Women who give birth incur $19,000 in additional health costs

Health care costs associated with pregnancy and childbirth average almost $19,000, including $2,854 in out-of-pocket expenses, according to a new analysis of large employers’ insurance claims.

Published by the Kaiser Family Foundation (KFF) in conjunction with the Peterson Center on Healthcare, the analysis compares three years of health care claims for reproductive-aged women between 15 and 49 who gave birth with claims for women who had not given birth. “The benefit of this approach is that it allows us not only to look at the cost of the delivery, but also at all health costs associated with pregnancy, childbirth, and postpartum care,” the authors note.

Women who give birth incur an extra $18,865 in total health care spending over three years than other women. This includes an average of an additional $19,906 spent on inpatient and outpatient costs, which is partially offset by a $1,040 reduction in prescription drug spending. Researchers say the lower drug costs likely reflect that pregnant women do not take birth control pills, which is one of the most common prescriptions for women of reproductive age. Additionally, some other drugs are considered unsafe to take during pregnancy.

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Differences in health spending vary by delivery type. Women who give birth via cesarean section spend an average of $26,280 more on health care than those who do not give birth, including an average of $3,214 out of pocket. Those with a vaginal delivery spend an average of $14,768 more, including $2,655 out of pocket.

The higher costs associated with cesarean section are not only because of the higher cost of the delivery, but also because of higher costs before and after the birth, which may be associated with additional care or related complications, according to researchers.

“The frequency and intensity of services associated with pregnancy and childbirth can lead to considerable out-of-pocket expenses for new parents, particularly those covered by private insurance,” they conclude. “Medical care for the infant can result in even more out-of-pocket costs for families with private insurance coverage. And these out-of-pocket health costs arrive just as these parents begin taking on additional costs of caring for a child. Many new parents also experience income losses due to a lack of paid parental leave, which can leave many new parents vulnerable to incurring medical debt.”

The full analysis, based on claims from 2018 to 2020 in the IBM MarketScan Encounter Database, can be accessed here.