Pregnancy Week by Week: Planning Your Costs
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Pregnancy week by week is a life experience like no other. Even when you’re sleeping, you’re being productive—growing a new life inside you. With that said, as each week passes, you may incur some significant prenatal care expenses—having a baby isn't cheap.
Depending on your individual pregnancy, insurance coverage and the tests that must be performed, your actual out-of-pocket costs can range from minimal to quite expensive. Knowing what to anticipate will allow you to plan ahead—and therefore to enjoy your time expecting to the fullest.
Your First Trimester: Weeks 1 through 12
You might still fit into your skinny jeans during most of your first trimester, but don’t let that fool you. Significant developments are already taking place within your body.
Week 1 of pregnancy
Because medical practitioners calculate pregnancy from the date of your last menstrual period, week one is technically the week of your last period before conception.
At the end of week two, the moment of conception, the sperm burrows through the egg and genetic material combines. The fertilized egg then starts dividing rapidly.
Your baby-to-be is now a ball of several hundred cells called a blastocyst.
During this important week, the blastocyst—only about the size of a poppy seed—divides in half. One half becomes the embryo and the other, the placenta.
Your baby now looks like a tiny tadpole, about the size of an orange seed.
Your baby is now starting to develop the beginnings of facial features. His or her heart is now beating at about 80 times per minute and (s)he is starting to develop lungs, a liver and kidneys.
About 10,000 times bigger than at conception, your baby is now about the size of a blueberry. (S)he’s growing about 100 new brain cells per minute and sprouting arm and leg buds.
Your baby is starting to look a lot more human as his/her face continues to take shape. The heart now beats at about 150 beats per minute and (s)he’s beginning to make spontaneous little movements.
Your baby has grown about an inch and all his or her joints now function.
Now your baby’s digestive organs are beginning to function. If you’re having a boy, his testes are beginning to produce testosterone.
Your baby now has hair follicles and nails, and is about two inches long. If she’s a girl, she’s developed ovaries.
About the size of a large plum now, your baby is starting to make white blood cells of their own, and their pituitary gland is beginning to function.
During your first trimester these expenses, procedures and screenings—which may or may not be covered by your insurance—are common. The good news is that health insurance for women is getting more affordable for many, and much of pregnancy care is now covered.
Prenatal Vitamins: Your doctor will likely prescribe vitamins, and your insurance will probably cover everything but the copay. Without a prescription, over-the-counter options cost about $10 to $20 for a bottle.
Prenatal Visits: Expect to see your OB/GYN about once a month for routine visits. The cost of these visits varies depending on doctor and location. Spend some time shopping around to find the highest-value OB/GYN. Because pregnancy coverage is one of many women’s health benefits under the Affordable Care Act, your prenatal visits will be covered—but keep in mind this doesn’t necessarily mean that the visits will be free.
Early Ultrasound: This test may range from as low as $120 to close to $500. An ultrasound will confirm pregnancy and allow you and your doctor to see how far along you are. Ultrasounds are preferable to imaging techniques such as MRI because they are less expensive and available in real-time.
First-Trimester Screening: Performed at 11 to 13 weeks, this maternal blood test screens for common birth defects. Because this screening requires a variety of tests, costs vary widely depending on your coverage.
Cell-Free Fetal DNA Testing: The baby’s blood may be screened for genetic conditions after 10 weeks of pregnancy if your doctor feels you’re at risk. The cost of this test can range from $800 to $2,000. If this test is recommended for you, beware that your insurance company may not cover it.
Chorionic Villus Sampling: The tissue around the baby is screened for a number of genetic conditions. This procedure is generally done if you’re age 35 or older, between weeks 10 and 12, and many insurance companies will cover the test.
Cystic Fibrosis carrier screening: Done any time but usually during the first trimester, this screening typically runs between $200-$300.
If you haven't already, now is the time to think about your ideal location for giving birth. If you're concerned with how much it costs to have a baby, you might consider alternatives like birthing centers or a home birth.
Your Second Trimester: Weeks 13 through 28
Mid-pregnancy is when many women feel great and others notice that they take on a real “glow.” Here’s how your baby is developing during this time:
Week 13 of pregnancy
Your baby has grown to about the size of a peach, and most of that volume is their head. Bones and vocal cords are developing. At this stage, they can move their arms and legs and may even suck their thumb.
Your baby can make facial expressions, and starts growing a coat of fine hair called lanugo.
Baby’s legs are growing longer than her arms and (s)he can sense light through her fused lids.
Your baby’s circulatory system is really working now, pumping about 25 quarts of blood per day.
Baby’s sense of hearing is beginning to kick in, and his/her umbilical cord is growing thicker and stronger.
With arm and leg muscles developing, your baby is moving around a lot and you may begin to feel that movement.
Your baby’s brain is now developing specialized centers for all his senses and his arms and legs are now in proper proportion to the rest of his body.
A greasy white substance called vernix caseosa coats your baby’s skin to protect him/her from the long immersion in amniotic fluid.
Baby’s eyelids and brows are now fully developed.
Beneath your baby’s closed eyelids, the eyes are formed but still lack pigment. The skin has a wrinkled appearance that will fill out as (s)he gains weight.
Baby can hear and become familiar with loud noises outside the womb, such as a dog barking or the music at a concert.
Your baby is getting ready to breathe as his/her lungs develop “branches” and cells that produce surfactant, a substance that helps air sacks inflate. Taste buds form to prepare baby for enjoying a variety of foods.
Baby now has a recognizable hair color and the skin is smoothing out as (s)he gains weight.
Ears continue to develop, and if your baby is a boy, his testicles are descending into his scrotum.
Your baby now sleeps and wakes at regular intervals, and can open his/her eyes. Sometimes (s)he gets the hiccups.
Baby’s vision is developing and (s)he will now turn toward a bright light outside the womb.
In addition to continuing with your prenatal vitamins and visits, common second-trimester expenses may include:
Glucose Screening: This test screens for gestational diabetes and is done at 24 to 28 weeks of pregnancy. Healthcare Bluebook recommends you pay roughly $130 directly at a lab and $66 at your doctor’s office or affiliated hospital—in addition to the cost of your visit.
Maternal Blood Screening: This test is performed between 15 and 20 weeks of pregnancy and measures four substances in maternal blood associated with birth defects: alpha-fetoprotein, estriol, human chorionic gonadostropin and inhibin A. Costs may vary depending on your doctor and location.
Amniocentesis: Generally done at 15 to 20 weeks of pregnancy, this procedure screens for genetic conditions such as Down syndrome. The average price for amniocentesis is $200 to $500, and is covered by many insurance plans.
Ultrasound: Your doctor may want to perform another ultrasound to check baby’s progress.
Your Third Trimester: Weeks 29 through 40
During the last trimester, your baby is truly getting ready to survive outside your body. Here’s what happening as (s)he prepares to make the grand entrance:
Week 29 of pregnancy
Your baby’s skeleton is hardening and his/her head continues to grow with his/her brain.
Baby may weigh up to three pounds and be about 17 inches long. As his/her brain develops, it takes on its classic wrinkled appearance.
Your baby may seem to move less as (s)he gains more control over his/her movements and fills up more of the available space.
By this time your baby has probably turned and is resting upside down in preparation for birth. (S)he may weigh up to four pounds.
During this week your baby’s head circumference has increased by almost half an inch. All of his/her senses are functioning fully now.
During this week, 99% of babies’ lungs have developed to the point where they could survive outside the womb.
Baby continues to grow and accumulate fat. (S)he may weigh up to 5.5 pounds and measure up to about 18 inches long.
Your baby is beginning to shed his/her lanugo and vernix caseosa. (S)he’ll swallow these substances, and they’ll become part of his/her first bowel movement.
Baby may drop lower into your pelvis this week in preparation for birth.
Your baby has a firm grip and probably weighs about seven pounds.
Baby’s endocrine system is gearing up to produce the necessary hormones to help him get through the stressful process of birth. His/her lungs continue to develop until the moment (s)he is born.
Your baby is ready to emerge! (S)he’s fully developed, but the bones of his/her skull haven’t fused, so (s)he’ll be able to get through the birth canal.
You’ll still be buying prenatal vitamins during your third trimester, and you’ll be coming in for prenatal visits every two weeks until week 36, then every week thereafter. Your doctor will likely perform a screen for group B strep at 35 to 37 weeks of pregnancy. Healthcare Bluebook suggests that the fair price for this test runs about $120 at an independent lab and about $61 through your doctor or affiliated hospital.
The largest third-trimester expense is delivery and newborn care. Recent Truven research estimates the average charges for a vaginal birth to be $32,093 and average Cesarean birth charges to be $51,125 for those with commercial insurance. Remember that each pregnancy and insurance situation is unique, and your total actual out-of-pocket pregnancy costs may be substantially more or less than the average.
Pregnant woman image via Shutterstock.