Thanks for being so willing to share this! I had no idea that even with good insurance, it could still cost so much.
*(insert worry about how husband and I will ever be able to afford to have children given hospital costs and daycare…eep.)*

I had two c-sections. I think the full bill was something like $45,000 for each one. I remember being totally pissed at getting a separate anesthesiologist bill b/c he didn’t take our insurance. I mean, I’m having surgery here, was I supposed to ask each doctor whether he or she took my insurance and make them leave if they didn’t? I realized later I could have fought that one with my insurance but I didn’t know that at the time. I had different insurance for each birth so I think all told I paid maybe $1500 out of pocket for the first one and around $2500 for the second one, once all the bills got added up. Getting charged to use the breast pump is insane and they should not charge you for that.

Another good reason to use a nurse-midwife: they are so much cheaper, even in a hospital! I’m so glad I was low-risk so I could have a nurse-midwife. I know my bill is going to be much lower than it would have been with my old OB.

14 years ago I had an uninsured $7,000. miscarriage, and i didn’t even stay overnight. Feeling powerless to contest or negotiate what i was charged for was almost as bad as the miscarriage itself.

After Violet was born 7 months ago, I got a bill that my insurance wouldn’t pay. Why? The hospital had listed my husband as a patient. He’s never had any treatment at the hospital for anything and all he did was spend one night on the fold out chair/bed. When I called the business office, they went over my details and figured they had put my husband’s name down as my brand new baby. No wonder the insurance didn’t pay – they knew I didn’t give birth to a 35 yr old man. And by that point, the business office had already put Violet’s charges onto my bill, so I might have ended up paying twice anyway. It got resolved pretty quickly in the end.
Also, when your insurance asks you to update your info and let them know about additional insurance, don’t ignore it because you haven’t made any changes. They really will assume you have other insurance and not pay your bills. We had to take 3 year old Ruby to the hospital for some tests and luckily the hospital caught it before they sent us a bill for $2700 (that makes up for their error over Violet).

I totally brought my own ibuprofen to my 2nd birth after being charged $8 a pill for my first birth. What a racket!!!

I love this post and I applaud your taking a front seat with regard to your health care needs.

All the unnecessary charges not only take money out of your pocket, but also the insurance companies. And guess what? They are money making entities too. So, they pay out additional money for unnecessary charges, which isn’t good for their bottom line, so they up their premiums. Increased premiums aren’t good for employers and their bottom line, so they pass the increase on to employees. It’s a horrible cycle.

Not all procedures or visits can be avoided, but we all have the right to discuss what Drs and Nurses are doing and how it will ultimately benefit us. I imagine a lot of time, money and insurance claims would be saved.

As much as HMOs can be scorned, I have nothing but good things to say about mine. A flat $250 for a c-section (that would have been the exact same cost for a vaginal birth, a week in the ICU, a 2 month stay for whatever, etc.). No additional charges, no bills from a plumber who might have had to snake out a toilet, no add ons for food. An all inclusive resort, well, nah, but you get the drift. Each OB visit cost $25 which can definitely add up when you are high risk and have to go twice a week for the last 2 months, but still! At least the visits to the high risk OB did not cost ANYTHING out of pocket.

Wow – very informative post, Monica! It makes it easy to understand why the L&D ward is the most profitable part of hospitals. I would be curious to hear what Grace (with the in-hospital nurse midwife) ends up paying for her birth. I had a home birth with a certified professional midwife, and she charged $3000 for all prenatal care, the birth, and 6 weeks of post-partum care for me and well-baby care for Naomi. The best part was that my insurance covered her as an “out-of-network” care provider at 70% (!), so we paid $900 total out of pocket. Well, we also had to buy a $65 birth kit with gloves and waterproof pads and junk like that. Not a bad deal.

When my older son, now 42, was born, I made sure I checked every last item on that bill. Would you believe we were charged for crutches?! Before we left the hospital I made sure that little item was removed.

I never did see an itemized bill. The insurance covered most of it, or I might have asked for one. I do know that my epidural cost $2500, because the anesthesiology company tried to charge me full price for it because “the hospital submitted a written claim and we only take electronic claims” (I shit you not.) I think it’s because at the very end of 3 1/2 hours of pushing, the doctor asked if I wanted him to try forceps. I said yes, he said let’s get you back on the epidural, it hurts a lot. But, the epidural didn’t want to work anymore at that point. They still tried three times. Next time, I will just say never mind after the first one doesn’t take.

I had a miscarriage last year, and I weighed having a D&C over taking a pill at home. I opted for the pill at home, partially because I figured it would have cost me about $1,000 for the hospital procedure. There were certainly benefits to both, but being experiencing it in the privacy and comfort of my home (even though it took longer and wasn’t guaranteed to work) for $10 seemed the best choice, and I still believe it was. Though at the time I felt like a total cheapskate.

Should we have a vaginal birth cost $50 and a c-section cost $100? Do the math – health professionals, equipment, etc, etc….How many good doctors and nurses would work for nothing? I’ll pass.

Have you seen the documentary “The Business of Being Born”? Truly mind-blowing.

And sorry Nicole (the other one), I’ll be bringing my own generic ibuprofen for $0.12 per pill and I’ll let my nurse know I’m taking some. That charge is ludicrous.

hospital room = 24,840.00
pharmacy = 81.03
med/sur supplies = 0.00
non-sterile/supply = $150.25
sterile supply = 2411.50
prosth/orth dev = 336.25
supply/implants = 332.75
lab/immunology = 708.46
lab/hematology = 397.75
anesthesia = 2554.00
drugs = 473.88
deliver/labor = 22,590.00

nursery/newborn = 7128.00
pharmacy = 82.77
non-sterile/supply = 675.75
laboratory = 108.75
lab/immunology = 679.48
audiology = 268.00
drugs = 303.30

not including pre-natal care (sonograms, downs tests, blood work…)

My bills blew me away but I am so lucky I hit my out of pocket maximum before i was placed on bed rest. I went into labor at 23weeks with my twins. I was admitted and was told I couldn’t leave. At 28 weeks my water broker and that started my sons 3 month stays in the NICU. And plus I was there for about 45 days prior and 4 days after. My sons also had open heart surgery while in NICU having to be transferred back and forth from different hospitals.

Anyway all the bills added up to over 2.5 Million!! Best part is my out of pocket max was 3k to which I had hit wall before I was admitted to the hospital. We are very lucky this happened 9.28.09. Unfortunately one of our sons is having issues with his heart and lungs still so every year the bills pile up again

My best advice for avoiding unnecessary charges in the hospital is to avoid the hospital altogether, if you can! My first child was born in a really well run HMO hospital/birth center on the West Coast and I think we only had to pay a few hundred dollars out of pocket total. After relocating to the Midwest, we decided to have our second at home. The fancy medical center we toured appeared to be all about the ‘business’ of childbirth (with valet parking, room service, flatscreen TVs, and each room equipped for an emergency c-section should all the ORs be occupied).

A previous commenter (in the health care industry) made the suggestion already: “If you don’t want to pay for healthcare professionals to monitor you and the baby to make sure you are as safe as medically possible, I recommend you get a midwife and have the baby in your bathtub at home.” Although I think she was being sarcastic, she has a valid point. For the vast majority of women, childbirth does not need to be a “medical” event. It is a life event! I would also argue that there are plenty of healthcare professionals out there who can safely monitor low-risk pregnancies and births in the comfort of your home, without the enormous cost and bureaucracy associated with hospital births.

Wow, it makes you appreciate good insurance. I didn’t have to pay a dime.

God love the NHS!

This makes me so glad that I was in the Air Force for my first and a Navy wife for my second and soon to be third. Say what you will about military medical, but you can’t beat the cost (or lack thereof).

Try having a high risk pregnancy that required 6 weeks of hospitalized bed rest, multiple ultrasounds (at the hospital) before the twins were born 13 weeks premature and required 12 weeks of staying in the Intensive Care Nursery. During which time they received multiple x-rays, ultrasounds, eye exams, ivs, shots, hearing tests, and everything else under the sun. Luckily we have excellent insurance and only had to pay $300 per person in the hospital. But, our bill was well over $600,000.

Wow, I am so thankful that the military has great insurance coverage! I didn’t pay anything from conception to post-natal care. Well that’s not true, I elected to get better (ie more readily absorbed) prenatal vitamins and paid $9 a bottle. I know it is a great job my husband does being in the military, but I’m very thankful we have a country that recognizes that (most of the time) & gives us great insurance!

Let me just encourage everyone to VERIFY with your insurance company on every single bill you receive. I’ve had the same insurance for 8 years now. Aetna. In 2005, my hospital co-pay for the birth of our son was $250. That was it, no hidden fees or bills from everyone. My daughter was born in 2007, the co-pay went up to $500. Thought that was a heck of an increase but whatever, she was worth it and we weren’t broke. Our 2nd daughter was born in December of 2010. We are STILL getting bills, from EVERYONE, the anesthesiologist, the hospital pediatrician, my OBGYN, lab work, you name it we got the bill for it. Let me just say, INSURANCE companies are the ones to blame for the post-postpartum headaches. 1/2 of everything they billed us for was WRONG! If my husband had not called the insurance company to verify every single charge we would have paid more than twice what we actually owed which was around $1200 when it was said and done. Let me just say, in the end, $2000 for 3 healthy deliveries is completely worth it. Even the hassle of it all!

I checked my itemized bill and it turned out they charged me for all sorts of things I didn’t have, most notably the epidural and multiple bags of IV fluids, etc… when I showed up and pushed the baby out with no interventions whatsoever (seriously, I almost gave birth in the triage room). They basically just have a set list of charges that are standard for most births, regardless of the actual events. I contested it and they audited my account only to tell me that the extra charges didn’t even matter because the contracted rate was the same regardless and my portion wouldn’t have changed. The lady did commend me on not having an epidural though. Apparently 95% of the births at the hospital have them so they are not used to billing for births without one.

I ended up paying a similar amount to what you described but I regret not asking the hospital for a discount if I paid cash. Hospitals are so used to getting burned entirely that they are often willing to negotiate with you, especially if you are paying in full. I just wrote a check for the $2800 and now I kick myself all the time for not at least asking for a discount. Lesson learned.

thank you for writing this. Not everyone realizes just how much of a business hospitals are. I was lucky and had amazing insurance when my first child was born and everything for me was covered (we did have to pay most of the baby charges). I lost my job and had to go under my husbands insurance which covers substantially less. When I started realizing just how expensive it could be I started looking into other options. Ultimately I decided to have my baby at home, this was a decision not based entirely on cost of course but the price was sure an added bonus! The entire bill was 3k (that included prenatal appointments and 6 weeks post partum care as well) My insurance covered around half of this and so after my midwife took her cut of that we ended up paying a little over 1k total for everything and let me tell you I’ve never felt more taken care of in my life.

I know my choice isn’t for everyone and you really have to do your research before selecting a midwife, but if I ever have more children I know what I will be doing from the start

When looking back at my bill i saw that they charged a different fee (higher) when you were pushing as opposed to the laboring fee. It was charged by the half hour. I’m sure glad i didn’t have to push for more than half and hour for more reason than one now!

I had my bill yesterday and have to pay 988, 60 euro for the delivery and 91,14 euro for the pediatrician (that’s about 1 560 dollars) with mutuality but without private insurance deduction. I had an epidural and stayed 5 days in a private room in hospital. I live in Belgium.

To the other Nicole; I’m also a hospital worker and completely agree with everything you have posted. I really wish the fact that the loss of payment from the uninsured and the less that medicare and Medicaid pays the more the insured have to pay out brought up in more in health care debates . The unisured and underinsured costs us all.
Just wanted to add one thing . While I get that cost is a factor in wanting to get out of your labor or recovery room, it’s also not really feasible to demand being moved asap. Again it’s part beurocracy and part space management. Hospitals aren’t holding you there willingly charge you more. Delays in moving patients anywhere within the hospital system are caused by any number of things from not having an empty bed , not having the staff allotted to new patients, and even lazy or already busy staff not taking a timly report, to the ob not being clear on the orders. Our network bed turnaround is averaged at about an 30 min to an hour. That’s down from about 4 to 6 hours 10 years ago . We are all doing the best we can, but it admittedly is not enough.

Bloody Hell! I second Ria Griffiths with God Bless the NHS.
My boy Joe, was born by emergency c section at 27 weeks. I was in hospital for 2 weeks (before and after as I had pre eclampsia) Joe was in SCBU/NICU for 4 months, he come home on oxygen and still needs regular appointments. (I have a week of work next week, as it is spring break, good job really as Joe has an Orthodentist and then a Dentist appointment on monday, Physio appointment on tuesday, Occ Therapy appointment also on tuesday, Orthoptic and Lycra appointment to pick up new splints and a new lycra suit on wednesday am, plus a visit to pick up his new wheelchair on wednesday pm and a visit to the nurse for his yearly asthma checkup also wednesday at 9am) all for free. Thank eff it is free, god only knows how much that little lot would be.
x

Come and live in England where it’s all free!
A good job too, as I was in hospital for two weeks with my first born and a week with my second. Both were in the Special Care Baby Unit for a month, so I dread to think what the bills would have been if we’d had to pay.
Seriously though, even with insurance that’s a heck of a lot of money every time you have a baby – how about a home birth if there’s ever a baby Bielanko number three!

It’s called pay for service…just like everything else.

I don’t know if what we have is an HMO or what, but we use their doctors/care providers and facilities or the specific facilities that they contract with. We were sent a bill from the hospital that our daughter was born in (contracted with our health plan and using a midwife from our health plan), but we were told not to worry about anything, and if anyone called to harass us, that we should just call our health plan. We ended up paying $10 copays for each prenatal visit and a $50 copay for the birth and three-day NICU stay for our daughter.

Having said that, I second the advice of several other posters. Go with a midwife if you can, whether it’s certified nurse midwife or certified professional midwife. We’re giving birth in an out-of-hospital birth center this time, and our insurance is covering everything that they covered last time–same $10 copays for prenatal visits, $50 cost for birth. After asking the MW what their cost without insurance is, I understood why our insurance gives homebirth or birth center births as an option for approved healthy, low-risk pregnancies–just MY charges in the hospital (keep in mind this was using my MW, NOT the hospital OB, except for a phone consult that they charged almost $1k for) were over $10k, for a natural birth with no meds or interventions. The MW we’re working with now said that for all prenatal visits, birth at the birth center or at home, plus follow-up at home checkup and 6-week PP appointment, is $3800. Yeah, that’s a BARGAIN compared to the hospital costs… and much simpler billing than the $7 ibuprofen as well. :-p

It’s really very sad, everything from the insurance costs and billing nightmares that people are hit with, to the fact that more women with healthy low-risk pregnancies are not educated more about their options regarding midwifery care and natural childbirth, in or out of a hospital. It really doesn’t hurt that much, trust me. ;-) I was in MUCH more misery for week after I had four crowns done at once. It’s all about knowing more about labor positions (ie, not lying flat in bed, or lying in bed at all) and pain management techniques. I’m a pain wimp, so if I can do it, many other people probably could as well. ;-) (Although you’ll notice I didn’t say anyone–NCB is not for everyone or every situation, and neither is midwifery care.) As someone else said, for the majority of pregnancies, having a baby is not a medical condition that needs management and treatment, it’s a physical act that needs occasional guidance and support.

One of the first things i noticed on my bill after ds was born was how much the motrin cost per pill. I told dh, next baby we’ll bring our own! Everthing else seemed reasonable for us, especially my epidural! haha….

With my son I was lucky and paid only $50. With my daughter it was a little different but we still only paid $200. My daughter spent 5 weeks in the NICU and it’s true they charge you for everything separate. There was a charge for her to be there, charges for tests, charges for meds, and then charges for the doctors who were out of network even though the hospital was in network. If you have a preemie as if there is a case worker who will help you handle billing. We had an awesome case worker who would fight with out insurance about covering things and she got the most out of them she could and then was able to get the hospital and doctors to write off the rest so the $200 was just for me. This time around we have different insurance and I have no idea what to expect but I do know that we will pay $200 a day for my room but 100% of newborn care is supposed to be covered. My daughters bills added up to close to $400,000 possibly more. Ask for a case worker, they make a huge difference!

I had a homebirth with an amazing midwife that cost $3,000 total – including all pre-natal visits (which were at my house and usually lasted at least an hour) and post-natal visits (which were also at my house, often more than an hour and included help with breastfeeding!). My insurance covered about $1,800, the two ultrasounds I had, and the blood work. So, my total out of pocket was about $1,200 – crazy cheap for what I got.

Dude, what the hell? How does anybody afford children in the US? That sounds awful!

-commenter from the land of universal health care

I adopted both of my kids through private domestic adoption. One adoption cost 32K, and one was 38K. My first was a preemie and if Medicaid hadn’t stepped in (since she was technically a ward of the state at the time), her NICU stay would have cost us $52,000, on top of our fees of 32K for the adoption. Now that I have my two, I have no desire to be/get/ever be pregnant, but am jealous of seeing how much cheaper it would have been if we could have had bio kids. :)

I find this so hard to get my head around. Never have I been more grateful for the NHS (National Health Service) we have here, which is free to all.

As an Australian I find the way health care works in the USA really sickening and disturbing. Not to mention immoral. As an expat in another country close to the USA our health care system here is very similar but from what I can tell nowhere near as bad. I paid 20% of each OBGYN visit as I went and after having a straightforward birth in the hospital received a bill for about $14. The whole thing really confounds me, but as I didn’t really have to pay anything to the hospital I had no need to ask more about it. I have a question about the itemised list: What does it mean to be charged $225 for an Epidural “tray” and $97 for a breast pump? Do you then own those items and take them home?

Jeebers. Homebirth all the way. $3k out of pocket, for fantastic pre-and post-partum care. Four healthy babies, four great births. Even those whose insurance fully covers their experience don’t see that someone somewhere is getting overcharged, which is what happens when you treat a normal occurrence as a disease needing an entire hospital’s back up.

All of these comments are amazing me! While our insurance was expensive for us coming out of our paychecks, it really was fabulous insurance. We ended up paying a 20$ copay, total. All ob visits, ultrasounds and the delivery and 2 night hospital stay was at “no charge” to us. I honestly never knew how good I had it until we heard about these kinds of things. Definitely will make me think things through the 2nd time around though!

My birth center charges a universal fee of 5,500 for your entire prenatal care and labor. I believe this even covers baby’s one week visit. I will pay an extra fee for using the waterbirth room, about $100. Of course, there is no option for an epidural.

I am having the baby at home because I don’t have the option for maternity insurance. We are both self employed so no group plan. And in America as of last May no insurance companies will let you buy maternity coverage as an individual. There isn’t even an option because it is bad business for them. They know they will have to pay out on that and your monthly premium won’t cover their costs so they are no even offering it any more. I wanted a home birth and I am low risk so hopefully everything will be ok. But I am terrified if I have to get transferred to the hospital and the costs that will be involved. I have to be careful and only go if it is an emergency. I can’t go just because it hurts a lot and I want an epidural. I envy you Canada!

wow! I’m from the U.S. but currently live in Denmark. I had my first baby in Copenhagen. I’m married to a Dane so I have all the healthcare that a regular Dane receives and I didn’t pay anything. the healthcare in America is ridiculous! Also I had a c section and I heard it costs about $10,000 in the U.S.
I was induced,had an epidural, had a c-section and also stayed in the hosp for 3 days, my husband even had a bed next to mine and I had 3 meals a day and all the pain killers I could get.
I know that working in Denmark you are taxed a lot but it all works out. I mean in America you pay like 30% to 45% tax but then you have to pay for insurance. Even if you have the most expensive insurance you are still billed.

The comments have been wonderful. I will be 27 weeks tomorrow. I have been seeing on OB and paying as I go. When I signed up for my insurance last year, I looked into my options and what would work out best. My insurance guestimated $3000.00 out of pocket after my $250.00 deductible and my 15%..This is my first child and we are all praying for a short and healthy stay in the hospital. I have researched with the insurance on what hospitals are in network and which are out, just in case. I appreciate the comments about the anesthesiologist, as I will look into my options with them. Thanks for everything and good luck to all.

It’s amazing how people in the medical profession defend the fact that healthcare costs are recovered by the people who are willing to pay. The system is SO broken. Insurance companies and Medicaid/Medicare pay partial amounts but the uninsured patient is billed astronomical charges. Makes no sense, any way you slice it.

Also used two different pumps at the hospital more times than I can remember and had a hospital grade pump rental for a month and didn’t pay a penny. Not trying to run it in, just really purplexed at what insurance and hospitals would do that to people.

Just to clarify – I would MUCH rather pay more tax (if that’s even the case, although I know that’s the theory), than be hit with a medical bill I could not pay. There are MANY horror stories of people not being covered enough in emergency situations. A woman who lives in my community was not covered enough by her basic insurance to have her premature twin babies airlifted to hospital in the States and so they were literally left here to die, which they did (we live on a small island near the USA). All down to dollars. I would much rather pay more tax and know that everyone in the community is covered for good and timely medical attention. Of course it’s never for free, but in Australia (where I’m originally from), where the health system is not perfect, at least people’s lives aren’t put in the balance due to an immoral system that effectively makes money off people’s need for medical care and in many cases leaves them in a precarious financial situation.

I’m shocked by your hospital charges. They’re outrageous! I live in Canada and our health care covers everything except for the room charges, which in most cases is covered by individual health insurance. Most people end up paying next to nothing in Canada, to have a baby.

Had my babies at home and have to pay $4000 out of pocket…but I don’t mind because I know the money is going to one loving and caring midwife who takes care of all my needs. I wouldn’t have it any other way!

Thank you for taking the time and initiative to write this, and there are some excellent comments on here, too. I had my son in October 2009 in the U.S.. My husband and I are self-employed and had no health insurance. I started with an OB, and then had to be switched to a high-risk OB (long story, which I am happy to elaborate upon, but not the subject of this so I will leave it out), and was able to get switched back to Low-risk at 35 weeks so I could then switch to a Midwife for a homebirth. I was terrified that something would go “not according to plan” and I would have to transfer to the hospital, obviously for other reasons, but partly because of the exorbitant charges we would accrue. Thankfully, that concern was unfounded because we were able to stay home – it was a completely complication-free birth, big healthy baby, great experience, etc.
Low Risk OB (2 visits, 1 ultrasound) – $500
Lab Work – $6000
High Risk OB (15 weeks)- $15,000
Midwife for week 35 through birth plus 6 weeks PP care – $2700
Midwifery care is the single best “deal” out there in childbirth. Not only is it “cheaper”, it is far better care for situations that are TRULY not high-risk. I ***LOVED*** my Midwife!!!!!
I suppose it goes without saying (but I’ll say it anyways!) that I will start with the Midwife for the next baby, although now our situation is completely different. We have moved to Germany where we have Universal Health Care (thank god!) and we pay a small monthly fee for ALL of our healthcare for our whole family. I had to go to the hospital for x-rays recently when I was thrown off a horse, and I paid $10. That’s it. My Midwife (homebirths are covered by insurance here) will be covered, and if I (for some reason) have to transfer to a hospital during labor, that will be covered, too. The US needs to really step up to the plate – something has GOT to change for health care in that country. Although I am out of that scenario, I am still very much concerned because I have family and friends there. It is a total racket!

Um..my hospital bill for my daughter (just the hospital, NOT the doctors) was $141,000. She was 9 weeks early and spent 30 days NICU. I don’t even care..she’s worth it! Can I pay this? Nope! I have great insurance or I would be totally bankrupt.

OMG, move to Canada man! I had to stay in the hospital for 5 days in a private room with my little guy, he was jaundice and received treatment for that, was transferred to another hospital for 2 more days (moved in an incubator in an ambulance and everything) when that treatment didn’t work, I ate like a horse the whole time, was given a shelf communal fridge with extra snacks (sandwiches mostly) for if I got hungry between meals, my little guy was so tiny and had trouble eating, they gave him formula, I was given tylenol and advil at my disposal, and the only thing we paid was $4/day at the first hospital for the phone and $5/day at the second for the phone as well! How on earth do you american families do it?

sorry “Sicko”