · Posted: Sep 25, 2013 12:42 pm Post subject:

eich82 · Addict Joined: 13 Jan 2003 Posts: 860 City: MTP

Bethany · Posted: Sep 25, 2013 1:52 pm Post subject:

Conventional obstetrical care treats pregnancy as an illness which must be managed. This often results in routine interventions in the birth process- everything from constant fetal monitoring and epidurals to labor induction to episiotomies and routine non-emergency Cesareans. Nearly all OBs deliver babies only at hospitals where interventions are easily available and commonly used. In contrast, CNMs view birth as a natural process.

Exactly why I said that if there is an emergency there would be a back up plan. There are hospitals that do employ midwives. Birthing centers also have an OB on call for emergency (as CNM's are not surgeon's )and most are within a mile of a hospital.

Women have been successfully having babies for millions of years. Intervention is there for a reason, and in my opinion shouldn't be abused. I also think our OB care and education needs a major overhaul.

jryoung · Ladies Man Joined: 19 Mar 2004 Posts: 7664 City: Man Jose

ontrider · Ladies Man Joined: 30 Jul 2003 Posts: 16491 City: Russia

Was that a water birth?

jryoung · Ladies Man Joined: 19 Mar 2004 Posts: 7664 City: Man Jose

nmballa · Posted: Sep 25, 2013 7:36 pm Post subject:

My buddy recently had his second kid. He was on a new insurance and hadn't read the fine print. His $1500 per month for his wife, child, and him didn't cover any type of self inflicted condition. Ended up costing him around 15K out of pocket.

b_girl · Posted: Sep 26, 2013 4:21 am Post subject:

A midwife isn't for me, I've decided that much. Here, we can hire our own midwives or doula's to bring to the hospital with us if we want, they don't mind one way or the other. If you don't have one, then the nurses will help guide you. You can tell them ahead of time what you want to try and they'll do their best to accommodate (different positions, in the tub, etc).

Personally, I will be trying a bunch of different things, and also intend on making use of an epidural. Sure, they didn't exist before and women successfully delivered babies... but at the same time, they are available now so why not use it? You wouldn't get a root canal without freezing would you? That didn't exist hundreds of years ago either... So why deliver a baby without "freezing".

I've spent a significant amount of time researching the different options out there, both natural and medicated routes and feel I'm making the best decision for myself. Also, my prenatal instructor was AMAZING - she used to be a delivery nurse at hospitals in Texas as well as my local hospital, and was also a delivery coach for a few years. She went into details on the pros and cons of each option and didn't press for natural or medical, but wanted us to have all the information to make our own choice. So that was definitely appreciated (and helpful).

Now that being said, I'm not going to put myself through unnecessary medical procedures if not needed - for example, c-section... but here, you can't just decide if you want one or not, they'll only do it if they have no other options or if there's some pre-determined medical reason for them to do it (which I don't have, so if it happens, it'll only be in the case of an emergency)

Lindsay · Posted: Sep 26, 2013 4:55 am Post subject:

I delivered both mine in the hospital with CNMs catching (and I mean, literally catching when it came to number 2, girl shot out of me like a rocket). Wouldn't do it any other way. For us it was the right combination of "hands off" while still in our risk tolerance comfort zone.

Whether it's a CNM or an OB, I think it's important to find a provider that treats pregnancy like a mostly normal, boring biological function that can sometimes have complications. OBs are trained surgeons, and their residencies (and let's be honest, malpractice insurance) train them to seek out problems to fix. There are OBs out there that are midwife-like, or so I hear because I never found one. Not a surprise when I live in an area with a 50% c-section rate.

CNMs usually have master's degrees in nursing and have spent years as L&D nurses. They aren't trained surgeons like OBs, but they are plenty skilled to handle a normal pregnancy and know when to escalate a patient to an OB. And you don't have to be all crunchy granola "natural birth FTW" to benefit from using a CNM. My CNMs offer epidurals.

Regarding the expense, it's total insansity. I'm also on a high deductible HSA plan, so I read my invoices pretty carefully. What they billed for two nights in the hospital and a delivery that had ZERO complications and no interventions or narcotics of any kind was BANANAS. Even the in-network insurance negotiated rates were pretty darn high. My CNM's fee was $5K and that included all pre and postnatal visits as well as the delivery. That's pretty reasonable, all things considered. The hospital charges are where it gets crazy. I think they may have charged me for every minute of hot water I used while laboring in the shower.

Lindsay · Posted: Sep 26, 2013 4:59 am Post subject:

eich82, when you deliver with an OB in the hospital, do you know who is taking care of you for the vast majority of your labor? An L&D nurse, who probably is caring for more than one patient in labor.

ohsix · Posted: Sep 26, 2013 6:03 am Post subject:

My son's delivery was a little complicated, and I'm glad he was delivered by an OB in a hospital. Everything was natural until it was almost time to push, which is when the external heart rate monitor quit working because of how he was turned. They had to screw a heart rate monitor into the top of his head. That may seem like overkill, but while pushing, he got stuck because his head was too big to fit through the birth canal. They had my wife keep pushing until his heart rate started dropping, which is when the OB pulled him out with giant tongs. He had inhaled a bunch of fluid while stuck in the birth canal which is why his heart rate started dropping. A CNM may very well be trained to pull babies, and may very well have made the decision to add the heart rate monitor in the baby's head, but if both those decisions had not been made for my son, I'm not sure he would have survived birth. I especially wouldn't want the hospital or the OB minutes away when they're needed.

If I had a child, or wife, die during delivery because I didn't insist on the most advanced care, I would never forgive myself.

eich82 · Addict Joined: 13 Jan 2003 Posts: 860 City: MTP

Lindsay · Posted: Sep 26, 2013 7:04 am Post subject:

An "I did it and I was fine" anecdote holds the same weight has "I did it and it wasn't" at the end of the day. Anecdotes =/= data. I was comfortable with the very, very small risks based on actual data of delivering in the hospital with a CNM and back up OBs on site. You're right, everybody should choose what they are most comfortable doing, and hopefully they have more than just anecdotes (good and bad) on which to base those choices.

Women and babies also have complications from c-sections, up to and including death. Risks for the really bad outcomes are very small, but it is major surgery and I think it's perfectly reasonable to take precautions to avoid one, including selecting the provider and location that have lower c-section rates.