This article was originally published on July 19, 2022.
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The out-of-pocket cost of giving birth, with insurance, is $2,854, according to a new analysis released Wednesday by the nonpartisan Kaiser Family Foundation (KFF).
The analysis comes on the heels of the Supreme Court’s landmark decision to overturn Roe v. wade, the 1973 case that guaranteed the right to abortion. the June 24 decision gave states the power to ban the procedure. in the past two and a half weeks, eight states have begun enforcing outright abortion bans. three more states are actively banning the procedure for people more than six weeks pregnant.
Giving birth is just the first expense: Raising a child represents its own financial burden, and previous research has shown that people who are denied an abortion face significant financial harm. a project known as the turnaway study found that 72 percent of people who were unable to access a wanted abortion lived in poverty, compared to 55 percent of those who were able to terminate a pregnancy.
read more: it’s time to recognize the damage of childbirth, say doctors and mothers
The kff analysis builds on that understanding and illustrates just one of the excessive costs of giving birth. offers a snapshot of the financial burden associated with pregnancy and highlights that many Americans cannot afford to give birth.
“There will be more women who end up having a full term delivery because they were unable to access a timely abortion or an abortion at all. and what that can mean is that they have very significant costs,” said cynthia cox, vice president of kff and author of the study. “This is the first cost that you would experience, the cost of birth. But, of course, there are also other costs: the cost of medical care for the babies, and the care and support of their children for many years after that.”
Out-of-pocket costs represent insurance-related bills related to pregnancy, labor and delivery, and postpartum care. The researchers analyzed a dataset of health insurance claims from 2018 to 2020, comparing women between the ages of 15 and 49 who gave birth to those who did not. the data does not take into account transgender and non-binary people who may have given birth.
Total, pregnancy and childbirth for someone with private insurance costs about $18,865. most of that is paid for by the insurance plan, but it can result in higher insurance premiums in the future. so, while the $2,853 figure is only a fraction of the total cost, it represents the bills new parents have to pay out of pocket for a single birth.
By comparing cumulative medical costs for women who gave birth and those who didn’t, the analysis captured a more complete picture of how expensive giving birth can be. out-of-pocket costs included psychiatric care, prenatal visits, and other medical services that may not be labeled “birth-related,” but are a direct result of being pregnant and carrying that pregnancy to term. Birth cost analyzes typically focus only on the cost of labor and delivery.
But in any case, the paper underestimates the cost of pregnancy, Cox said. the category of people who did not give birth includes people who were pregnant for a period of time but who may have had an abortion or miscarriage. that means they incurred some, but not all, pregnancy-related costs.
The study looked only at people insured through large employer-sponsored private health plans. about half of all births are covered by private insurance; most others are insured through the public Medicaid program, which covers low-income people and has lower associated out-of-pocket costs.
Of the private plans, the large employer-sponsored plans are often the most generous. People with other forms of private coverage — insurance sponsored by a small employer or a plan purchased on the individual market — likely faced even higher out-of-pocket medical costs when giving birth, Cox said.
The findings underscore that even as millions of Americans have lost the ability to terminate a pregnancy, giving birth remains unaffordable for many Americans. An earlier KFF analysis found that 45 percent of single-person households had no more than $2,000 available to pay medical bills. Nearly a third of multi-person households lack enough money to cover the out-of-pocket costs of pregnancy and childbirth.
read more: Navigating insurance coverage for abortion can be complicated. here’s what you need to know
“These costs are more than many families can afford,” the report says.
High-risk pregnancies, which more often result in C-sections, also led to higher out-of-pocket costs, according to the article. Cox suggested that this might take on particular relevance in the post-roe world. Abortion bans could lead to more people with high-risk pregnancies giving birth, forcing patients to bear greater life-threatening medical risk as well as an even greater financial burden.
And, the analysis notes, out-of-pocket medical bills are just a cost issue. Because the KFF analysis looks at health insurance claims data, it does not take into account patients’ potential spending on over-the-counter medications that are not covered by insurance, such as prenatal vitamins.
and there are costs beyond the medical bills faced by a pregnant woman. when giving birth, people can forego their salary if their job does not warrant paid parental leave. Caring for a new child may mean incurring other new expenses, such as child health care and new non-medical costs. the loss of income, coupled with the new financial burdens, increases the new parents’ risk of medical debt. current parents are also more likely to have medical debt.
“This is perhaps the least of the costs,” Cox said. “It’s the first of many.”