The Cost of Giving Birth without Insurance

So you’re having a baby! At the end of labor and delivery, you get your tiny bundle of joy—and a bundle of bills, too. It’s no secret that childbirth in the United States is expensive, but the amount that comes out of your pocket depends on several factors: Do you have health insurance? Will you have a hospital birth, a home birth or go to a birthing center? Is it a vaginal or Cesarean birth? Will you or your baby be treated for complications, including time in the NICU?

While there are some things you can’t predict, it’s possible to plan for at least some of your childbirth expenses using cost averages from across the US. And making a plan for those expenses is important, especially if you’re giving birth without health insurance and need extra resources to help reduce the cost. Here’s how much you can expect to be billed for pregnancy and childbirth and how to make those bills more manageable.

The Cost of Giving Birth in the USA without Insurance

The total cost of giving birth will vary based on your childbirth experience. Essentially, the more complicated birth is, the more expensive. The averages below include all related childbirth expenses—not just labor and delivery cost without insurance, but also prenatal appointments, ultrasounds, room and board for post delivery, medications, recovery products, doctor fees…so many list items that it can feel like you’re being nickel-and-dimed. Both the full cost and the itemized expenses can be overwhelming, so we’ll provide as much transparency as possible to help you feel more prepared.

Keep in mind that these cost averages don’t include fertility services like IVF or IUI, which can increase your out-of-pocket expenses by over $10,000.

According to data gathered by the financial experts at LendingTree via hospital data transparency, the US average for a vaginal delivery was $13,024 in 2020. But that’s the average across the country—your location plays a big part in how much you’ll have to pay. Data from the Health Care Cost Institute shows that, on the low end, a vaginal delivery in Mississippi will cost about $6,500 with no complications (just the delivery, no other services); on the high end, in California, a vaginal delivery with no complications will cost over $16,500.

Even within states, there’s a lot of variation. You can expect to pay more if you give birth in a major metropolitan area.

If you have a C-section, whether elective or medically necessary, the cost to deliver a baby without insurance could range anywhere from $3,000 to $12,000 more than a vaginal delivery, with the national average being $22,646 in 2020, including all related pregnancy and delivery expenses.

If your baby is born premature, the extra NICU care can increase your hospital expenses by up to four times the cost of an uncomplicated vaginal delivery, averaging nearly $50,000.

A Breakdown of All Childbirth Expenses

Even without taking the type of birth into account, there’s still a lot of variation among all the other pregnancy and childbirth expenses. Especially for prenatal care, the total cost greatly depends on your health, your baby’s health, how many appointments you have and which tests you have.

Prenatal Expenses:

According to Healthcare Bluebook, the average total cost of maternity care is between $2,000 and $3,500. While your unique pregnancy experience may not include all of these things, here’s what you can expect to pay for each of these appointments, tests and procedures without health insurance:

• Routine prenatal check-ups: $90–$500+ per appointment (estimate 10 to 15 appointments over the course of nine months)
• hCG test (pregnancy confirmation): $26
• Prenatal Blood Panel (including Complete Blood Count, blood type & Rh factor, Hepatitis B&C and STI testing): $200–$300
• Ultrasound: $130–$950+ (estimate one to three ultrasounds)
• Noninvasive Prenatal Testing (NIPT): $800–$2,000
• Fetal Nonstress Test: $150–$400+
• Glucose Tolerance Test: $10–$55+
• Group B Strep Test: $30–$150+
• Amniocentesis: $570–$1,800+
• Chorionic Villus Sampling (CVS): $1,300–$4,800

Labor and Delivery Expenses:

It’s nearly impossible to estimate how much birthing centers or hospitals charge for each individual service, so just keep in mind the average ranges we provided above. So that you’re prepared, here are some charges you might see on your itemized hospital bills after giving birth:

• Delivery room
• Hospital stays (estimate two nights in a recovery room for a vaginal delivery, three nights for a C-section)
• In-room doctor’s visits (estimate one visit per night for you and baby each)
• Epidural, spinal or combination
• Nitrous oxide
• Systemic analgesia (opioids)
• IV hydration
• Antibiotics (especially if you’re positive for Group B Strep)
• Fetal heart monitor
• Surgical supplies
• Newborn blood screenings (vary by state, but may include PKU, sickle cell anemia, congenital hypothyroidism and more)
• Newborn hearing screening
• Newborn nursery or NICU
• Lactation consultation (estimate one to two visits)
• Pharmacy supplies (including ibuprofen and stool softeners)
• Nursing/feeding supplies (including nipple cream, nipple shields, donor breast milk, formula and/or breast pump)
• Ambulance
• Circumcision
• Newborn vaccines

Other Factors that Can Affect the Cost of Giving Birth

Like we said before, your total cost for pregnancy and childbirth can be affected by your health and baby’s health. Preexisting health conditions, like diabetes or sexually transmitted infections, as well as any conditions you develop while pregnant, like gestational diabetes or preeclampsia, will require extra treatment during your pregnancy.

Similarly, any conditions detected in your baby either while they’re in the womb or immediately after birth will need immediate attention, especially heart and lung conditions.

The sooner any maternal or fetal conditions are discovered and treated, the less costly they’re likely to be. So it’s important (for both your health and your wallet) to invest in any early detection tests, especially if you have risk factors for any diseases, and get treated as soon as possible.

What Childbirth Costs Will Health Insurance Cover?

Thanks to the Affordable Care Act (ACA), all major health insurance plans are required to cover a portion of all prenatal, delivery and postpartum services, including routine prenatal visits and tests, hospitalization and emergency procedures. The amount that’s covered depends on the unique insurance plan, but according to the Kaiser Family Foundation (KFF), the average out-of-pocket cost with insurance was $2,655 for vaginal birth and $3,214 for C-section.

How to Pay for Childbirth without Insurance

Giving birth without health insurance means you’ll have to pay for all associated prenatal, delivery, recovery and newborn care costs out of your own pocket. But you don’t have to resign yourself to paying tens of thousands of dollars; there are a number of resources available to help reduce the cost.

• Check if you qualify for Medicaid. Depending on your household income, you may qualify for low-cost or free state-sponsored health insurance, which could reduce your pregnancy and childbirth bills to a more manageable amount.
• Negotiate your bill. This may not sound like it’ll work, but sometimes just explaining your financial situation and politely asking for a reduced bill is enough to significantly lower the amount you pay. Whether via phone, email or mailed letter, being polite, honest and thorough will go a long way in addition to providing proof of income. Hospital billing departments are used to negotiating costs with patients, certified financial planner and physician Carolyn McClanahan tells CNBC, but it’ll probably take you more than one attempt to successfully reduce your bills.
• Ask for an itemized bill. Seeing every single charge in detail gives you the opportunity to check for errors (like incorrect patient information or mistakes in medications or services provided) and challenge any possible overcharges (you can check Healthcare Bluebook for the fair price of medical services).
• Set up a payment plan. Most hospitals and birthing centers offer the option to pay your bill in installments, and they usually don’t require you to qualify for eligibility.
• Ask for support via crowdfunding. GoFundMe has been a key resource for financial help for years, especially when it comes to medical bills. It does take some marketing on your end, since you’ll have to share it within your own community (social media really comes in handy for this), but creating a GoFundMe profile gives your family, friends and even complete strangers the opportunity to help you out.

Can I get health insurance if I’m already pregnant?

You can! If it’s during an open enrollment period, health insurance providers are required to make coverage available for pregnant people, and they can’t increase premiums due to the “pre existing condition.”

If you’re trying to get coverage outside the open enrollment period, it may be tough to sign up. Pregnancy isn’t a qualifying life event for insurance enrollment, but the birth of a child is. If you qualify for enrollment due to another life event (losing previous health insurance, getting married or moving), you can get insurance outside of the normal enrollment.

Sources:

• KFF: Coverage and Use of Fertility Services in the U.S.
• Health Care Cost Institute: The Price of Childbirth in the U.S. Tops $13,000 in 2020
• March of Dimes: Preterm Birth
• Healthcare Bluebook
• Value Penguin: Average Prenatal Care Costs & How Health Insurance Covers It
• Canadian Agency for Drugs and Technologies in Health: Non-invasive Prenatal Testing: A Review of the Cost Effectiveness and Guidelines
• Forbes: How Much Does It Cost To Have A Baby? 2023 Averages
• HealthCare.gov: Health coverage if you’re pregnant, plan to get pregnant, or recently gave birth
• Health.com: How To Negotiate Your Medical Bills
• CNBC: Yes, you can negotiate your medical bills. Here’s how to lower your costs.
• GoFundMe: Financial Help for Pregnant Women: 3 Ways to Get Assistance