If you’re pregnant or planning a family, figuring out how much it costs to have a baby can be tricky in the wake of health care reform. Under Obamacare, maternity and newborn care are required to be covered by insurance, which is great news, as families in the U.S. face the highest birthing costs in the first world. Obamacare or not, there are ways to keep costs at a minimum while still receiving the care you and your infant need.

How much does it cost to have a baby?

The bill can vary quite considerably. A recent University of California, San Francisco study found that the cost of uncomplicated vaginal births in California varied between hospitals by as much as $34,000, ranging from $3,296 to $37,227 for on-site hospital costs.

A larger study compared five different states and found the average charges among women and newborns with employer-provided commercial health insurance in 2010 to be approximately $30,000 for vaginal births and$50,000 for cesarean births. Even with insurance, the study found, out-of-pocket costs still ran about $2,200 for vaginal births and $2,700 for cesareans.

Why does it cost so much?
There are many reasons contributing to the overall high cost of pregnancy. Many pre-Obamacare plans provided minimal maternity care or none at all, according to Childbirth Connection http://www.childbirthconnection.org/ , an organization that helps women make informed health care decisions.   With the Obamacare changes more maternity and newborn care will be covered as required by the law, and out-of-pocket costs should start to decrease.

Health care in the U.S. is billed per service, and each hospital gets to set its own prices. For complicated admissions such as for childbirth, a lot of small charges can add up quickly. Non-profit hospitals are increasingly converting to for-profit entities, which charge more for services across the board.

Obstetricians can face the highest malpractice risks among physicians, so your doctor may recommend unnecessary tests and scans, thinking that more information is safer. Consequently, the U.S. standard of care for childbirth has grown to include a number of blood tests and ultrasounds that are both costly and avoidable. When combined with the fee-for-service payment system, there are many opportunities for hospitals to overcharge.

What can I do to try and lower the cost of having my baby?
You should start by researching and choosing a high value pregnancy provider.  Also take some time to understand the details of your insurance coverage. If your plan is Obamacare-compliant you’ll have access to many maternity benefits. If you have a grandfathered plan, find out what, exactly, your insurance covers. There’s a chance that pregnancy coverage is not one of your benefits.

Then, work out your delivery options. If you have a choice between hospitals, do some research to find out what each one charges and whether they are nonprofit or for-profit. Hospitals are not required to publish their fees unless directed by your state or county, so you may have to do some investigating.  Also keep in mind that what the hospital charges won’t necessarily be what you pay, since insurance companies have contracted rates set up with hospitals. Even if you’re uninsured, you may be able to negotiate your bill to be much lower than the original expected charge.

Some hospitals offer comprehensive maternity packages. These packages charge a set rate for the entire delivery, as opposed to billing separately for each item. You’ll definitely want to know whether such a package is available to you and what it includes. If so, check out the package options before you buy because you’ll have to agree to it up front.

If you do not have a choice of hospital, make sure you know what tests you’ll face and the reasons for each. Check with your obstetrician to make sure all procedures are absolutely necessary, especially if you and your baby are healthy—it’s always ok to get a second opinion.

Alternatives to hospital birth

Of course, hospital birth is one option, and obviously the most common one.  However, home birth is another possibility that some women will consider.

Home Birth Expenses (if the mother has no insurance)

The main expense of a home birth would be the midwife. A midwife would charge anywhere from $1,500 to $3,000. Typically, home births are not covered by insurance, so there is a good chance that this would be an out-of-pocket cost.

Of course it is always important to have health insurance, but if you don’t have it for some reason, a home birth could save you a lot of money. Other than the midwife, the other expenses include supplies, labs, and a doula. A doula’s services range in cost from a few hundred to a thousand dollars. So overall the expenses could be between $1,500 and $5,000.

Home Birth Expenses (if the mother has insurance)

If a woman does have insurance, and her insurance will not pay for a home birth, she will be paying considerably more for the home birth. If a woman’s insurance will pay for the home birth, she may be paying about what she would for a hospital birth.  Therefore the expenses would be between $1,500 and $5,000 (whereas a hospital birth might cost the mother around $1,000).

Birthing Center

For a woman who wants an experience similar to a home birth, she has the option to go to a birthing center. A birthing center encourages natural birth and allows the woman to have more control in the decision making. If an emergency should arise during the birth, it can be handled more quickly than at home. Also unlike the hospital, the woman and baby go home a few hours after the baby has been born. The cost is somewhere between that of a home birth and that of a hospital, and it is usually covered by insurance.

Once you have decided on your preference between a hospital, home birth or birthing center, it is important to do your research thoroughly, check your insurance coverage and get written information about costs so you can compare your options.[/fusion_text]