It’s hard to fathom that it has been over five months since our second child, Leo, entered the world. His mother, Marissa, is doing well, which is certainly a relief considering the high maternal mortality rates in the United States. Leo is thriving, even if he’s not exactly a champion sleeper at night. What’s truly astonishing, however, is that I am still grappling with bills from his birth.
As someone who studies health policy, I thought I was prepared for the journey ahead once we discovered Marissa was pregnant. I’ve written extensively about the intricacies of the American healthcare system, yet nothing could have truly prepared me for the realities of experiencing it firsthand. Our birthing experience was straightforward, and we had health insurance, yet the sheer volume of paperwork and expenses was overwhelming.
For those without the same resources or understanding of the healthcare landscape, I can only imagine how daunting the process must be.
Pregnancy and Childbirth: Not What It Used to Be
From the initial doctor’s appointment, we were met with an avalanche of administrative tasks and bills. The frequency of visits escalated from monthly to biweekly, to weekly, each accompanied by its own set of charges. In our state, West Virginia, due to the opioid crisis, nearly every doctor recommends a drug screening.
My wife’s obstetrician ordered a multitude of blood tests and ultrasounds—collectively categorized as “outpatient diagnostic services”—costing thousands of dollars. It’s hard to question these expenses when your primary concern is the health of your baby, and your doctor seems to be the ultimate authority on which tests are essential.
Naturally, we wanted reassurance regarding our baby’s health. The bill for genetic testing sent to our insurance company was a staggering $26,755.
Delivery for our first child, Max, had been quite the ordeal, involving over 30 hours of labor. This time, determined to minimize hospital time, Marissa nearly delivered Leo in our car. Eventually, I managed to get her into a hospital room just in time for the birth. I joked that at least we wouldn’t incur a delivery charge—little did I know how mistaken I was, as every detailed bill I requested revealed new charges while others inexplicably vanished.
Breakdown of Hospital Costs
The delivery room, which we used for approximately one minute, cost about $7,000. Marissa’s two-day stay in the hospital added another $3,100 to our tab. Just two Tylenols for her post-delivery relief? That’ll be $25. Laboratory work? An additional $1,200.
And let’s not forget about Leo. His room and board racked up over $1,500, and various lab tests added about $1,400. The hearing test? Another $260.
I attempted to keep track of all the medical personnel involved, but soon it became overwhelming. The doctor who was absent for the birth billed us $4,200 for delivery and postnatal care. Pediatricians made several brief visits to check on Leo, charging $150 each time.
We also discovered that we couldn’t utilize a flexible spending account to cover many of these costs, as being merely pregnant doesn’t count as a “life event.” Only childbirth qualifies, but by then, the costs had already accumulated.
Life After the Hospital
While giving birth is undoubtedly challenging, the real trials of parenthood often begin once you leave the hospital. Like many American women, Marissa, a teacher, had no access to paid maternity leave, forcing us to rely on a single income for several months. As we were bombarded with medical bills, many of which contained errors, I found myself making countless calls to sort them out with our insurer.
Diapers and baby essentials are costly, too. When my semester ended in early May, Marissa returned to work, leaving me to care for Leo. This transition brought additional challenges, particularly since I don’t receive summer pay as a professor.
While the Affordable Care Act provides some benefits for breastfeeding, limitations persist. Not all breast pumps are covered, and insurance companies have become increasingly restrictive. This is ironic given ongoing initiatives to promote breastfeeding, which is known to be highly beneficial for both mothers and infants. Finding suitable times and places to pump breast milk at work has proven difficult. Marissa often has to lock her classroom and seize every spare moment to do so.
Looking ahead, we count ourselves fortunate. The Affordable Care Act ensures that well-child visits and preventive care like vaccinations are included in our insurance. However, should any serious medical issues arise, we could again face significant out-of-pocket expenses.
My employer allows me to work from home during the fall semester, enabling me to care for Leo simultaneously. However, while I may not be teaching on campus, my research and service commitments remain unchanged. Soon, we will need to enroll Leo in daycare, and we’ve been on several waiting lists since Marissa’s pregnancy. Last time, I had to drive Max 45 minutes to a daycare we trusted. Even if we find a suitable daycare nearby, the fees will likely surpass in-state tuition at my university.
In Perspective: A Shared Experience
Our story is not unique. The most vulnerable members of society are often shielded from medical costs, as Medicaid typically does not require out-of-pocket expenses. However, families on the Children’s Health Insurance Program or those receiving cost-sharing subsidies under the Affordable Care Act can also face significant challenges. In both cases, the high costs associated with childbirth are ultimately borne by public resources and those of us with private insurance.
The real challenges for low-income families begin when they try to raise children with limited resources and declining government support. Meanwhile, the middle class finds itself increasingly squeezed by rising healthcare premiums, deductibles, and copayments.
The current political climate, with ongoing attempts to dismantle the Affordable Care Act, threatens to strip protections from those of us with employer-sponsored insurance. Many are already grappling with student loan repayments, which delays marriage, family planning, and home ownership. For us, it has meant cutting back on nearly all discretionary spending, including family vacations, and taking on side jobs to make ends meet.
Caught between being too affluent for government assistance yet too financially strained to avoid hardship, it’s no wonder that the middle class often harbors resentment toward publicly funded programs. This frustration can lead to support for punitive measures and stricter conditions for social services.
Our nation’s approach to supporting families—through healthcare, parental leave, childcare, and education—is inadequate. As a society, we must strive to do better for parents and families.
In summary, the experience of welcoming a new child into the world is fraught with unexpected costs and challenges, even for those well-versed in health policy. As we navigate this complex landscape, it becomes increasingly clear that comprehensive support systems are essential for all families.
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