How much does pregnancy cost?
How much does pregnancy cost? Figuring out the medical costs associated with pregnancy and deliver in the United States is nearly impossible ahead of time.
The costs vary widely by insurance and state, with the average out-of-pocket cost for a vaginal delivery estimated to be over $4500 for those with insurance.
[DISCLAIMER: THIS POST MAY CONTAIN AFFILIATE LINKS, INCLUDING AMAZON ASSOCIATE LINKS WHERE I EARN FROM QUALIFYING PURCHASES. THERE IS NO COST TO YOU & THE COMMISSION HELPS SUPPORT THIS SITE]
In a group of women with similar due dates, the reported costs of delivery ranged from under $200 to over $10,000.
But labor and delivery is not the only cost associated with pregnancy.
Detailed, itemized breakdowns of all pregnancy medical costs are even more limited and again give ranges or estimates.
Out of curiosity (and an abundance of time on bedrest), I recorded every pregnancy and baby expense we’ve incurred.
I offer up all my pregnancy medical bills and costs to give an example of one American family’s pregnancy medical bills and costs, from the pregnancy test through delivery.
I hope it will give a more detailed idea to help answer the question how much does pregnancy really cost?
Overall, I spent $3245 on pregnancy-related medical costs. I go into detail about each cost below.
Obviously, the medical costs surrounding pregnancy are greatly dependent on a person’s health insurance status. I had good health insurance by American standards, and I am grateful for that.
I hit my maximum out-of-pocket limit with my labor and delivery, so I did not have to pay for a few hundred dollars of my delivery and had no medical co-pays for the rest of the year.
Nevertheless, health insurance premiums were by far the biggest pregnancy-related cost we faced. If I were to do it again, I would have made different decisions prior to pregnancy in order to lower our insurance costs.
Knowing a pregnancy was a possibility, I elected a standard plan with a low maximum out-of-pocket annual cap instead of a high deductible plan. I mistakenly thought that high-deductible plans were only for healthy individuals who did not anticipate many medical expenses.
However once you total up monthly premium costs, high-deductible plans are often still cheaper, even for those who hit their maximum out-of-pocket limit.
High-deductible plans also have the benefit of Health Savings Accounts (HSAs). HSAs put aside pre-tax dollars to be used for medical expenses — essentially a 10-30ish% discount depending on your tax bracket.
As an estimate, opting for a high deductible plan would have saved us about $1700 in the year I was pregnant, assuming I would have hit the maximum out-of-pocket annual limit on both plans (high-deductible plans have a higher maximum out-of-pocket limit) and not taking into account HSA pre-tax savings.
If you see a pregnancy coming down the pipeline, I recommend crunching the numbers on standard vs. high-deductible plans. Keep an eye on each plan’s annual out-of-pocket maximum and try to estimate how much your pregnancy may cost beforehand.
Before Pregnancy Medical Costs
In preparation for a pregnancy, I incurred the following costs:
J-Screen Carrier testing – $262: Both myself and my partner had a carrier genetic screening done prior to pregnancy. We loved JScreen and highly recommend them. There are different philosophies around carrier screening and JScreen aligned with our wanting to test for as many things as possible.
For those looking at carrier screenings, one strategy is to only test one person first who you think is least likely to be a carrier. If their screening comes back with no known carriers, the other person does not have to test.
If we had done this, our cost for carrier screening would have dropped to $131.
Pregnancy tests – ($11.49 in Dec 2018): I got cheap early detection tests on Amazon. I didn’t want to have to worry about the cost of taking a test and didn’t need anything fancy. The early detection alleges that they’ll give a positive 6 days sooner than regular tests.
Drinking water test kit – ($25.82 in Dec 2018): what can I say, we are anxious people. One of my doctors recommended not drinking straight from the tap during pregnancy because of possible water quality issues.
Honestly, I’m not sure how founded it was but my partner decided to do a test just to see. I wasn’t going to exclusively drink bottle water all pregnancy so thankful the test (and all the actual data about our city’s water) came back fine.
Doctor & hospital parking passes – $65: we had to pay for parking every single appointment and hospital trip so we pre-paid for parking passes.
This total includes 20 prepaid discounted parking passes and one time that I valeted the car by labor & delivery because I was really sick with hyperemesis gravidarum and did not feel like walking. I’m worth it.
TOTAL PRE-PREGNANCY COSTS: $233.31
Cost of Pregnancy Medications
I started a cocktail of medications within weeks of finding out I was pregnant because hyperemesis hit me hard and fast. My baby was made of Zofran (an antiemetic) and my long-lost muscle mass.
My insurance thankfully covered the cost of the prescription medications, though initially I had to spend a lot of time fighting for some of my antiemetics to be covered. You would think that it would be easy math that one prescription is cheaper than repeat hospitalizations for banana bags, but alas.
Since pregnancy made me a regular pill popper, one of the best medication-related purchases we made was for a pill cutter. I used it every single day of my pregnancy once I was sick.
Pill cutter – ($5.13 in March 2019). I loooove our pill cutter and am so glad we made the purchase. I took a half of unisom all pregnancy so it definitely was put to good use. You can find one like mine here.
Zofran – $0: I was on Zofran until about week 30 of my pregnancy to keep from puking. I started out taking 8mg dissolvable tablets 3 times a day and was able to start tapering that down around mid-pregnancy. When I finally got off it, I was down to one 4mg pill in the mornings.
Zofran is a very expensive drug and this was the medication I had to go back and forth with insurance on trying to get prior authorizations through. The first time my doctor prescribed 90 pills for 30 days and insurance only let them fill nine pills – a three-day supply.
It was a headache but after the first couple refills, they stopped requiring the prior authorization. This would have been 100% unaffordable if it hadn’t been covered by insurance.
Phenergan – $0: I tried this for anti-nausea but it did not work as well as Zofran.
Reglan – $0: I tried this for anti-nausea but it did not work as well as Zofran.
Remeron – $0: I tried this for anti-nausea but I ultimately didn’t find it provided enough relief to outweigh the concerns I had taking it during pregnancy. It also made me feel hella weird, though that may have waned if I stayed on it longer.
Cervical incompetence medication
Progesterone – $0: I was on daily progesterone from week 23 to week 36 for cervical incompetence. The research is mixed on the best course of action for cervical insufficiency but for me, I was glad to do progesterone.
Logically I know it was a coincidence but I stopped progesterone on a Wednesday and was holding a baby by early Saturday morning.
Over the counter medications:
CVS-brand Unisom (doxylamine succinate) – ($35.57 from March-September 2019): I took doxylamine succinate and B6 as an antinausea medication. This is the equivalent of diclegis (or Bonjesta).
Unisom is a sleep aid and I took it basically every night of my pregnancy. I had no problems coming off it and I found it more pleasant than when I took benadryl or melatonin in the past.
Vitamin B6 – ($6.99 in March 2019): This was taken in conjunction with unisom as an anti-nausea for the duration of my pregnancy. I took half a pill so one bottle lasted through the pregnancy.
Urinanalysis Ketone Test Strips – ($11.79 in March 2019): I used these to monitor my ketones at home. Ketones in the urine are an indicator starvation and/or dehydration.
Vitamins / Supplements
Regular prenatals – ($24.02 in 2019) – These were the prenatals I took prior to pregnancy. I actually got a couple free bottles from Amazon because the description erroneously listed the wrong type of folate. This happened twice, even after I double checked with their customer service before ordering a second time.
These were great before I got hyperemesis. After that pretty much everything made me nauseous and the iron in them did not mix well with Zofran.
Folate – ($11.68 in Nov. 2018): Folate is important early in pregnancy to prevent neural tube abnormalities. Some women have a gene variation that reduces their ability to convert folic acid to active folate. Most women do not know if they are in this subgroup, so I opted for prenatals that had methylfolate instead of folic acid.
However, when Amazon sent me the wrong prenatals, I got methylfolate to supplement. I used two bottles worth.
Gummy prenatals – ($12.99 in Feb. 2019): When my hyperemesis set in, I could no longer take my original prenatal vitamins. These gummy vitamins were hit or miss on making me nauseous and I only took them sporadically. I got through one bottle by the end of pregnancy.
Slow FE brand Iron – ($19.99 in August 2019): I was found to be anemic in my last two months of pregnancy and was told to start an iron supplement. I went with this brand hoping it would be easier on my stomach since I was still hyperemesis-y.
It wasn’t terrible but I was very glad to get off this after birth. It is also very constipating and taking this with Zofran at the same time was truly awful. I had to stop Zofran almost immediately after starting this.
Miralax – ($10.29 in March 2019): I tried a lot of anti-constipating medicines throughout my pregnancy. The worst side effect of Zofran is constipation. In hindsight, I should have taken more than I did.
If I were to do it again, I would probably take a half dose of Miralax every other day or so while taking Zofran, if not more.
For more on what I learned about pregnancy constipation and what I’d do differently, check out this post: 7 Lessons from My Hyperemesis Experience
Senakot – ($8.49 in March 2019): Another anti-constipation medicine I took to try to counteract the Zofran constipation side effect
Milk of Magnesia – ($5.99 in March 2019): Again, more meds to deal with Zofran constipation.
Stool Softener – ($9.99 in March 2019): I got a huge bottle of stool softener at Costco and it was a great decision. I took them like candy during pregnancy, and continued to use them during postpartum recovery.
Costco brand Pepcid AC (Famotidine) – ($12.99 in summer 2019): I actually bought Kirkland brand Zantac the week before they started recalling it. Costco was great and let me switch it out famotidine this instead. This was two bottles worth and I didn’t use much before I went into labor.
CVS brand Tums – ($6.49 in summer 2019): I took Tums occasionally through my pregnancy for calcium, and then I tried it briefly for heartburn before opting for something stronger.
TOTAL MEDICATION COSTS – $182.40
Doctor Visits & Lab Work Costs
I had a high risk pregnancy so I was seen more frequently than standard pregnancies. My insurance did not charge co-pays for maternity visits or lab work.
In total, I had 18 O.B. appointments, 2 vaccinations visits, 1 genetic counselor appointment and 7 lab work-ups, all of which cost me $0.
Were I to have had a standard $40 co-pay per office visit, I would have paid $720 for my prenatal O.B. visits.
Below I provide a few examples of common pregnancy services cost to give a better idea of how much pregnancy prenatal care costs. I break down how much my providers billed and what the insurance negotiated rate was (which I would have paid were I on a high deductible insurance plan)
- Prenatal doctor appointment – Provider 1: Billed $99; Negotiated rate $28; Provider 2: Billed $250; Negotiated rate $110 (Note: I only had two claims billed, as I saw two different providers initially. I listed both as there was a pretty big difference in costs)
- HCG blood work (to confirm pregnancy) – Billed: $272; Negotiated rate: $10
- NIPT testing (genetic fetal screening) -Billed: $1100; Negotiated rate: $735; Genetic company’s max out of pocket cost if not covered by insurance: $300
- AFP testing (for neural tube conditions) – Billed: $99; Negotiated rate: $7
- Gestational diabetes testing (including CBC and STD tests) – Billed: $294; Negotiated rate: $42
- Group B Strep testing -Billed: $94; Negotiated rate – $2
TOTAL APPOINTMENTS AND LAB WORK COSTS – $0
Cost of Pregnancy Ultrasounds
I had a total of 10 ultrasounds during my pregnancy. This is a lot more ultrasounds than the standard one or two.
Because of a connective tissue disorder, I was always going to have extra transvaginal ultrasounds to check my cervix mid-pregnancy. I also ended up with a lot of growth scans in the end as I was underweight due to hyperemesis.
I had the following ultrasounds:
- 2 early ultrasounds: at 6 and 8 weeks
- 2 anatomy scans: the second was a follow-up after they couldn’t get a good picture of something in the first
- 2 transvaginal ultrasounds: I also had 2 more transvaginal checks done during the anatomy scans
- 4 growth scans: I had my first growth scan early because I was measuring small. At that scan, my amniotic fluid was low so they did another scan. At that scan, the baby’s measurements were out of proportion, buying me another scan. The last growth scan was the day before my water broke because I had started losing weight again a couple weeks before.
I had to pay a $40 co-pay for each ultrasound, for a total of $400 in ultrasound costs.
Here are a few examples how different ultrasounds were billed and what the negotiated rate was (what I would have paid on a high deductible insurance plan) as reference for possible pregnancy ultrasound costs.
There was some variation between the costs of each ultrasound but this gives a general idea.
- Anatomy scan – Billed: $610; Negotiated rate: $221
- Transvaginal scan – Billed: $186, Negotiated rate: $78
- Growth scan – Billed: $252; Negotiated rate: $55
TOTAL PREGNANCY ULTRASOUND COSTS – $400
Pregnancy Hospitalization Costs
I made three hospital trips while I was pregnant. The first was hyperemesis-related where I had to spend a day getting IV fluids and nutrients.
The other two visits were because of preterm labor risk. The first preterm labor trip I was able to go home that evening but the second I was admitted overnight for observation.
I include how much I paid per trip, and also the billed and negotiated rates for reference.
Cost of 1st Pregnancy Hospitalization (Hyperemesis):
- Billed: $967
- Negotiated rate: $948.34 (of which, $249 was for lab work and prescriptions)
- What I actually paid: $253
Cost of 2nd Pregnancy Hospitalization (Pre-term labor risk):
- Billed: $400
- What I actually paid: $400
Cost of 3rd Pregnancy Hospitalization (Pre-term labor risk):
- Billed: $3415
- Negotiated rate: $3318
- What I actually paid: $173
TOTAL PREGNANCY HOSPITALIZATION COSTS – $826
Labor & Delivery Costs
My hospital asked me to prepay my labor and delivery costs about 2.5 months before my due date. I pushed back a little as I expected to hit my annual out-of-pocket maximum but did not put up much of a fight about the early payment.
In hindsight, I wish I would have because they held up hundreds of our dollars for months.
I was asked to pre-pay $2408 dollars for my delivery.
I was billed for three separate charges: 1. the obstetrics doctor services; 2. the epidural; 3. hospital room and board charges.
- Obstetrics doctor – billed $4714, with a negotiated rate of $2242. I paid $0 for this claim.
- Epidural – billed $4025, with a negotiated rate of $835 (#worthit). I paid $0 for this claim.
- Hospital room and board – billed $10,224, with a negotiated rate of $8749. I was responsible for 25% of the negotiated rate until I hit my maximum out of pocket, so I paid a total of $1274.
- Hospital TV & phone – I paid $30. This was automatically billed without the opportunity to opt out and it was not covered by insurance. Should have watched more Game Show Network…
Once the baby was born, he had his own costs for his part of our standard hospital stay after delivery.
We were billed for four different claims for the baby, totaling $300.
This included him being evaluated at birth by a NICU doctor, in addition to the usual nursery newborn checks because he was a preemie. The billed rate for these four claims was $664 and the negotiated rate was slightly over what we paid at $308.
TOTAL LABOR AND DELIVERY COSTS – $1604
Total Pregnancy Medical Costs (with Insurance)
All told, my pregnancy medical cost totaled to $3245.
This total only reflects medical bills I had while pregnant.
It does not take into account possible lost wages, food costs, childcare issues, etc. that a pregnant person may face, especially if their pregnancy becomes high-risk or complicated.
It also doesn’t detail my postpartum care. I have had a longer postpartum recovery given my pregnancy complications and pre-existing conditions.
My postpartum care has included visits to pelvic physical therapy, dermatology to remove a “pregnancy tumor,” urogynecology, and multiple postpartum follow-ups with my gyn. I will write a post specifically on all my postpartum costs to date soon.
I would love to write a follow-up to this post with others’ pregnancy medical costs, as there is such a wide range in the United States. If you are comfortable sharing the costs you faced while pregnant, please comment below or reach out to me at [email protected] if you’d prefer to remain anonymous.
Like this post? Pin it!