How Much Does It Really Cost to Have a Baby?

In our current obsessed state of all things pregnancy and baby related, there is one thing that kind of gets glossed over in the baby books — the actual cost of giving birth.

As we’ve all seen in the recent case of one mom who was shocked with an almost million dollar bill for giving birth prematurely while vacationing in Hawaii, birth is almost always guaranteed to be two things: 1) unexpected and 2) expensive.

But why — given the relative frequency of women giving birth — is the cost still such a mystery?

Reporter Stephen Brill shed some major light on the issues with healthcare billing in the U.S in his 2013 Time expose, “Bitter Pill: Why Medical Bills Are Killing Us,” detailing how, namely, there is no standard for what medical services and products cost. Although insurance companies “code” for services, there are hundreds of different companies and codes and no overseeing agency to make sure hospitals and doctors are charging similar prices. When it comes right down to it, it’s like a free-for-all for how much service providers want to charge – clients that have full private insurance, for instance, may get charged more because the hospital knows they will get paid, while Medicaid-reimbursed coverage will be standardized because Medicaid is clear about what they will and will not cover. Or, in other words, depending on what kind of insurance you have, your hospital may just charge whatever the heck it feels like — and what you pay for giving birth at one hospital may look nothing like what you would pay at another hospital.

My curiosity getting the best of me, I called up the hospital where I had recently given birth to my fourth baby back in August and requested an itemized bill from my stay with her. Some of the highlights included:

1 Tylenol #3 tablet … $7.84

One Tylenol cost me almost eight bucks a pop (and let’s be real — I took a couple of those bad boys), although I could probably pick up an entire bottle for much less than that the cost it takes the hospital to buy them wholesale.

Misc. medical surgical supplies … $485.20

Categorized as unspecified “medical-surgical” supplies, the base charge for items that are routine during a mother’s stay are usually rung up in one flat fee, no matter if you use them or not, such as a sitz bath for $7 and that plastic inflatable “invalid ring” for $4. When I worked as a labor and delivery nurse, we would charge out basic supplies to set up a room, even before the patient used them.

Drug screen … $126.30

Because I worked as an OB nurse, I knew that a drug screen was a “mandatory” part of a routine patient admission — and that a positive would send an automatic referral to Social Services, even though errors were quite frequent. A test to screen for drugs I have never even seen in my life cost me more than my husband’s daily wages as a teacher.

Errors … $1,584.70

Because I worked in this particular hospital and know exactly what the services entail, I even noticed some errors in the billing, like the fact that I was charged for “overnight” continuous 02 monitoring — even though I never used it. There was also a $321.30 “culture, other” charge that my doctor never told me about nor released the results to me about — and considering I had rampant postpartum infections, may have been useful information before I subjected myself to ineffective antibiotics. And then there was the little fact that even though I requested — and was granted — an early release, the hospital charged me for a standard two-day stay. Our little family stayed exactly 24 hours and left just after one o’clock in the morning, and yet I was billed for a whole extra day at a cool $1,183 per day. Considering that housekeeping could get the room ready in less than an hour or two and another woman could have been booked in immediately, the hospital may have collected double on that room.

Cardiac monitoring … $201.20

This “cardiac monitoring” is a routine part of receiving an epidural. Nurses strap on EKG leads that give a live reading of a patient’s heart pattern, alerting to any potential disruption while she receives an epidural. While this may be technically life-saving, it’s also notoriously unreliable and hard to monitor — a woman in labor is usually sweating, the leads fall off, and the readings are most important during and immediately following the epidural. What’s also interesting about this “standard” charge is that the time a woman may be monitored also widely varies — in my case, I had my epidural for less than a few hours, so why would I be charged as much as someone who was monitored for longer?

DTP/HIB vaccine … 183.20

This vaccine is recommended for pregnant women especially because it is supposed to protect against whooping cough — a life-threatening illness for newborns in particular. I opted to receive it, but I can honestly say I had no idea it cost almost two hundred dollars.

Perineal wash … $28.40

The kit for a perineal wash — which amounts to two packets of cleansing soap in a sterile basin that the nurse uses to wipe you down quickly before delivery and sometimes doesn’t even do because there’s no time — costs almost $30.

Standard vaginal delivery … $3,148

I was really shocked to see the actual charge for just the delivery itself — a straightforward, uncomplicated vaginal delivery that took less than 10 seconds (it was my fourth baby, after all) and left the doctor walking out of the room minutes after delivery. How exactly is such a number calculated? What if I would have pushed for four hours like with my first baby? Does the charge go up?

Total cost for my routine vaginal delivery with no complications and an epidural … $8,707.29

I have to say that in all honesty, I think my delivery charge is on the conservative side — I delivered in a small, rural hospital and had no complications, not even so much as a tear after delivery. And let’s not forget the fact that that bill is just for me — the cost for newborn care once that baby is on the other side of your body is an entirely different matter.

So it’s really not absurd to see how that poor family could rack up medical charges close to a million dollars. And I’m not really sure what we should take from their story …

That we are all in need of a major overhaul in how the cost of pregnancy and birth is managed …

Or if parents should just give up the idea of taking vacations all together. Because who’s got money for that with how expensive kids can be?

Image courtesy of Chaunie Brusie

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