How Much Does It Cost to Have a Baby? :)

I was working for a health insurer when I was first pregnant; I tried to stay in the system but it was just too dangerous (I was working in medical statistics, and it was just not justifiable, the risks and standard 'treatments' that hospitals assume/require ... even though it is SO much better than it was 40 years ago!). So I got pushed into the midwife route because I wouldn't bow down and let the system decide there was an emergency when cleary there wasn't, and at the time I felt very betrayed ...

... but I am SOOOOO glad I got pushed out !!!!!

Our first two kids were born at a midwifery clinic two minutes from a hospital (partly to assuage relatives' fears about me Not Being In A Hospital), the last two were born at home. I wish I had been brave enough to birthe at home the first two times as well ... so many less stressors = SO much better birth experience. Plus, you _really_ don't have to move, and all your own food is of course Right There. I did all four births dry (although my first labor was 38! hard hours and for about 6 of those hours I was in the jacuzzi tub in jut candlelight, which was very nice--but not for the birth), so can't speak to the birth tub.

Our midwife costs in 2000 were something like $1200, which we (painfully) paid out of pocket and which included all prenatal and 6 postnatal visits (the midwives don't want women to put off prenatal care to 'save money,' so there is no discount for starting late ;) ). But not lab tests (the insurance did pay for those) nor ultrasound (I didn't do ultrasound, which now finally is starting to be exposed for the un-safety-proven technology it is, and for its suspicious confluence with the rise in autism-spectrum disorder in industrialized nations around the world ... every once in a while, the mainstream media catch a whiff of that forbidden secret ... GROWL ... ). Thatyear (2000), the Oregon Health Plan paid for a friend's midwife birth at a clinic (so maybe they still do), but wouldn't pay for homebirth, but my big-medicine plan of course didn't pay for either (sigh--it's safer and cheaper, but of course a threat to their whole concept). In 2000, a basic hospital birth at a high-end maternity ward in Portland started at about $5200, if nothing set off any non-basic tests or treatments (that $ number I had from inside the system).

In 2002, the midwifery birth clinic birth was $1500, but Lifewise paid for it (yay Lifewise! truly "wise"!). The clinic had to charge $2100 to get the $1500, of course--insurance billing is tricky : P.

In 2004, there was a big drama because we had No Money and I was trying to figure out how to make the insurance work for me but not be sucked into the hospital system. I don't remember what we paid in the end (for our homebirth), but not very much, because a midwife I knew granted me a BIG HUGE favor--and my husband, perhaps finally believing I was (very) serious about laboring and delivering in the van in the hospital parking lot and only going into the building if something seemed to be going wrong, decided we could go a little bit in debt to have an attended birth at home instead. An interesting side note, though, that I learned from a nurse midwife after the hospital tour (when all the non-problem mothers had gone away and couldn't be scared by me ;) ), is that the midwives on Native American reservations are (of course) not bound by all the legal stuff the affects state-liscenced midwives ... she offered to connect me to a Native midwife she knew who would take barter for payment. Since we were poor, I considered this, but really we had nothing much to barter ... so I was glad I already knew my midwife, and she trusted me enough to take me on something like only two weeks before I was due!

In 2007 there were new big dramas (my husband left), but I'm pretty sure the price was $2500, paid out of (our) pocket(s) because our current big insurer of course (sigh!!) wouldn't pay for the homebirth ... I think the last I heard was that a basic hospital birth costs something like $7000 ... but that's a vague memory, as I wasn't exactly actually 'in the market' for hospital services ;)!! Thank goodness my husband was still capable of listening to reason about it not being fair to not give this baby all the statistically supported chances his older siblings had had. I did (since I was essentially abandoned, sigh ... ) break down and panic a couple of times and go in for ultrasounds, to make sure the baby was still alive. I wish I hadn't, and I will try to maximize anti-autism health choices Just In Case, but there it is. Nothing like being off-balance to cloud one's judgement!

Anyhow, those are the $ numbers I remember.

However, I'd say: make the decision about where you will feel safest, because that is where you should labor. I have lots of friends for whom the 'safest'-feeling place is a hospital maternity ward. And I don't bother them about it (really! ;) ) ... well, unless they ask me to ;) ...

If your insurance won't pay, ask yourself how much it is worth to you to do it the way that you feel is best for your family? How much support (financial, emotional) do you have from the people around you, and is it enough? What medical risks balance how much financial risk/effort to fight with the insurer? How many fears will be assuaged one way, how many the other?

For the first birth, standing more or less on my own about my non-hospital, let-her-go-late choices was very very(!) hard. It would've been nice to have the actual (not just the nervous verbal) support of both families. That might have been worth a large amount, actually, except that I was very sure I would end up in a C-Section if I stepped foot in a hospital (which as it turned out I definitely would have) ... and that would have erased completely the relative worth (to me) of the family support.

Anyhow.

If you choose to go with a midwife, find a midwife you trust. They seem to come in two basic flavors: mother (which was great(!) for my first birth) and fellow-woman/friend (my preference later). Often you will choose one midwife and she will call one or two others as assistants/backup, and if you hire her early in your pregnancy she can get to know you a bit first and better choose the team so they are women she suspects you (and your partner, if applicable) will work well with. All of that is included in the total cost. Usually one midwife is an apprentice putting in her hours toward her certification, so you get to hear the teaching and take delight in her discoveries, which are sometimes your discoveries as well :).

May you have a blessed pregnancy and birth--and everything beyond :)!

--K.

PS One thing I kinda feel like midwives don't realize you should be warned about ... after every birth, mine asked if I wanted to see the placenta. Ummmmmm ... NO. No, not really, thanks ;). From hospital-birth friends, I gather this is not part of the medical routine ;). My midwives were very into the Beauty of Birth :) ... and actually, by number four, I was used to the idea and recognizing that it might be my last chance, and I did ask to see it. And it was cool (really cool!) ... but I'm really glad I didn't for the first three, because I really _wasn't_ ready, and seeing it for number four really confirmed that :P!

Hi L.,

There really isn't a set price. It greatly depends on the level of insurance you have. It cost my friend a whole $50 and it cost me $5,000 (she works for a huge conglomerate - I work a small non-profit...). A cost of a doctors appointment could be a co-pay of $20 or if you have a high deductible plan, you'll pay for 80% of the office visit until you reach the specified deductible amount.

The appointments gradually increase from infrequent, to once a month, until the final month, than you're going once a week.

I had my first at the Anduluz Water Birthing Center with a midwife team and it was $2400 and insurance picked up part of the tab.

I had my second at home and it was $2900 for all the prenatals, the birth tub rental, lab tests, birth supplies and my awesome midwife team!! The schedual was approx once a month until the 36th week, then once a week for 4 weeks, towards the end twice a week, and after baby twice a week for a little then the 6 week postpardom.

Both times one of the first visits we worked out a price and a payment plan. Any midwife that has done this for a bit can quote you the price.

I LOVE midwives because their appointments are an easy, hour long chat and they are willing to sit and listen to EVERYTHING!! They also are going be very interested in your health overall-- how you are eating, if you are sleeping well, is everyone emotionally coping, and will take the time to explain tests (and then give their opinions on tests). The only "downside" to a midwife is that they can not administer pain meds for birth -epidurals were not options in my out of hospital births.

Different doctors offices have different prices. Of course, if you decide to go to a hospital, there will be that charge too. Most of the hospitals and doctors offices will work with you on payment plans. I currently work for an OBGYN office and we do "contracts" and help you get set up on payment plan with our office. A lot of them have global fees, which means that your office visits for normal OB check ups are included in one price and if you come in for something different during your pregnancy, that is billed seperatley.
I know someone who had their baby at home with a midwife and she ended up being rushed to the hospital after the baby was born because she started bleeding horribley bad! I personally would go to a hospital and have a baby there, just in case something was to happen to you or your baby. When my son was born, he wasn't breathing, so I am glad that I was at a hospital.
I would call around to different offices and talk to someone about prices, the global fees, etc.
Hope this helps!

My daughter was born almost 2 years ago and I had her at Andaluz Waterbirth Center. It was about $2300, but you get a discount, I think of 30% if you pay all at once! Anyway it was well worth every penny. I got to see the midwives every month and then towards the end it was weekly. They would spend an entire hour with me answering all my questions which was wonderful because it allowed me time to remember all the questions I had and I felt like we covered everything. Also, I loved the fact that I developed a relationship with my midwive who was there for the whole labor, the birth and then for follow up check ups! It was the best birth experience I could ever hope for! Next baby I am having at home with the Andaluz midwives!

And reading your a little about me, I thought you would like to know that the Andaluz families all keep in touch online and we get together for potlucks and social engagements. It's like a family/community where we support each other.

I used a midwife and had a homebirth which we paid for completely out of pocket. For all the appointments, the birth, the birth kit, the postpartum visits, the screening test for our daughter, and the birthing pool it was under $3000. All of our visits were at least an hour long and I labored how I chose and ate what I wanted while in labor. I strongly encourage homebirths with midwives. Most offer payment plans and discounts for paying off before a certian period of pregnancy and many are also covered by insurance. I personally recommend Kelli McIntosh here's her website http://www.myspace.com/portlandmidwife tell her M. sent you, trust me when I say she's amazing and so sweet.

I had my son at home with a midwife. Although my insurance covered the cost fully, it would have cost about $2000 to pay them for their service. Most midwives just give a flat rate that includes all the appointments, the birth, and the baby check ups after birth. Some places have a sliding scale if you don't make as much money.

You see them one time a month until about 26 weeks, then two times a month until 36 weeks, then one time a week until the baby is born. That's the standard protocol for all midwives and doctors, so it will depend how far along you are in your pregnancy when you start going.

I had a wonderful home-birth experience and would highly recommend it.

Let me try and answer each of your questions...

Doctor's appointments are recommended every month until you are around 28 weeks. Depending on your doctor or midwife this could be within the first few weeks of you finding out you are pregnant or around your 10th-12th week of pregnancy. Then you have appointments every two weeks until 36 weeks, and finally ever week until 41 weeks. And if you still haven't given birth then typically every few days until you do. (Of course this depends on your doctor's policy and whether or not any complications/emergencies arise.)

The cost for a doctor's appointment depends on your insurance. With insurance my co-pays were around $15 - $25. If you use a midwife/birth center who is out of network from your insurance then it can be upwards of $35 per visit OR a flat fee of a few thousand which includes all appointments and the birth should you have no insurance.

Costs involved depend again on your insurance and what they cover. Ultrasounds (depending on your doctor you can have anywhere from 1 to 5 in a pregnancy), and blood tests (usually only done once for all STDS, gestational diabetes, Group B strep, and other labs). Ultrasounds and labs are usually in the couple hundreds of dollars range without insurance.

Birth costs really depend on if you are using a hospital or a birth center or even a homebirth. Also, keep in mind if you have to have a c-section, or your child requires extra care that dramatically changes the cost of everything.

My first birth including prenatal appointments and labs, etc. Amounted to $3500 (using insurance, with a few ER visits, and one night in a birth center following a natural birth with a healthy baby and no complications.)

My second was $2500 also covered by insurance with no ER visits and a three night hospital stay.

Hi L.,

I'm glad you asked about this. Something I learned with my first baby is that most maternity care is "bundled" (that's what they called it), which means that prenatal visits are not billed individually. The only time there is a bill for maternity services is after the birth. Though, any ultrasounds or tests are extra. So there's no need to skimp on prenatal care. If you switch providers, you owe all your money to the provider to go to for the actual birth, unless you have some other agreement, which you often do with homebirth midwives.

You can interview homebirth midwives for free and choose the one you feel most comfortable with. They they often ask for a deposit, which is not refundable and that protects the time they've spent with you if you do decide to switch providers.
Home birth with a licensed midwife is incredibly safe and I would argue the care is better than in the hospital. It's much more personal. It's so much less expensive than going to the hospital, but remember that as far as money goes, you're still taking a gamble. Some 6% to 10% of women that plan to give birth at home will need to transport to the hospital. In that case you will need to pay for the hospital birth and your midwife as well. Still, there is a 90% chance that you will have a successful home birth.

I have had two home-births with midwives. I would highly recommend it. For my last birth the charge was $3200, though we paid $2700 because she offered a 15% discount for paying before 28 weeks. My midwife was very cost-conscious so she would send me to an inexpensive place for my labs that would be done out of pocket. You do not need a routine ultrasound. I never had one for either of my pregnancies. So you can skip that expense unless there is a medical reason to do one. Each time I had labs done it was around $100. I think I had to do 3 or 4 of them. For you, it could be less, because I am Rh negative and had to pay for an antibody screen each time, which you probably will not have to do.

Other things that cost money at home are the home birth supplies. You usually have to buy a box of stuff to have at your house to be used for the birth, things like absorbent chux pads, latex gloves, lubricant, a peri-bottle for after the birth. It's mostly fairly inexpensive.

I'm sure there's more, so if you have any questions, feel free to contact me directly. Good luck. I know it's hard to crunch the numbers!

Unless you have insurance the cost out of pocket for a midwife is considerably less. My last pregnancy I paid 2200 but insurance picked up some of it. This pregnancy we are probably going to be paying out of pocket which will run us about 4000. This includes prentals and 6 postnatals.

Some one said that they highly recommended a hospital birth due to potential complications, while yes this can happen, midwives are trained to deal with any and all situations. Midwives cannot give you an epidural, but they carry everything with them to deal with hemorrhaging, and a baby who need resuscitation. If there is a need for a transport for a c-section midwives know when to do that. In a hospital you will still have to wait 20-30 minutes for an OR, which you can spend that time in transport.

Midwives are also much more honest about why tests are need and whether they are worth it. OB/GYN's (in my experience) have not explained why I needed a certain test or satisfactorily explained what it will do for me or my child.

S.

I can't answer all of your questions but this was my experience. I used midwives planning a home birth. my baby ended up flipping breech a few days before my due date so i had to go in for a c-section. I had one meeting with the ob. our total hospital bill for the c-section was 15,000. cost of pre/post natal provided by the midwives was about 2000-that includes labs/ultrasound. the hospital really gives it to yah. 1500 bucks a night each (you and the baby)plus of list of about 15 other charges that i don't even remember. my ob let me leave after 2 nights so we saved a bit here!

anywho, i'm prego again and have decided to try for a home birth again. total cost is 3,200. plus no one wakes you at night for blood pressure and charges you more then a 5 star hotel in new york city!

I've had three babies, all born in a hospital with a nurse midwife. I would not do it anyother way. We have insurance so I really don't know how much it cost..............I do know it was alot! worth every penny!
D.