How Much Does a Pregnancy Cost?

Pregnancy can be stressful, as well as exciting. But figuring out how to pay for the services you need in advance can help you concentrate on the positives and your growing family’s health. 

You may have different health insurance options when you are pregnant, and insurance can save you a lot on the costs of having a baby.

What is the average cost of having a baby? 

A Kaiser Family Foundation analysis found the average cost of having a baby is nearly $18,900 for people with large employer group insurance plans, with out-of-pocket payments averaging roughly $2,850. But, because there are so many variables, you may find that your costs are a good deal higher or lower than the average. 

A major factor is where you live. The cost of giving birth in the most expensive state (California) is more than two times higher than in the least expensive state (Mississippi). There are even wide variations in the prices between neighboring states and within small geographic areas. 

In addition to your location, the total cost of your pregnancy will depend on several other factors, including:

• Whether you have health insurance

• How comprehensive your coverage is (for example, whether or not have a high-deductible health plan)

• If you have pregnancy complications and need a hospital stay

• If you have a cesarean section (C-section) delivery

What expenses are factored into the cost of a pregnancy?

Many pregnancy-related costs may not be obvious, at first. For instance, you can look up the cost of a C-section by ZIP code on the nonprofit price-comparison site FAIR Health. But the price you see might not include all the procedures you may need to get along with the delivery, like anesthesia and a hospital stay. 

Here are the most common expenses related to pregnancy and childbirth: 

• Regular checkups

• Routine lab work

• Ultrasounds

• Glucose screening and other routine screening tests

• Vaginal or C-section delivery

• Hospital stay

• Anesthesia (optional for some people)

• Postpartum care

Optional, extra costs and potential costs with high-risk pregnancies include:

• Doula services

• Chorionic villus sampling (CVS) 

• Amniocentesis

• Cell-free fetal DNA testing

Pregnancy, maternity, and newborn care collectively make up 1 of the 10 essential health benefits that the Affordable Care Act (ACA) says qualified health plans must cover. Under the ACA, insurance plans must cover as many prenatal visits as your provider thinks you need, without cost to you. Most routine tests are included in your regular preventative checkups, so they likely won’t add to your costs. But ultrasounds, when ordered by a doctor, usually have a copay or coinsurance.

Since more than 98% of U.S. births take place in a hospital, these are the costs that we focus on below. But, for the small percentage of women who choose to give birth at home or in an alternate setting like a birth center, the costs would likely be lower. 

How much does the delivery of a baby cost?

The delivery of the baby accounts for the largest chunk of the total cost of a pregnancy. A vaginal birth without complications is the least expensive delivery scenario. C-sections and other procedures add costs. The chart below compares the costs of different types of deliveries.

Many people giving birth vaginally in the U.S. receive epidural, spinal, or combined anesthesia. The procedure is common and included in average costs associated with delivery. For uninsured people, the cost of an epidural can range from about $1,000 to over $8,000.

Doulas, who support a pregnant person before, during, and sometimes after the delivery, are an optional cost. They don't perform medical procedures but can help manage pain, lower anxiety, and help people advocate for themselves during labor and delivery. The cost of a doula can be between $800 to $2,500. Some insurance plans, including some Medicaid programs, offer coverage for doulas.

How does health insurance affect the cost of pregnancy?

Under the ACA, most health plans must cover maternity and newborn costs. They also cannot deem pregnancy a preexisting condition to avoid paying for care. And all plans must cover preventative care with no cost-sharing for the patient, including:

• Prenatal care 

• Prenatal vitamins and folic acid supplements

• Smoking cessation costs 

• Breastfeeding support 

Health insurance companies negotiate the costs of services at hospitals in their network, so out-of-pocket can vary between hospitals. If you give birth at an in-network hospital, or at an out-of-network hospital in an emergency, you are protected from getting surprise bills that your insurance won’t cover. 

Medicaid

Medicaid covers about 42% of U.S. births. If your income is below a certain level, you may qualify for Medicaid. And you can apply for Medicaid at any time of the year. 

If you qualify for Medicaid only due to your pregnancy, your coverage continues for 60 days after you give birth. Medicaid offers comprehensive coverage for prenatal, delivery, and postpartum care. The requirements to qualify for Medicaid and what services are covered under the plans vary by state. 

Marketplace coverage

All insurance plans available through the ACA or state marketplaces are required to cover maternity care. Pregnancy is not a qualifying event for enrollment, so you need to wait until your baby is born to enroll them in coverage. (The birth or adoption of a child is a qualifying event.) Your out-of-pocket pregnancy costs will depend on the level of marketplace plan you have, known as your metal tier.

Employer-sponsored coverage

The ACA requires employers with over 50 workers to offer health insurance, and those plans must include maternity coverage. Smaller companies can choose to offer insurance and, if they do, the plans must cover pregnancy. 

With employer-sponsored coverage, out-of-pocket pregnancy costs vary by plan type. Ask your insurer about your out-of-pocket limit  and other important coverage details. 

Uninsured

Pregnancy costs can cause financial strain for people who don’t have insurance. Depending on where a person lives, delivery costs alone can range from $6,500 to $27,000 without insurance. But inflation can drive those costs even higher. 

Nearly 15% of Americans of childbearing age were uninsured as of 2019, although many could have qualified for Medicaid or marketplace subsidy plans. 

Though most insurance now covers the cost of pregnancy, if you’re under age 26 and on your parent’s employer-sponsored plan, you may not be entitled to any maternity coverage. Make sure you know what your insurance covers or, if you are uninsured, look into plans that will help you pay for the cost of pregnancy.

Can I use a health savings account toward pregnancy-related purchases?

If you have a health savings account (HSA), you can use the money to pay for qualified medical expenses, including many pregnancy-related ones. Unlike a flexible spending account (FSA), the money in an HSA rolls over year to year. 

Can I use my partner’s insurance to cover my pregnancy costs?

If you are not married, your partner’s insurance will probably not cover your pregnancy costs. Because you are not in a legally binding relationship, most insurance plans will not consider you a dependent eligible for coverage. Whether or not domestic partners and common law spouses are eligible for coverage depends on state law and insurance company policies. 

Tips to reduce pregnancy costs

Here are some ways you might be able to lower the cost of pregnancy:

• If you don’t have health insurance, go to healthcare.gov and find out if you can enroll in a free or low-cost option like Medicaid or a marketplace plan with a premium subsidy. You often can get health insurance even if you have low or no income, so be sure to check your eligibility.

• If you have insurance, check your policy to see what providers, hospitals, and services it covers and for restrictions like prior authorizations. Some hospitals offer maternity packages that provide a discount, as well as optional extras like a private room. 

• Shop around to compare the costs of different hospitals, and then see if you can negotiate pricing with those hospitals.

• Consider using a birth center or other alternate setting for your delivery if you have a low-risk pregnancy.

• If applicable, inform your health insurance within 30 days of your baby’s birth so your plan will cover your newborn’s care. 

• Know your rights during pregnancy, in the delivery room, and for postpartum care.

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Written by:

Julia Tell, Ph.D.

Julia Tell is a freelance writer covering healthcare, education, and digital transformation. She holds a Ph.D. in media & communications and has written for publications including Business Insider and EdSurge, as well as nonprofits, international businesses, and educational institutions.

Edited by:

Charlene Rhinehart, CPA

Charlene Rhinehart, CPA, is a personal finance editor at GoodRx. She has been a certified public accountant for over a decade.

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