The Expectant Father. Armin A. Brott

go through.

      Pregnancy and Childbirth

      Most doctors charge a flat fee for your partner’s care during the entire pregnancy. This generally covers monthly visits during the first two trimesters, biweekly visits for the next month or so, and then weekly visits until delivery. But don’t make the mistake of thinking that that’s all you’ll pay. Bills for blood and urine tests, ultrasounds, hospital fees, and other procedures will work their way into your mailbox at least once a month. Here’s what you can expect to pay (before your insurance pays its part) for having your baby:

      OB/GYN

      Expect to pay $2,500–6,500 for general prenatal care and a problem-free, vaginal delivery. Add a few thousand more for a C-section. Most doctors will meet with you to discuss their rates and the services they provide. For a list of important questions to ask, see pages 20–21. In addition, be sure to discuss which insurance plans, if any, they participate in (it might actually be easier to start with the doctors your insurance covers and choose from there). You should also ask whether they’ll bill your insurance company directly or will want you to make a deposit (most will want to collect about 25 percent of the anticipated bill up front); whether you can make your payments in installments; and whether they expect their fee to be paid in full before the delivery.

      MIDWIFE

      The average cost of a delivery by a midwife is $2,000–4,000, but it can vary greatly depending on where you live and whether you expect her to be with you throughout labor or just the part that’s right before the birth. If you’re delivering at home, you’ll also need to add the cost of the supplies the midwife thinks you’ll need for the birth (sterile pads, bandages, and so on).

      Lab and Other Expenses

      • Blood: Over the course of the pregnancy, you can expect to be billed anywhere from $200 to $1,500 for various blood tests.

      • Ultrasound: At least $250 each. In an ordinary pregnancy, you’ll have between none and three.

      Prenatal Testing

      If you and/or your practitioner decide that you’re a candidate for amniocentesis or any other prenatal diagnostic test, you can expect to pay $1,000–1,500. In most cases genetic counseling is required beforehand, and that costs an additional $400–600. If you’re having any prenatal testing done just because you’d like to find out the sex of the baby or want reassurance of its well-being (and not because you’re in a high-risk group), your insurance company may not pay for it. But if your partner is thirty-five or older, they probably will pay for testing.

      At the Hospital

      • If you’re paying for it yourself, a problem-free vaginal delivery and a twenty-four-hour stay in a hospital will run anywhere from $4,500 to $9,000, depending on where you live. Add $5,000–7,000 for a Cesarean.

      • If you’re planning to spend the night in the hospital with your partner, add about $250 per day.

      • Anesthesiologists usually charge from $1,000 to $1,500, depending on what they do and the time spent doing it.

      • Although a lot of people worry about preterm delivery, there’s also the issue of late delivery. If your baby decides to stay inside any more than seven to ten days past his due date, your partner may need to have labor induced. If that happens, add another $1,000–3,000.

      • If your partner does deliver early (by more than a couple of weeks) and your baby needs to spend time in intensive care, the bills—most of which you will hopefully never see—can go into the hundreds of thousands.

      If Your Partner Needs a Cesarean Section

      If your partner ends up having a C-section (which happens more than 30 percent of the time—up from 21 percent in 1993), all bets are off. Even though it’s routinely done, it’s still considered major surgery, and is expensive. The operation, which your OB/GYN will perform, is not included in his or her flat fee, and you’ll have to pay for at least two other doctors to assist, plus a nurse, who must be in attendance to care for the baby. In addition, a C-section entails a longer recovery period in the hospital—usually four to five days—as well as extra nursing care, pain medication, bandages, and other supplies. If the baby is in good health, you can probably take him home while your partner stays in the hospital, but chances are you’ll want the baby to stay with your partner, especially if she is breastfeeding. The baby’s additional time in the nursery costs more too.

      “Listen, are you absolutely sure you want to have kids?”

      An Important (and Possibly Profitable) Word of Advice

      Make sure that you and your partner check your birth-related bills very carefully. Hospitals can make mistakes—in fact, a study by credit giant Equifax found that nine out of ten hospital bills contain errors, and they’re rarely in your favor. After we’d recovered from the shock of the C-section bills for the birth of our first child (which started off at about $17,000), we asked a doctor friend to go over them with us. He found that we’d been charged for a variety of things that hadn’t happened and overcharged for a lot of the things that had. For example, we’d been billed $25 for a tube of ointment that the hospital’s own pharmacy was selling for $1.25. We (actually, mostly our insurance company) ended up paying closer to $15,000. And for the second pregnancy, our nitpicking review of the bills cut about 20 percent off the total.

      Look for double billings, services you never received (say, a private room when you were actually in a shared one, or brand-name drugs when you really got generics), and any kind of suspicious jargon. A wonderful exposé done by ABC News found that people had been billed hundreds of dollars for a “disposable mucus recovery system” (a 79-cent box of tissues) and “thermal therapy” (ice cubes in a bag). Also keep an eye out for procedures that never happened. I’ve heard stories about new parents being billed for their baby’s circumcision. That would have been fine, except that they had a girl.

      While some of these things may seem silly, they can really add up—especially if you’re footing a big portion of the bill. In the Equifax study, the average error was more than $1,300. And according to a joint study done by Harvard’s Medical and Law Schools, “[n]early half of all Americans who file for bankruptcy do so because of medical expenses.” About 10 percent of those are childbirth related.

      Even if all the bills are being paid by your insurance, reviewing those bills can still be profitable. Although most insurance companies have their own internal auditors, all they’ll be able to catch are charges that are above the “usual and customary” and/or procedures that simply aren’t covered. They won’t know about most of the things mentioned above and will be ecstatic if your review ends up saving them money. In fact, some insurers are so thrilled that they’ll actually give you a percentage (sometimes as much as half) of the money they save. Naturally, though, you’ll have to ask for your reward. So, read your policy carefully and, if you still have questions, talk to your agent or one of the company’s underwriters.

      And while you’re reading your insurance policy, here are a few other things to look out for:

      • How long before the birth does the insurer need to be notified about the pregnancy and estimated due date? Not complying with the carrier’s instructions could mean a reduction in the amount they’ll pay for pregnancy and birth-related expenses.

      • When can the baby be added to the policy? Until the baby is born, all pregnancy- and birth-related expenses will be charged to your partner.

      After the birth, however, your partner and the new baby get separate bills (all baby-related expenses, such as medication, pediatrician’s exams, diapers, blankets, and various other hospital charges, will be charged to the baby). Some carriers require you to add the baby to your (or your partner’s) policy as far in advance as thirty days before the birth; most give you until thirty days after.