My friend is very excited about the soon-to-be birth of his first baby. He’s been working on a budget of estimated labor and delivery costs and asked me if I encountered any surprises with either of my kids. I did indeed – and not just because I didn’t do an estimated budget (which in retrospect would probably have been very smart). But, even if I had set a budget, there are some childbirth expenses tend to sneak up on you.
In honor of my friend and his new family member, I asked my network of parents to share their surprise costs of birthing babies. As it turns out, many of us shared six of the same unexpected costs.
1. The anesthesiologist could be out of network
When I asked my Facebook friends what unexpected costs they incurred from labor, this was the most popular answer. I wasn’t surprised, because this happened to me, too. I received a large bill from the anesthesiologist who gave me an epidural, after my insurance had already paid the in-network allowed amount.
I called the doctor’s billing department and they informed me the anesthesiologist was out-of-network (meaning he didn’t have a pre-negotiated contract with my Blue Cross plan), even though the hospital where I delivered (and where that doctor worked) was in-network.
If this happens to you, do not pay that bill. Instead, call the hospital administration (just call the main number to the hospital and tell the operator you want to talk to someone in administration). Explain your situation and that it is not acceptable for an in-network hospital to have an out-of–network anesthesiologist charging patients hundreds more than insurance will pay. After all, you did your due diligence to make sure your OBGYN and hospital were in-network. It’s not like you get to pick what anesthesiologist is on duty the day you go into labor.
When I called my hospital admin, I got no resistance. In fact, she was audibly frustrated with the doctor. The bill was taken care of, and I didn’t pay a dime of the anesthesiologist bill.
2. You may have to meet two deductibles
If the hospital bills you and your baby separately, you’ll be responsible for the deductible for each of you. With my first labor five years ago, I received one bill under my name for all the delivery and baby care expenses.
When my second baby came two years later, he spent 24 hours in the neonatal intensive care unit, and he was billed separately from me. That meant we owed two deductibles and co-pays, which amounted to several hundred dollars more.
Call the hospital where you plan to give birth and ask the billing department how they bill mother and child, including if the child needs extra services. Then call your insurance and find out what deductibles you’ll owe for labor and delivery.
Also, remember that you’ll pay two deductibles to your OBGYN if your pregnancy carries over from December of one year and January of the next year.
3. You’re being charged for every single supply and pill
The nurses give mom and baby lots of "goodies": diapers, wipes, bulb syringes, breast pump accessories, lanoline, pain pills, and other labor recovery supplies. My nurses were very generous with replenishing my goodies. They even offered to send me home with extras. Then I got the bill and realized I was charged for every single item. I was even charged $2 per ibuprofen pill.
Get the most for your money. Take all of those supplies home with you, and make sure you request an itemized bill from the hospital so you can see exactly what you were charged for. Billing mistakes happen all the time but you shouldn’t pay them without asking questions first.
4. Many hospitals charge for parking
For the births of both my children, my mom and husband would take turns staying with me at the hospital. That meant we were paying for two cars to have in-and-out privileges in the hospital parking lot, which amounted to about $40 a day – $160 over the course of my stay.
If your hospital doesn’t validate, it’s hard to avoid the cost of parking (you’re not going to be looking for a spot on the street while your wife is having contractions). So add parking fees to your baby delivery estimate.
5. You may very well need to pay for lactation help
Thanks to the Affordable Care Act, some form of lactation help (including a breast pump) has to be covered by your insurance. Call your insurance company while you are pregnant and find out how to get a pump that is covered (I had to special order mine from a specific company and it took a few weeks), and how your coverage for lactation support works. Make sure to ask if the rental of a hospital-grade pump is covered (several of my friends needed the stronger pump to help with lactation issues).
I got zero lactation help from our first pediatrician’s office. I had so many problems, I finally paid a few hundred dollars out of pocket (this was before the ACA) for a lactation consultant, but it was worth every penny.
With my second child, we had a great pediatrician with a lactation consultant on staff. And (thanks to the ACA provision) the consultant was completely covered by our insurance. I can’t tell you what a difference access to breastfeeding help made in my stress level and overall happiness with my second baby.
6. Moms might need a new wardrobe
You know you’re going to need maternity clothes, but you may underestimate the number of breastfeeding or pumping-friendly tops and bras of various sizes needed that first year of motherhood. Plus, if you’re headed back to work, you need clothes to fit your new shape and make you feel confident. One friend of mine even experienced a permanent shoe size change after having kids.
As you buy maternity clothes, try to collect items you can also wear post baby (as you work your way back to your normal size). Some maternity tops double as breastfeeding-friendly tops so you get more wear for your money. And, if you find that your feet aren’t willing to return to normal size, try getting your shoes stretched.
Hopefully, your labor experience is filled with many joys – and few financial surprises.