fbpx The True Cost of Pregnancy

The True Cost of Pregnancy

What to expect (to pay) when you're expecting.
Giddy Staff
Written by

Giddy Staff

Most people know labor and delivery costs can land families a sizable bill, but hospital fees aren't the only expense. Nine months of pregnancy prior to childbirth add up. Mothers may be aware they'll incur the costs of standard testing, doctor appointments and genetic testing—but that's not all. The strain on a pregnant person's body necessitates maternity clothes and accessories, over-the-counter medications, pregnancy pillows and more. And, for new moms to feel adequately prepared, they might shell out for childcare classes, a doula or a midwife.

Before we get any further into the nitty-gritty, let's start with the standard fees.

While the World Health Organization (WHO) recommends pregnant women receive a minimum of eight prenatal care visits, current guidelines from the American College of Obstetricians and Gynecologists (ACOG) recommend a prenatal visit schedule for uncomplicated pregnancies as follows: one visit every four weeks until 28 weeks, every two weeks until 36 weeks and weekly until delivery. The number of visits this corresponds to can vary based on when you find out you are pregnant and how early (or late) you deliver.

For a standard 40-week pregnancy, American Congress of Obstetrics and Gynecology (ACOG) guidelines recommend a low-risk pregnant woman be seen by her OB-GYN 15 times during the course of her pregnancy. If the pregnancy has any complications or is at a higher risk, the pregnant woman will need to be seen for additional visits.

With insurance, each visit will typically cost around $25, but without coverage, average visit costs jump to $150. This is not to mention the cost of additional medical screenings and procedures, and genetic testing to disclose health markers of the child. Plus, there is the 20-week ultrasound that reveals the sex and anatomical features of the child, which alone can run up to $1,000 uninsured.

Table 1
The costs in this table are based on national averages and do not reflect individual expenses incurred for these medical visits. / Illustration by Tré Carden

The disparity in costs between the insured and uninsured becomes even more marked when it comes to the many required screenings and procedures a mom undergoes during her pregnancy. From anemia testing to the flu shot to screening for gestational diabetes, insurance will completely cover each procedure, thanks to changes from the Affordable Care Act (ACA). Those without insurance, however, are often left out to dry. Some tests will run as low as $15—but the most intensive can reach up to $600 out of pocket.

Table 2
The costs in this table are based on national averages and do not reflect individual expenses incurred for these medical tests and procedures. / Illustration by Tré Carden

As seen in the vastly different costs above, the true cost of pregnancy can vary widely from person to person. For women who don't know they are pregnant until they are in labor (1 in 2,500 women), costs can be minimal. These women won't spend any money on prenatal care—a sharp difference from women with high-risk pregnancies who spend thousands of dollars on specialty genetic testing.

To illustrate the wide range in what a woman can spend during her nine months of pregnancy, Giddy has created four scenarios, each representing different pregnancy costs. The cumulative costs of pregnancy in these scenarios range from approximately $650, at the lowest end, to approximately $9,400, at the highest end. These four scenarios are garnered from average national costs and are to be used for illustrative purposes only. They do not reflect real women and real expenses.

Illustration by Jaelen Brock

Mia is a 31-year-old woman who is pregnant for the first time. Her doctors have told her that her pregnancy is high-risk due to her family history. Because of this, she's taking extra precautions and opting for extensive genetic testing. While most women choose one or two genetic tests to ensure the health of their child, Mia is receiving nearly every one available to her. Specifically, she is choosing to undergo the following screenings:

These screenings can run well over $1,000 without insurance. Mia, however, comes from a dual-income household and can afford the highest insurance premium available to her. With her insurance kicking in to share the cost of these tests, Mia is paying about half of what she would without insurance.

Since this is Mia's first pregnancy, she will also need to purchase maternity clothing and accessories for the first time. These costs quickly add up, and she ends up spending $850 on new maternity clothes and bras alone. She also buys a pregnancy pillow to help her sleep on her side, compression socks to help with her swollen feet and a belly support band to ease lower back pain during the third trimester.

The costs continue to stack up as Mia buys over-the-counter (OTC) medications and supplements to support her pregnancy. She selected a high-quality prenatal vitamin, which runs $40 for a month's supply. She also experiences considerable heartburn and nausea during the course of her pregnancy, so she buys antacids and anti-nausea medication. These symptoms prevent her from getting a good night's rest, so she purchases a pregnancy-safe sleep aid.

On top of the costs above, Mia still needs to pay for medical and professional help over the course of her pregnancy. Her insurance covers 100 percent of the cost of the medical procedures and screenings outlined in Table 2. While her insurance continues to cover the bulk of her medical expenses, she also incurs a $15 copay for each of the 15 visits to her OB-GYN (her visit schedule corresponds to the one outlined in Table 1). She pays an additional $100 to cover her share of the cost of the 20-week ultrasound that checks the child's anatomy and sex.

In addition to visits with her OB-GYN, Mia employs the help of a doula and attends childbirth classes. Because she lives in a metropolitan area, Mia's doula is priced at the upper end of the $500 to $3,000 average range for a doula's care during pregnancy, birth and postpartum. Mia's childbirth classes through her local hospital set her back another $100.

Cumulatively, Mia spends $9,610.50 over the course of her pregnancy. This averages out to $1,067.83 per month.

Illustration by Jaelen Brock

Naomi is already a mom to a healthy toddler and didn't want to wait too long to have a second child. Since she is 29 years old and healthy, her pregnancy is considered low-risk. To avoid the high cost of childcare, Naomi stays home to take care of her toddler. Her partner, Stephanie, is the only source of income for the family, so they choose to stick with the lowest insurance premium available through Stephanie's job to lower their monthly expenses.

The couple, fortunately, had a friend who donated sperm for them, so they didn't have the extra expense of paying for a sperm donor. They did, however, need to use Stephanie's insurance to help cover the cost of the 15 OB-GYN visits as outlined in Table 1. Because of their low premium, their copay per office visit was $35. This multiplied the cumulative cost of medical visits, resulting in Naomi paying $300 more for the same number of OB-GYN visits as Mia.

In addition to the standard medical visits, Naomi shells out for the 20-week ultrasound that checks the child's anatomy and sex—her insurance covers all but $300 of the procedure. She also elects to receive two genetic tests that will screen for the health of her child. The tests she chooses are as follows:

Her low-cost premium health plan still covers a portion of these tests and leaves her with a $120 fee. Additionally, due to legislative changes under the Affordable Care Act (ACA), Naomi doesn't have any cost-sharing for other medical procedures needed during her pregnancy, including vaccines, STI testing and other health screenings. (For a complete list of no-cost-sharing health screenings and procedures during pregnancy, see Table 2.)

For medical visits and procedures alone, Naomi spends $945 over the course of her pregnancy. These expenses, however, are just the start. Naomi still needs to pay for daily prenatal vitamins, medications to ease the symptoms of pregnancy and supplemental maternity clothes.

Naomi chooses a standard prenatal vitamin, which runs her just over $25 per month. She experiences substantial nausea during her pregnancy, which results in her needing to buy anti-nausea medication. She additionally needs to supplement her maternity wardrobe. While she still has essential items from her previous pregnancy, she needs to buy a few additional items of maternity clothing and one maternity bra. The cost of these clothing items sets Naomi back $200.

Since it is her second child, Naomi is choosing to forgo any additional help from childbirth classes or doulas. She does, however, have to pay the premium for her portion of Stephanie's health insurance. This costs $100 per month, resulting in a cost of $900 over the course of her pregnancy.

Cumulatively, Naomi spends $2,307.50 over the course of her pregnancy. This averages out to $256.39 per month.

Illustration by Jaelen Brock

Chloe is a 34-year-old single mother of two young children. Her job does not offer insurance, so she's uninsured when she becomes pregnant with her third child. However, having had children previously, she's prepared.

She seeks care from a local low-cost clinic that covers the cost of all the screenings and procedures listed in Table 2. The clinic also greatly reduces the cost of her regular doctor visits. She only pays a $20 visit fee for each of the 15 prenatal appointments (her visit schedule follows that in Table 1), totaling $300 for her entire pregnancy.

The clinic also covers the majority of the cost of the 20-week ultrasound to check the child's anatomy and sex. This procedure out-of-pocket at a traditional doctor's office would cost around $1,000, but the clinic only charged her $100 for the procedure.

Additionally, the clinic helped cover the cost of her prenatal vitamins. Chloe only has to pay $10 for a month's supply of the supplements.

While the clinic offers a lot of benefits for Chloe, it does not offer genetic testing of Chloe's unborn child, so Chloe forgoes those screenings. If she wanted to do the noninvasive prenatal screening (NIPS) and the quadruple blood test, it would cost her nearly $600 out-of-pocket.

Because she recently had children, she, like Naomi, still has maternity clothes in her closet and doesn't need to spend much money on additional clothes or maternity items. In fact, all she needs are a couple more maternity outfits to wear to work, which end up costing her $125.

Chloe also experiences nausea during her pregnancy and needs to buy anti-nausea medication ($11) and a pregnancy-safe sleep aid ($20) to help manage her symptoms.

No insurance premium and access to a low-cost clinic means Chloe pays the lowest fees out of all four scenarios. Over the course of her pregnancy, she spends $657.50, which correlates to $73.06 per month. This (relatively) low monthly cost allows her to continue to use her single income to provide for her two young children while also getting the necessary care she needs for her unborn third child.

Illustration by Jaelen Brock

Ariana is a mother to a preteen and teenager. She wasn't expecting to become pregnant again in her late 30s, so the news came as a big surprise. This is her first pregnancy in "advanced maternal age" (defined as age 35 and older), so she'll have to take special precautions, even with her first two children having been born healthy.

Thankfully, Ariana and her husband have two incomes and good health insurance. This support net will allow Ariana to receive the care she needs while also being able to provide for her two older children.

Since she was last pregnant over a decade ago, Ariana has long since donated all of her maternity clothes and items. She'll need to invest in a new pregnancy pillow to help her sleep on her side and a belly support band to ease lower back pain during the third trimester. She also needs to buy a whole new maternity wardrobe, which costs her close to $500.

In addition to the costs of maternity gear, Ariana has to pay for the 15 OB-GYN visits (as outlined in Table 1). Her Silver insurance plan affords her a relatively low copay of $25 per office visit, which cumulatively costs her $375 over the course of her pregnancy. Her insurance also completely covers—thanks to the Affordable Care Act (ACA)—all the medical procedures and screenings in Table 2. Ariana only has to pay a relatively small portion ($200) of the cost of her 20-week ultrasound.

Additionally, due to her high-risk pregnancy, she is shelling out for multiple genetic tests. The tests she is choosing to undergo to ensure her child's health are as follows:

Ariana also decides—due to the length of time since her last childbirth—to take childbirth classes again. These classes are mostly covered by her insurance, leaving her with a $30 patient responsibility.

While these expenses add up, so do the cost of over-the-counter medications and supplements. She selected a standard quality prenatal vitamin, which costs her $25 per month. She also experiences substantial heartburn and nausea during the course of her pregnancy, thus prompting her to purchase antacids and anti-nausea medication.

Cumulatively, Ariana spends $4,660.50 over the course of her pregnancy. This averages out to $517.83 per month.

Illustration by Jaelen Brock
Adding it up

Clearly, the costs associated with nine months of pregnancy can vary widely. And, these numbers don't account for emergency care or other unexpected expenses. The total cost of pregnancy ranges from manageable to exorbitant—and it's unclear which route you'll go down after that test reads positive.

And nine months of heartburn and tiny kicks are just the beginning. Labor and delivery comes with much stress to your body and mind, as well as costly hospital bills for childbirth and hospital stays (among other little fees).

Read on for the stories of real women and their own financial experiences with childbirth.