What is the cost of giving birth? How much does childbirth cost in a hospital? I looked up these and other similar terms after deciding I wanted children and again after getting pregnant, but very few pages actually explained the breakdown of their bills and what sort of insurance they had. I am sharing my costs in case there are others who were trying to read more about the same things.
My insurance for this childbirth was Cigna Open Access Plus In-Network with HRA. There is a $4000 deductible and $4000 Out-of-Pocket (OoP) per person, with an $8000 family Out-of-Pocket. The deductible is where I pay for 100% of my care until I have paid $4000, and the Out-of-Pocket in my plan means that I pay for 20% of my care until I have paid another $4000. Once both are met, I pay for 0% of my care. Even if I meet my OoP, my daughter and husband continue to pay 20% of their medical bills until one of them also pays $4000, in which case everyone in the family pays 0%. I met the deductible and my personal OoP during the childbirth, so all my remaining healthcare was paid for by Cigna. My baby’s medical bills were not fully paid by Cigna.
After giving birth in the Saint Barnabas Medical Center in New Jersey in the United States, I received a lot of separate bills relating to my hospital visit for giving birth. (My baby received a few, too, but naturally addressed to me because my baby has no money and is a minor besides.) I have made up tables to show what I was charged for. There are further details and remarks to elaborate on the charges in each table. Each table has the item as it appears on a bill, the amount charged, and the amount after insurance processed the claim, also known as the amount I paid.
Click on any of the bill names to jump to that section:
- Baby’s Bill from Saint Barnabas Medical Center
- Mother’s Bill from Saint Barnabas Medical Center #1
- Mother’s Bill from Saint Barnabas Medical Center #2
- Mother’s Bill from Hospital Pathologist #1
- Mother’s Bill from Hospital Pathologist #2
- Baby’s Bill from Hospital Pathologist #1
- Mother’s Bill from Hospital Pathologist #3
- Mother’s Bill from Hospital Anesthesiologist
- Mother’s Bill from the Ob-Gyn
- Baby’s Bill from the Pediatrician
- Baby’s Bill from Hospital Pathologist #2
- Total Cost of Childbirth at Hospital
- Other Costs Related to Pregnancy/Childbirth
Baby’s Bill from Saint Barnabas Medical Center
| Item | Charges | After Insurance |
| Nursery/Level I | 2 nights at $4000/night totaling $8000 | $756.00 |
| Laboratory | 2 units totaling $74 | $0.00 |
| Laboratory/Chemistry | 2 units totaling $286 | $0.00 |
| Laboratory/Immunology | 3 units totaling $464 | $0.00 |
| Drugs/Detail Code | 2 units totaling $65.18 | $0.00 |
| Self-Adminstrable Drugs | 1 unit totaling $17.84 | $0.00 |
| Vaccine Administration | 1 unit totaling $199 | $0.00 |
St. Barnabas told me that I would have to contact a different department and pay to receive anything more detailed for the hospital bills than what is on this page. I think it is absurd that I have to pay extra to know what precisely they are billing me for. In the end, my curiosity does not outweigh the trouble of tracking down further information and making more phone calls while taking care of a baby who likes to be the center of attention.
The Nursery stay is self explanatory. That was Young Sophie’s room and board, as my insurance’s Explanation of Benefits (EoB) described. Everything else was labeled “INPATIENT HOSPITAL”, so the hospital bill was actually more detailed than the insurance EoB. Young Sophie actually spent almost all of her time in the same room I was in, it being the time of Covid-19, but I understand this billing item to cover not just the nursery space but also the nursery nurses.
Young Sophie did have 6 lab tests in total.
Young Sophie may have been given drugs by the nurses. I have no idea what those are and cannot find out unless I pay.
Young Sophie obviously did not self-administer any drugs. However, I also did not give Young Sophie any drugs. The nurses must have given this, and I apparently shan’t be allowed to know what the drug was unless I pay St. Barnabas.
Young Sophie was vaccinated for Heptitus B.
Mother’s Bill from Saint Barnabas Medical Center #1
| Item | Charges | After Insurance |
| OB/2BED | 3 nights at $6000/night totaling $18000 | $3793.03 |
| IV Solutions | 1 unit totaling $6 | $0.00 |
| Lab | 1 units totaling $37 | $0.00 |
| Lab/Immunology | 9 units totaling $4016 | $0.00 |
| Lab/Hematology | 1 unit totaling $140 | $0.00 |
| Lab/Urology | 1 unit totaling $68 | $0.00 |
| Drugs/Detail Code | 5 units totaling $86.71 | $0.00 |
| Self-Administrable Drugs | 13 units totaling $44.09 | $0.00 |
| Delivery Room | 1 unit totaling $3784 | $0.00 |
I spent one night in the PET and two nights in whatever the new mother area is called. The hospital did not allow discharge before 36 hours after childbirth and my ob-gyn told me they did try to get people out after the minimum because of Covid. Most people just check out in the late morning if 36 hours after would put you in the wee hours of the morning. (As my Ob-gyn said, they are not going to kick you out in the middle of the night just because you gave birth 36 hours before.)
I did have an IV.
According to the paperwork I did see, I only had 11 tests, not 12. However, now that I am thinking about it, I actually had 2 Covid-19 tests that day. The first one, probably in “Mother’s Bill from Saint Barnabas Medical Center #2” was not a rapid test, so they did a rapid test in the labouring room. My nose was not comfortable. If the 12th test is the rapid Covid test, then 12 tests is accurate.
The drugs are where it gets funny. Saint Barnabas refuses to tell me what drugs they think I was given unless I pay extra for the records, and I think I was not given as many drugs as they think I was given. I was given a pill to induce labour. When my labour stalled, the doctor insisted on pitocin, which was given by IV. (The anesthesiologist, in a separate bill below, gave me an epidural and an extra vial of something.) After childbirth, I took a pill to help pass gas and a pill to soften stool. Each was taken a total of 4 times, for 8 units. The nurses and doctors kept reminding me that I can take pain relievers even though I kept saying I did not want to. In fact, I could take both Motrin (ibuprofen) and Tylenol (acetaminophen) at the same time: You take one at 6 and 12 and one at 3 and 9, and then you are completely covered! I felt that the hospital was pushing me to take as many drugs as possible. Anyway, I counted a total of 8 self-administered drugs and not 13. The drugs the nurses administered might have been 5 units depending on how the pitocin is counted.
They call it a “Delivery Room”, but I stayed in the same room I had been labouring in while the nurses wheeled in necessary supplies. A lot of supplies were needed. What also made it different was that there were 3 doctors and 2 nurses.
I did not actually receive this bill from the hospital yet. It has been 3 months, and I see on Cigna’s Explanation of Benefits that I do owe the hospital money on this bill. I did inquire about this bill in an email when I asked about the drugs, too! Does the hospital not want my money…?
Edit: They finally sent the bill in early June.
Mother’s Bill from Saint Barnabas Medical Center #2
| Item | Charges | After Insurance |
| Laboratory | $ | $ |
I believe this was one of the Covid-19 tests I took that day. Because St. Barnabas wants me to pay more to know what it was and I do not want to pay more, I cannot be certain. Also, even though I tested negative on both Covid tests, I still had to give birth in a mask. I had to pull the mask down whenever I wanted one of the ice chips that my husband was feeding me during those “Push! Push!” late labour times.
Mother’s Bill from Hospital Pathologist #1
| Item | Charges | After Insurance |
| LABORATORY | $15 | $0.00 |
| Complete blood count (CBC) with automated differential white blood cell count | $15 | $0.00 |
| LABORATORY | $15 | $0.00 |
| Blood test to determine a patient’s blood type | $15 | $0.00 |
| Blood test to determine if the patient’s blood type of positive or negative | $20 | $0.00 |
| Screening test for RBD antibodies | $20 | $0.00 |
| LABORATORY | $15 | $0.00 |
I read this as that there is a standard laboratory fee of $15 for every test. The tests themselves seem rather basic and normal.
Mother’s Bill from Hospital Pathologist #2
| Item | Charges | After Insurance |
| LABORATORY | $15 | $0.00 |
This bill is to be paid to the same person as “Mother’s Bill from Hospital Pathologist #1” and took place on the same day. Why is it a separate bill? I do not know. If my theory about “LABORATORY” being a mandatory $15 fee for each test, it makes sense given there were 4 individual things tested in “Mother’s Bill from Hospital Pathologist #1”.
Baby’s Bill from Hospital Pathologist #1
| Item | Charges | After Insurance |
| LABORATORY | $15 | $1.76 |
| Blood test to determine a patient’s blood type | $15 | $0.98 |
| Blood test to determine if the patient’s blood type of positive or negative | $20 | $0.98 |
Well, it is important to know what the baby’s blood type is, too.
Mother’s Bill from Hospital Pathologist #3
| Item | Charges | After Insurance |
| Urinalysis with microscopy | $15 | $0.00 |
This 3rd bill from the Hospital Pathologist makes sense, because it took place on a different day. I was in the middle of labor or done with labor on this day. I am not sure of what they were looking for given the timing of the test.
Mother’s Bill from Hospital Anesthesiologist
| Item | Charges | After Insurance |
| Anesthesia | $17,464.05 | $0.00 |
Hospital anesthesiologists are notorious for being out of network, but the anesthesiologist who gave me an epidural fortunately was not! I had not planned on an epidural and I had not wanted an epidural, but I was told that I could not move too much and the nurses seemed a bit put out that I kept moving even if they said nothing about it. (My visits to the bathroom and simple position changes kept moving the monitors, so nurses kept having to come back in to adjust the monitors.)
I finally agreed to an epidural after some 14 hours of labour. I must say that the hospital was very fast in getting the anesthesiologist in. On the other hand, the epidural did not kick in for nearly half an hour, which was apparently unusual. They called the anesthesiologist back, he asked me questions, and then he put more medication in to first make sure he had gotten the right spot. If he had not, he planned to redo the epidural site. Within 10 minutes, I was numbed and could not move myself from the waist down for about 4 hours.
Mother’s Bill from the Ob-Gyn
| Item | Charges | After Insurance |
| INPATIENT HOSPITAL | $5,150.00 | $0.00 |
Although the ob-gyn I saw throughout my pregnancy was not present at the hospital to deliver the baby, I received a bill from her. I did not receive a bill from the delivering doctor, which is what I thought would happen instead.
Baby’s Bill from the Pediatrician
| Item | Charges | After Insurance |
| Management of hospital discharge during the day (up to 30 minutes) | $150 | $17.01 |
The hospital assigned a random pediatrician to the baby, because we had not yet chosen one. He came by to check on the baby and declare that the baby seemed healthy enough to go home. He also advised by phone when the baby had not had much stool on her second day of life. An older nurse noticed this when reviewing Young Sophie’s activity log (When and how long did the baby drink? When did the baby need a diaper change? What sort of diaper change?) and told us that this might be something to pay attention to. She called the doctor, who left instructions for what to do and to call back if there were still problems. The solution was to force-feed the baby a specific quantity of formula to make sure she definitely had enough food. She did not have a stool before leaving, but he cleared us for discharge, instructed us to just feed the baby until the baby did not want to eat, and asked us to call if there was still no stool by a certain time. We did not have to call.
Baby’s Bill from Hospital Pathologist #2
| Item | Charges | After Insurance |
| LABORATORY | $15 | $1.86 |
| Blood test to measure total bilirubin levels | $15 | $1.66 |
This is a standard test to see whether your new baby has jaundice. I once was asked to contact another company to inquire about buying a jaundice-checking device to be used on sheep and chickens, but I think the company manufacturing the machines thought I was joking. They stopped responding after I mentioned the farm animals.
Total Cost of Childbirth at Hospital
| Total Billed | Patient Responsibility | |
| Mother | $49,301.85 | $3793.03 |
| Baby | $9,336.02 | $780.26 |
| TOTALS | $58,637.87 | $4573.29 |
Going to the hospital to give birth and staying until discharge incurred almost $60,000.00 of billed charges for my baby and me. Because I live in the United States, that just means the total billed to my insurance, which then used their special agreement pricing to knock down the billed charges by 90% in some cases. I already paid some of the Deductible and Out-of-Pocket for 2021 before the hospital visit, which is why the “Mother” portion of Patient Responsibility did not on its own reach the maximum $8000 total I might have to pay for my care in a calendar year.
What happens if you do not have insurance? Well, an acquaintance gave birth without insurance in a hospital in New Jersey (Different hospital, though. I think it was the Hunterdon Medical Center.) and had bills totaling roughly $7,000.00, which puts it at roughly what my maximum responsibility for my childbirth with insurance was. I have heard that some hospitals may bill very differently depending on your insurance (or lack thereof) or that some hospitals are willing to give a discount on services to some people. Some hospitals realize that you cannot squeeze blood from a stone.
Another relevant detail is that my pregnancy and childbirth were not all in a single calendar year, which means there was a deductible reset during the pregnancy. That means that I could have spent less overall if I had all my pregnancy visits and my childbirth in the same year. One would probably want to have the childbirth early enough in the year that additional care is covered. The thought of deliberately getting pregnant in November (1st Ob-Gyn appointment is usually at 8 weeks, which could then be in January) for an expected childbirth date in July/August just to minimize personal cost is funny.
The reason my patient responsibility is $3793.03 rather than $8000 is because my family already met the deductible and I pet some of my personal Out-of-Pocket before I gave birth. The total I spent before getting to the hospital was roughly $3200 spread out over the previous 9 months of pregnancy, so my total cost from the first ob-gyn visit to exiting the hospital, or the cost of getting a baby born and discharged, was approximately $7,000.
To put out the least amount of money and get the most back, we filled an FSA to the maximum ($2,750 in 2021) to use pre-tax dollars and we used a 2% credit card on the bills which allowed card payment without a fee. We also had an HSA funded by the employer with $1000 each year to use.
The total I paid for the hospital visit for childbirth and other things relating to pregnancy was roughly $7,000.00.
Other Costs Related to Pregnancy/Childbirth
What are the other things relating to giving birth to a child? There are a few, but most of them fell under the “prenatal visits” cateogory.
There were many Ob-Gyn check-ups, blood/urine tests, and ultrasounds during the pregnancy. The Ob-Gyn visits were originally every 4 weeks, then every 2 weeks, and then every week. There were many, many tests they wanted to run. I had ultrasounds at 8 weeks and at 12 weeks and then a second level ultrasound at 25 weeks. I was given a few more ultrasounds in the last two or three weeks before I gave birth. They totaled approximately $3200 that came directly from me.
I had to take the whooping cough vaccine (TDaP). All pregnant women are advised to take it between the 27th and 36th week of pregnancy every time they are pregnant. This being preventative care, it was listed as always 100% covered.
Although Cigna said on their website that they only covered breast pump rentals, they did cover a breast pump purchase in full. I had originally planned not to get a breast pump through Cigna because I was not keen on the idea of a used breast pump or having to take the trouble of returning a breast pump after I was done with it. My Ob-Gyn’s office told me that they could submit an order form anyway to see what insurance said. The pump ended up being covered. Also of note: In one of the .pdfs I found on Cigna’s website, they said that they covered breast pump rentals up to the cost of purchase. I wonder if they write what they do on the site to discourage women from seeking a breast pump, because I am surely not the only one finicky about a used breast pump!
I chose to see a physical therapist who specializes in the pelvic floor when I still had pain about 3 months after childbirth. The physician actually suggested it was this or an x-ray! Given that my deductible and out-of-pocket were already met, my PT visits require no payment from me. I am normally covered for 20 visits for the year on my current insurance. I am not sure of whether the deductible and OoP being met means that Visit 21 would also be covered.
Last, a cost I wanted to incur did not happen: I told the hospital that I wanted to see a lactation specialist. They said, “Okay, but she is only available in the morning.” The next day, we got caught up in the baby’s lack of stool and forgot to ask about the lactation consultant again. The hospital forgot, too. I never did see a lactation consultant.
