It’s hard to believe that it has been over five months since we welcomed our second son, Max, into the world. His mother, Jane, is doing well, which is a blessing given the alarmingly high maternal mortality rates in the United States. Max is healthy and growing, although he hasn’t quite mastered nighttime sleep. What’s truly astonishing is that I’m still receiving bills related to his delivery.
As someone who studies health policy, I thought I was prepared for what lay ahead once we discovered Jane was pregnant. I’ve authored extensive pieces on the American healthcare system, yet navigating it personally has been an eye-opening experience. It’s important to note that our birthing experience was straightforward, and we had health insurance.
I can only imagine how daunting this process must be for those with fewer resources or less knowledge about the U.S. healthcare landscape.
From the moment we stepped into the doctor’s office, we were met with a mountain of paperwork and bills. The routine doctor visits started monthly, then shifted to biweekly, and eventually weekly, each accompanied by corresponding charges. In our home state of West Virginia, the ongoing opioid crisis means most doctors require drug screenings as a standard precaution.
As it turned out, Jane’s doctor ordered extensive blood tests and ultrasounds, labeled as “outpatient diagnostic services,” which added up to thousands of dollars. It’s hard to question any of these when all you want is a healthy baby, and the doctor is the expert determining which tests are essential. Like many parents, we were eager to ensure our baby’s well-being — the bill for genetic testing alone was $26,755.
The memory of delivering our first son, Leo, was quite intense for Jane; she labored for more than 30 hours. This time, determined to avoid a prolonged hospital stay, Jane nearly gave birth in our car. Thankfully, I managed to get her onto a bed in the maternity ward just in time for Max’s entrance.
I jokingly told her, “At least they can’t charge us for the delivery.” Little did I know how mistaken I was, as each detailed bill I requested seemed to reveal new charges while others inexplicably vanished.
The delivery room, which we used for a mere minute, cost around $7,000. Jane’s two-day stay amounted to over $3,100, and two Tylenols were billed at $25. Laboratory work set us back another $1,200. This didn’t even cover Max’s expenses — his room and board were approximately $1,500, with lab charges adding another $1,400 or so, and a hearing test costing $260.
I tried to keep track of all the medical personnel involved, but soon it all became overwhelming. The doctor who wasn’t present during the delivery charged $4,200 for her services, while pediatricians popped in occasionally to check on Max, each visit costing $150.
Due to the rules surrounding flexible spending accounts, we couldn’t take advantage of pre-tax savings for most of these expenses. While “giving birth” qualifies as a “life event,” contributions can’t be applied retroactively to prior costs.
Once we brought Max home, the real challenges began. Like many American women, Jane, a teacher, lacked paid maternity leave, forcing us to rely on a single income for several months. This timing was less than ideal, considering we were inundated with medical bills, many of which contained errors that required countless calls to providers and our insurance company.
Diapers and other baby essentials, naturally, aren’t cheap either. When my semester ended in early May, Jane returned to work, leaving me to care for Max. This brought its own set of challenges.
I also don’t receive summer pay as a professor, adding to our financial strain. While the Affordable Care Act offers benefits for breastfeeding, there are limitations; not all breast pumps are covered, and insurers are tightening their policies. Ironically, there’s a push to encourage breastfeeding due to its numerous benefits for both mother and child.
Finding time and space to pump breast milk at work, even with a decent pump and existing protections, presents a myriad of challenges. Currently, Jane utilizes every spare moment and locks her classroom door. Coordinating time for pumping during continuing education or field trips is a different hurdle altogether.
Looking ahead, we are fortunate in some respects. Thanks to the Affordable Care Act, well-child visits and preventive services like vaccinations are included in our insurance. However, if a significant medical issue arises, we could still face thousands in costs.
My employer lets me work from home in the fall semester, allowing me to care for Max simultaneously. Nevertheless, while I won’t be teaching on campus, the expectations for research and other responsibilities remain unchanged. Soon, we’ll need to enroll Max in daycare. We’ve been on waiting lists since we learned about Jane’s pregnancy. Previously, I had to drive Leo 45 minutes one way to a daycare that met our standards in Pennsylvania. Even if we find a suitable daycare nearby, the fees will likely exceed in-state tuition at the university where I work.
Our experience is far from unique. Those at the lower end of the economic spectrum often find some relief from medical expenses. Medicaid typically doesn’t require out-of-pocket payments, and programs like the Children’s Health Insurance Program limit costs for eligible families. However, the high price of childbirth is often passed onto public resources and those of us with private insurance.
The middle class increasingly finds itself caught in a challenging situation regarding healthcare. Premiums, deductibles, and co-payments rise steadily while options dwindle. Efforts to dismantle parts of the Affordable Care Act could strip many of us with employer-sponsored plans of vital protections.
Many of us are juggling student loan repayments, which often delays decisions about marriage, children, or homeownership. For my family and countless others, this also means cutting back on almost everything, from family vacations to essential appliances. We are continually seeking additional income through side jobs.
Future raises will likely be absorbed by increasing premiums and co-payments, as healthcare costs continue to soar. We find ourselves too affluent for government assistance but too financially strained to escape hardship.
Given these difficulties, it’s no wonder that frustrations among the middle class often lead to a sense of resentment towards publicly funded programs. Support for stricter work requirements and punitive measures regarding social assistance may stem from understandable frustration.
Our current systems aimed at supporting parenthood are glaringly insufficient. Health care, parental leave, daycare, and educational support need to be strengthened. As a nation, we should aspire to better support our families.
For those interested in more resources about pregnancy and home insemination, check out this excellent guide from WomensHealth.gov. Additionally, if you are looking for fertility assistance, make sure to visit Make a Mom for their expert kits. You can also explore Intracervical Insemination for more insights on home insemination.
In summary, navigating the financial and logistical challenges of having a baby in America can be overwhelming, even for those well-versed in health policy. From mounting medical bills to the struggles of returning to work, the experience can be daunting for many families, particularly the middle class, who find themselves squeezed between rising costs and limited support.