Having a baby is expensive. And it's not just the price of raising the child. The costs of prenatal care, birth, and postpartum care add up quickly, too. In fact, childbirth is commonly one of the most costly health events American families experience during their childbearing years.
A lot of factors can move your bottom line, says Aleksandr M. Fuks, M.D., Director of the Department of Obstetrics and Gynecology at NYC Health + Hospitals/Queens in New York. Here’s a breakdown of how much it costs to have a hospital birth and the factors that can increase or decrease your hospital bill.
Calculating the Cost of Childbirth
Estimating the cost of a hospital birth in the U.S. isn't as simple as it should be. Not only do different types of births come with different price tags, but your providers, hospital, location, and health insurance coverage (or lack thereof) will all factor into the final total on your hospital bills. And how much of that total cost you will pay out of your own pocket is yet another complicated equation.
To get an idea of where the cost of a hospital birth starts, here is a quick glance at four major categories of birth types and the average national cost associated with them, according to data from Premier Healthcare Database, which looked at 25% of births in the U.S. between 2008 and 2018.
Other data from the Kaiser Family Foundation (KFF) looked specifically at childbirth costs for pregnant people with employer-sponsored health insurance coverage and included prenatal care, delivery, and postpartum care costs, which may be why the following numbers are much higher than those from Premier’s report. It is estimated that as of 2020, about 54% of Americans were covered by employer-sponsored health insurance, according to the United States Census Bureau.
The cost of a hospital birth also depends on your state. You can get an estimate of what childbirth costs are in your state with or without insurance through Fair Health’s free healthcare expenses tool.
Average Cost by Type of Birth
Whether you deliver your baby vaginally or via C-section and whether there are complications will have a significant impact on the overall cost of your hospital birth. While it isn't always possible to know how your baby will come into the world, talking with your prenatal care provider about your birth plan and individual risk factors can help paint a clearer picture.
Vaginal deliveries account for about 7 in 10 childbirth in the U.S., and C-sections account for about 3 in 10. High-risk pregnancies result in even higher rates of C-sections than average, according to the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project.
According to data collected by Fair Health, the average cost of having a vaginal delivery is between $5,000 and $11,000 in most states.
C-section births tend to be more expensive than vaginal births, with costs ranging from $7,500 to $14,500. A C-section often costs more because it is a major operation that involves anesthesia, longer hospital stays, and higher instances of morbidity and mortality, says Toni Stern, M.D., Chief Patient Experience Officer in the Department of Obstetrics, Gynecology and Reproductive Science at Icahn School of Medicine at Mount Sinai in New York. All of these factors mean more resources used—and more dollars spent.
Premature birth is one of the biggest game-changers in terms of the costs of hospital birth. This complication occurs in about 1 of 9 pregnancies. Average health care costs for premature and low birth weight infants are over 10 times more costly than for newborns without complications, according to data from the March of Dimes.
However, knowing the symptoms of preterm labor and avoiding particular risk factors (such as excessive exercise, recreational drug use, smoking, and drinking alcohol) can lower your chance of going into premature labor. If you are pregnant or trying to become pregnant, talk to your prenatal care provider about what you can do to help prevent premature delivery.
According to the American College of Obstetricians and Gynecologists (ACOG), if you do go into premature labor, your doctor may use medications to halt uterine contractions—but those necessary meds will add to your hospital bill. And if they cause additional maternal complications, they are unfortunately going to cost you even more.
Other birth complications
Complications during childbirth can further increase the overall cost. For a vaginal delivery with complications requiring an operating room procedure, the cost is an average of $10,700—nearly double the average cost of a vaginal delivery without complications, according to a report by Premier on maternal and infant health trends.
People with high-risk pregnancies and/or preexisting conditions like obesity and diabetes are more likely to experience complications during delivery. Advanced maternal age (being over 35) may also increase your odds of needing interventions during birth. People carrying multiples are also more likely to end up with higher hospital bills.
Read more 13 Fun Things to Do in Redwood City
How Your Health and Your Baby's Health Affect Cost
Happy and healthy—that’s all that matters, right? Although that wish has nothing to do with hospital costs, your health and your baby’s health can impact them. Labor that does not progress is one of the most frequent labor complications, and needing to be induced can increase your hospital bill.
According to the National Institutes of Health (NIH), other common (and costly, but not-so-common) delivery complications include premature rupture of the amniotic sac, abnormal presentation, dangerous umbilical cord positioning, difficulty breathing, amniotic fluid embolisms, irregular blood pressure, postpartum hemorrhage, bleeding in the brain, fluid accumulation in the brain, neurological problems, intestinal problems, jaundice, and anemia.
Dr. Stern says that many of these complications are out of your hands, but you can help ensure they are treated as quickly and easily as possible by getting regular prenatal care. You want your health care team to know you and your baby's chart backward and forward, including all of your medications, allergies, health conditions, and any problems experienced during pregnancy, as all of these can affect how your doctor will treat you on the big day.
Talk, talk, talk with your OB-GYN during your prenatal checkups and on the big day. During the delivery, they can read the monitors, but not your mind—and since you'll be in labor, you may not remember to tell them all the pertinent details.
Be aware that certain health conditions can also increase your risk of complications, and by extension, delivery costs. Premier's analysis found that pregnant people with conditions like diabetes, obesity, or chronic pain had deliveries that were $1,000 to $2,200 more expensive on average compared to those with uncomplicated deliveries.
Essentially, the better health you are in, the better your chances of fewer complications and paying less for your baby's delivery.
How Health Insurance Coverage Factors Into Cost
Your personal health insurance coverage, including deductibles, cost-sharing, co-pays, and other variables, as well as which doctor and hospital you go to, will also significantly affect how much you pay for a hospital birth. Unfortunately, medical billing and insurance can be complex and error-prone.
If you don't know your maternity coverage, it's time to take another look. Carefully read the summary of benefits to fully understand your coverage. Pay attention to your co-pays, deductible, out-of-pocket maximums, and, of course, what percentage of maternity care is covered after your deductible is met.
Health insurance is vital to obtaining maternity care services—and being able to afford them—according to the March of Dimes. But having maternity coverage doesn’t necessarily mean that your maternity care will be fully paid for. How much of the total cost of your baby’s hospital birth will be paid by your health insurance plan (versus out of your wallet) depends on your individual plan.
Read more What Is the Cost of Having a Baby?
The impact of the ACA on maternity coverage
Thanks to the Affordable Care Act (ACA), pregnancy is no longer considered a pre-existing condition for most major plans, and pregnancy care and childbirth must be covered in all individual and small group insurance policies. That is to say that if you apply for coverage with an ACA-compliant insurance plan while pregnant, the health plan cannot deny you coverage and pregnancy and maternity care must be covered.
Additionally, if your plan covers maternity care, you are entitled to a minimum of 48 hours of hospital stay after a vaginal delivery or 96 hours after a C-section, according to HealthCare.gov. You also don’t need to be preauthorized from your insurance plan for the minimum hospital stay to be covered.
In-network vs. out-of-network providers
To reduce your overall hospital bill and avoid surprise out-of-network expenses, make sure that both your chosen doctor and hospital are in-network (i.e., are contracted with your insurance company). You'll want to check both; just because your in-network doctor has privileges at a hospital doesn't mean that the hospital is also in-network for your plan and vice versa.
To further complicate matters, it's also possible for providers like anesthesiologists (should you choose to have an epidural or you require a C-section or other surgery) and neonatal intensive care unit (NICU) personnel (should your baby require special care) to be out-of-network even if the hospital where the care is provided is in-network.
Though the federal No Surprises Act that went into effect in 2022 attempts to limit these types of surprise out-of-network costs for emergency services provided in in-network hospitals, it’s best to know ahead of time what you’ll be dealing with.
Resources for low-cost health insurance
According to the American Community Survey, over 15% of people between the ages of 19 and 34 are uninsured in the U.S. If you’re in need of health insurance, the U.S. Department of Health and Human Services provides information to help connect people with health assistance resources.
Programs such as the Special Supplemental Nutrition Program for Woman, Infants, and Children (WIC) and Children’s Health Insurance Program (CHIP) may help you find low-cost health insurance coverage if you’re not eligible for Medicaid.