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Having a baby is expensive — sometimes alarmingly so. Costs related to pregnancy, childbirth and postpartum care average nearly $19,000 for individuals covered by large group insurance plans, according to a July 2022 study by Peterson Center on Healthcare and KFF, a health policy nonprofit. Insurance covers most of the costs, with the average woman paying about $2,850 out of pocket.
Differences between actual prices as well as insurance coverage can span tens of thousands of dollars. Navigating the costs of nine months of pregnancy — and then the cost of raising a baby — can seem overwhelming, but knowing what to expect can help. Read this guide to understand your coverage as well as which expenses to expect and when.
Beware of major differences in cost and coverage
Any guide to medical bills and your share of the cost should come with several disclaimers.
Prices vary from city to city and even hospital to hospital. Researchers at the University of California, San Francisco found in 2014 that in the Golden State, the cost of an uncomplicated vaginal birth varied widely — from $3,296 to $37,227, depending on the hospital. Cesarean sections ranged from $8,312 to almost $71,000.
If you have health insurance, coverage differences are similarly dramatic. The Affordable Care Act requires most health plans to cover maternal and newborn care. But because ACA requirements remain broad, insurance coverage isn’t uniform.
Price and out-of-pocket cost estimates are handy but are estimates. The only way to know for certain what you’ll pay is to contact your medical providers and health insurance company. The more work you’re willing to do on the front end, the less likely you’ll get surprise bills.
Get a handle on your insurance
If you’re unsure how your health insurance works, now's the time to research your benefits. You could take an entire course in understanding your policy and still likely have questions. Consider this a cram session. Your top two study areas include:
Learning about out-of-pocket costs: copays, coinsurance and deductibles.
Making sure your doctors are in your provider network, if possible.
Contact your health insurance company — with policy number in hand — and ask the key questions below. Make sure to write down whom you talked to and the date.
Are prenatal care, labor and delivery covered benefits under my policy?
Do I need a referral from my primary care doctor to see an OB-GYN or other specialists?
Will I need pre-authorization for any prenatal care?
What prenatal tests are covered (ultrasounds, amniocentesis, genetic testing, etc.)?
What common prenatal, labor and delivery needs are not covered by my policy?
Which hospitals in my area are in my insurance policy’s network?
What do I need to do to ensure that my newborn is covered from the moment of delivery?
How long of a hospital stay is covered after delivery?
Does my policy cover a private room or suite, or will I have to share a room?
If you’re interested in nontraditional deliveries, like a home birth with a midwife, ask about coverage for these.
Throughout your pregnancy and into your baby’s well-child visits, err on the side of caution. If you are unsure about your coverage and want to be doubly safe, call your insurance company to get confirmation in advance.
Watch out: Depending on your medical providers’ billing practices and your due date, you could have to pay two deductibles if your prenatal care happens in one calendar year and your baby is delivered in the next.
Some providers package their charges to insurance companies in what’s called “global billing,” which can include all prenatal and delivery charges. Ask your OB-GYN whether they plan to use global billing so you’ll know where you stand.
Uninsured? Seek help
If you don’t have health insurance, you’re looking at tens of thousands of dollars in care over the next nine months.
Despite requiring health insurance companies to offer well-woman and maternity care, the Affordable Care Act doesn’t consider pregnancy a “qualifying event.” You will have to wait until your child is born to sign up for a new plan under the ACA.
But ACA insurance plans aren’t your only option. If you meet income requirements, you could be eligible for Medicaid, which covers many maternity care costs.
If you’re forced to pay cash for maternity care, these steps can help:
Comparison and price shop for prenatal visits, tests and your labor and delivery.
Explain to your doctor and all medical providers that you are a cash-paying customer. They often offer discounts for uninsured peoples.
Negotiate lower balances and payment plans on your medical bills.
Ask the hospital about “charity care” programs that may be available.
Consider a maternity package, increasingly offered by hospitals as a way for new parents to get all of their maternity and childbirth expenses covered under one price.
Prepare for how much it costs to have a baby
For all medical care from pregnancy to birth to recovery, the Peterson and KFF study places the total at $18,865. This is an average based on insurance benefits claims data from 2018 through 2020. The data included enrollees in large employer private health plans. Researchers compared health spending between female enrollees who gave birth and those who didn’t.
The type of delivery can have a big impact on the total cost. Pregnancies that resulted in a vaginal delivery averaged $14,768, compared with $26,280 for those involving a cesarean section.
Insurance pays most of that. The study reported out-of-pocket expenses of $2,655, on average, for vaginal delivery. The average balance for a C-section was $3,214.
» MORE: How to handle your medical bills
Averages can help you prepare. But unless you pay upfront for a maternity package, there’s no single, knowable price tag on pregnancy and childbirth. Labor and delivery might loom in your mind as the most expensive part of the experience, but a routine pregnancy requires several standard appointments and tests. Special concerns about your health or your baby’s could mean more doctor visits and interventions, all potentially coming at an additional cost.
It’s important to note that the cost breakdown below begins with a positive pregnancy test. If you hope to become pregnant after going through in vitro fertilization or some other fertility treatment, this guide can help you prepare for one phase of your journey to parenthood. You also may want to learn more about IVF costs.
Similarly, if you're looking to adopt a newborn, medical care for your baby’s birth mother may be a significant part of your expenses. NerdWallet can help you prepare for the other costs of adopting a child as well.
If you have an uncomplicated pregnancy, you’ll see your doctor for monthly checkups during the first trimester. Typically, these are subject to a copay.
These visits will involve checking your weight, blood pressure, fundal height measurement and fetal heart rate as soon as it’s audible. Additional lab work and tests will come throughout and could cost extra.
Prenatal vitamins: Your doctor may prescribe these, or you can find them over the counter at most drugstores. Under a prescription, they’ll be subject to your copay. Bought over the counter, a bottle containing a one-month supply will cost about $10 to $30.
Lab work: Blood will be drawn for a series of lab tests including screening for common birth defects, your blood type, Rh status, hemoglobin measurements, and immunity and exposure to certain kinds of infections. If you have insurance, it’s likely that much of this will be covered, though it could be subject to your deductible. Costs vary widely.
Early ultrasound: If everything appears healthy, your doctor may not recommend an ultrasound this soon. However, a first-trimester transvaginal ultrasound may be necessary to establish the location of the fetus, how far along you are, viability of the pregnancy and number of fetuses. For people without insurance, the average cost of an early ultrasound is $1,423, according to 2022 data from FAIR Health, a national, independent nonprofit that uses health care claims data to provide cost estimates to consumers. For those with insurance coverage, the average amount billed to the insurer is lower — $586 — because of agreements between the provider and the insurance company. The amount an insured person pays out of pocket depends on their plan’s cost-sharing rules.
Cell-free fetal DNA testing: After 10 weeks of pregnancy, your baby’s blood can be screened for genetic conditions. This testing is typically performed only for at-risk pregnancies, and costs can run upward of $4,000 for people without insurance, according to FAIR Health.
Chorionic villus sampling, or CVS: This test looks for many of the same genetic abnormalities as a cell-free fetal DNA test does but analyzes the tissue surrounding the baby, similar to an amniocentesis. The test looks for Down syndrome, cystic fibrosis, sickle cell anemia and other genetic abnormalities. Most insurance plans will cover CVS in high-risk pregnancies, though you could be responsible for out-of-pocket costs if it's subject to your deductible.
A medical bill often includes multiple charges for a single procedure. One charge covers the work of professionals who performed the procedure or interpreted test results. Another charge comes from the facility where the procedure was performed, covering the use of equipment and supplies. For this article, cost estimates combine these charges, which were each provided by FAIR Health.
Through the end of your second trimester (week 28), you’ll continue with monthly prenatal visits. In addition, you’ll likely need:
Glucose screening: Used to test for gestational diabetes, this bloodwork is typically done around weeks 24 to 28. If you’re not insured, you could pay about $240, according to FAIR Health.
Maternal blood screening: This blood test looks for four substances that could be evidence of possible birth defects. Costs vary widely by location and coverage.
Amniocentesis: An amniocentesis is the analysis of amniotic fluid surrounding your baby. It looks for genetic conditions like Down syndrome and is usually covered by insurance when medically necessary. The average cost to someone without insurance is $1,933, according to FAIR Health.
Ultrasound: The main ultrasound during a pregnancy occurs around 18 to 22 weeks, according to the American Congress of Obstetricians and Gynecologists. Your doctor will look for things such as the overall health and position of your baby and placenta, and your ovaries and cervix. It’s at this ultrasound that your doctor will be able to determine your baby’s sex — if the little one is willing to reveal that. This ultrasound is usually covered by insurance.
By your third trimester, basically every lab test that needs to be done has been done. Your monthly checkups will likely be every two weeks from weeks 28 to 36 and then weekly until the baby’s birth.
Birthing classes: These classes help you prepare for labor and delivery and are often covered by health insurance. If you’re a new parent, you might also be interested in classes that introduce you to breastfeeding or newborn care. Without insurance coverage, these classes can cost $50 to $200 each.
The largest expense you can expect during this last phase of pregnancy is the cost of labor and delivery.
Labor and delivery
Your itemized bill for labor and delivery will be immense, in ink and paper, if not cost. Hospitals in the U.S. often bill per service, and each hospitalization represents a series of small services and related fees.
It’s common to be billed for each doctor who attends to you and for each pill and IV fluid pouch as well as the use of your room, among many other things. Because these prices vary from hospital to hospital, the total cost of childbirth can be difficult to estimate.
On average, someone covered by insurance would see their insurer billed $6,230 for a vaginal delivery or $5,252 for delivery via cesarean section, according to FAIR Health. The cost to the person varies, depending on cost-sharing rules in their insurance plan.
For expectant parents without insurance, the average cost of giving birth ranges from about $10,000 for vaginal delivery to about $12,000 for a C-section.
If you have to be induced, need an unexpected C-section, receive an epidural or get a snack, the charges climb. Doulas, midwives and birthing tubs are typically considered optional and thus additional, too.
If you’re insured, determining how much you’ll pay will include knowing what’s covered and how much your share of the bill will be, including deductibles and coinsurance.
To try to lower childbirth charges:
Call the hospital’s billing office to get an estimate of total charges, and apply that to what you know about your policy specifics.
If possible, set aside enough money to cover any remaining deductible for the year, plus your coinsurance share of the expected charges and some cushion for unexpected denials and charges.
If you have access to a health savings account or flexible spending account through your employer, you can set aside these anticipated expenses using pretax dollars.
Consider a maternity package: It offers all the normally itemized features of a delivery for a flat fee. Many of these packages come with payment options and discounts for those paying cash, with some costing about $3,000 to $8,000.