The 1% Can Afford to Give Birth in America. The Rest Are Screwed.


Childbirth, typically a pretty straightforward (in-and-out, you might say) procedure, costs a staggering amount of money in the United States because pregnant women, uninsured or otherwise, are billed item by overpriced and often unnecessary item. Meanwhile, citizens in other developed countries enjoy the same access to high-tech care as we do for a fraction of the price — and record lower infant and maternal death rates. American patients have no agency to stop rising costs when they’re forced to pay up in order to procreate.

This New York Times report on the exorbitant price of giving birth in America is chock-full of statistics that will make you feel both angry and impotent. Maternity and newborn care make up the single biggest category hospital payouts for most commercial insurers and state Medicaid programs. The costs of around four million annual births totals way over $50 billion. Women with normal pregnancies — both insured and uninsured — get saddled with an overwhelming amount of services that they don’t want or need.

“It’s not primarily that we get a different bundle of services when we have a baby,” Gerard Anderson, an economist at the Johns Hopkins School of Public Health, told the NYT. “It’s that we pay individually for each service and pay more for the services we receive.”

And it’s getting worse:

From 2004 to 2010, the prices that insurers paid for childbirth — one of the most universal medical encounters — rose 49 percent for vaginal births and 41 percent for Caesarean sections in the United States, with average out-of-pocket costs rising fourfold, according to a recent report by Truven that was commissioned by three health care groups. The average total price charged for pregnancy and newborn care was about $30,000 for a vaginal delivery and $50,000 for a C-section, with commercial insurers paying out an average of $18,329 and $27,866, the report found.

In most other developed countries, “hospitals and doctors receive a flat fee for the care of an expectant mother, and while there are guidelines, women have a broad array of choices.” But this is AMERICA, so everything is marked up, “from the hundreds of dollars billed for the simple blood typing required before each delivery to the $20 or so for the splash of gentian violet used as a disinfectant on the umbilical cord (Walgreens’ price per bottle: $2.59).” Even removing the placenta costs money.

“We’ve created incentives that encourage more expensive care, rather than care that is good for the mother,” said Maureen Corry, the executive director of Childbirth Connection.

Despite all this, the United States “has one of the highest rates of both infant and maternal death among industrialized nations, although the fact that poor and uninsured women and those whose insurance does not cover childbirth have trouble getting or paying for prenatal care contributes to those figures.” The Affordable Care Act includes maternity coverage, but the law doesn’t specify what services must be included, which seems like a pretty gigantic oversight.

After reading the article, you may want to revisit this 2011 Details piece about polyandry which includes the best sentence in the history of journalism:

“The two men aided Jaiya in a natural, “orgasmic” labor in an outdoor hot tub that lasted 20 hours – with Jon sitting behind her at one point, massaging her anus and feeding her, and Ian in front massaging her nipples and clitoris, until at last Eamon passed into this world through one long climax while the Santa Anas blew and a pack of stallions whinnied nearby.”

Before reading today’s NYT piece, I thought I would literally kill anyone (even one of my many husbands) who tried to give my anus a massage while I was giving birth sans drugs. After reading about mother who compared negotiating her (tens of thousands of dollars of!!) birth costs down to navigating a used car lot, I’m reconsidering.


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