Tuesday, January 3, 2012

Is Having a Baby REALLY That Expensive?


I stumbled across a great article the other day on Stand and Deliver, a awesome blog I have come to really appreciate for it's forthrightness about many "DIY" or "natural" alternatives to pregnancy and birth. In the post What Does A Pregnancy Cost, author Rixa Freeze catalogs how much she spent on her last pregnancy. Her breakdown covers most of the basics - clothes, doctors, medical supplies; but doesn't take into account the things that first time parents might need to buy, especially young people in towns that aren't quite so fortunate as my Asheville in their lack of any sort of community birth support. She totaled in at $787, which to most middle class persons probably seems like a whopping cheap amount. But for me and my poor as hell comrades out there, that is a little more than my standard monthly income, which puts a little more pressure than most of us would like, especially since she hasn't taken into account anything after birth, specifically the dreaded insanely priced diapers of doom.
But ok, still pretty damn cheap when you break that bad boy up over the entire pregnancy, and assuming you found out about 6 weeks in, you still come in at a little under $105 a month. On the other side of the coin, I decided to go check out a standard "reputable" source and see what they thought having a baby should cost.
Ok, because there was a decent bit of wading to get to the nitty gritty of this one, I'll spell it out for you:

At Home Pregnancy Test: $9.62

Prenatal Vitamins ($10-20/month): $90-$180

Out-of-Pocket Prenatal Care: $2,000
or
In the Pocket (of the Insurance Company) Prenatal Care: $3378*

Maternity Clothes: $300

Body Pillow: $60

Childbirth Education Classes: $50-$200

Baby Shower: $100-$1,000

Doula: $650

Hospital Vaginal Birth: $9,000
or
Hospital Vaginal Birth (w/Ins): $463

Hospital C-Section: $15,000
or
Hospital C-Section (w/Ins): $523

When we add all this up, you end up paying an average of $5,700 if you have insurance, and $15,830 if you don't, just for your pregnancy and birth, with the major difference being in the cost of the actual hospital birth, not the difference in prenatal care. The main point being though, whichever way you look at it, Rixa is detailing a birth that leaves out that huge, gaping cost of the hospital swallowing up all your money, of which your birth only costs them about 30% of what they charge you.



Now, being that I'm fairly horrified at the idea of a hospital birth, I will also note that a popular local Midwifery Practice does home births for a flat rate of around $1,000 - and if you simply replace the uninsured cost of hospital birth listed above with said fee, you end up reducing your cost down to $4,830 - suddenly less than it would cost to have an insured hospital birth. And changing the insured hospital birth to an insured home birth adds only $507 to the average cost - which doesn't seem like much if you can afford insurance, right?

But of course, that is the big point here - most weirdos cannot afford insurance, and many of us would never want it even if we could. For those of you who even might be poor enough, I would urge you to look into getting Medicaid. Carol Sakala, director of programs at Childbirth Connection, a national nonprofit organization that works on behalf of mothers and babies to improve the quality of maternity care in the U.S. says that “While 13% to 35% of the pregnant women qualified for Medicaid coverage, many either didn’t qualify or didn’t apply, finding private insurance or paying out of pocket,". Link Lots of people don't even consider the fact that they might qualify for Pregnancy Medicaid, WIC, Work First, and many other programs available through local Health Departments and Department of Social Services offices.

In 2011, the Federal Poverty Level was $1,226 for a family of 2, but many programs only require you to be under 200% of the poverty level - $2,452! Personally, my family doesn't even hit the first one, and 200% of the poverty level seems like a vast fortune we could live easy on. $29,420 a year? Yowza!

So what would it cost someone like me (or our lovely step-daughter, who is due in July) to have a baby while actually taking advantage of state support, local community groups, family networks, etc.?

At Home Pregnancy Test: Kinda silly, if you really want to cut corners, but I got about 20 free on eBay when I bought 100 OPK's for $5 - ($0-$5)

Prenatal Vitamins: Free at most local Health Department, with no paperwork - $0

Prenatal Supplements: I prefer food and herbs for use during birth and pregnancy, my personal favorite being The Wise Woman Herbal for the Childbearing Year, which I've used to make tasty syrups for most common pregnancy complaints in the past two weeks, and on the cheap, even though it's winter and I had to buy all my herbs from the local co-op - $30

Medicaid Co-Pays ($3 per visit): $27

Books: Utilize your local thrift and used book stores, but first look to Midwifery or Alternative Medicine practices to see if they have lending libraries. I just got a slew of baby books by contacting my local Doula Association and asking my loan list to be passed around at their next meeting. As always, remember to ask friends an family who are in a parental way, and never forget the public library - $0

preggo or heavyset friends - $50

Body Pillow: A quick Google search finds us a plethora of DIY pregnancy body pillow's, here and here, for about $10

Childbirth Education Classes: Often free if you look for community run ones or ask about scholarships. Medicaid ones cost around $10, and if you look, you can even find things like this parenting transition class that is a research study where you can win $250 - ($0-10)

Baby Shower: Potluck that bitch, and for the cost of a few phone calls and a Facebook Event page, you can get lots of lovelies (hint hint - specify that hand-me-downs will be appreciated to even get stuff from your ne' er-do-well friends) - $0

Doula: Look for a doula in training, or ask about scholarships, or offer (even partial) work/trade (art? babysitting her kids while you're pregnant? some awesome veggies from your garden?) for some deeply discounted rates - $0-$200

Birthing Tub: Some people will tote how much better actual birthing tubs are, but for us strange ones, bathtubs and kiddie pools will often do. You can buy kiddie pools online or locally during the summer at Mega-Stores, mom and pop places, or the local flea market, but I would suggest looking to your young'un having brethren for a loan. Just make sure it's a high walled soft or blow-up pool, not the hard plastic things. Think about how deep you want it - 30" pools run around $40, though consider some with unusual designs if you think it will provide a more comfortable place for you to lay - $0-$70

Homebirth: Again, ask often and apply early for scholarships, network through community birth groups, local food co-ops, and don't be scared to ask every strange looking person you see with kids or a bump if they know of someplace for you to hook-up with some delicious freeness - $0-1,000
or
Freebirth (aka Unassisted Birth, DIY Birth): Maybe on your own, maybe with your partner, or maybe with a doula and your 20 closest friends, this really just means there isn't a "medical" professional there. That is the free part, though you will need some supplies, which you can find in kits, or scramble those individual supplies together. Again, you can find creative ways to make some of these things on the cheap (cloth pads v. disposable, or getting bulb syringes from feed stores instead of medical supply websites, cuz sterile is sterile), and you can look to local community groups for loans, but these costs can vary a lot depending on how much you want to work for it, and how much stuff you feel you need. $0-$200

Now to end this monetary rambling rampage, I will sum up planned costs for my husband's step daughter's (and my future) pregnancy. On the higher end, including a fully paid Midwife for your Homebirth, you would pay $1,402, and on the free(ish) Freebirth end, you would pay $117 if you can get a tub and supplies for free, but still only $387 even if you buy a new tub/pool and a birth supply "kit". Thus ends this rant, with my personal conclusion on the sanity of freebirth still upheld.

*Ok, trying to track down any semblance of "average" health insurance costs is nearly impossible, but some searching and personal experience unearthed these numbers:
$183 a month / $2,935 deductible
$490 a month / $500 deductible
So lets assume some sort of average between those, at $336 a month / $1717 deductible
And maybe if you're lucky, you've met about 1/2 of your deductible, leaving you $858 to pay off. Even assuming you have no co-payments (which is highly unlikely) after you find out at week 6, you still have 7 1/2 months of premium to pay off, ringing your total insurance costs in around $3378. So much for not having to pay those "huge" out of pocket expenses for prenatal care, huh?





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