Giving birth can be an expensive endeavor in the United States, which lacks universal healthcare coverage. Without insurance, just the hospital and physician fees for an uncomplicated vaginal delivery can cost on average $10,000-$30,000 nationwide, according to estimates. A C-section delivery can cost $20,000-$50,000 on average. However, there are options for uninsured, underinsured or low-income women to give birth for free or reduced costs if they meet eligibility criteria for certain government healthcare programs or clinic assistance.
Quick Answers
Can you give birth for free?
Yes, it is possible to give birth for free in the USA if you qualify for Medicaid, utilize charity care programs, or give birth at home. Uninsured women with low incomes may qualify for emergency Medicaid to cover labor and delivery costs. Many hospitals provide charity care or sliding scale fees. Birthing centers and at-home midwives can also cost less.
What programs help pay for giving birth?
Medicaid, CHIP perinatal coverage, and the Emergency Medicaid for Labor and Delivery program can help pay for pregnancy care and giving birth if you meet eligibility criteria. Some clinics and hospitals provide prenatal care assistance and charity care programs or sliding scale fees.
Should I try to give birth at home to avoid costs?
Home birth with a midwife is an option to avoid hospital costs but has risks. It’s recommended you give birth in a hospital, especially if you are high risk. If you are uninsured, look into Medicaid, charity care hospitals, birth centers and negotiated costs to make hospital birth affordable.
Evaluating the Costs of Giving Birth in the USA
Giving birth can be extremely expensive in the United States compared to other developed countries. On average, an uncomplicated vaginal delivery costs about $10,000-$30,000 nationwide without insurance, according to Fair Health. A C-section delivery can cost $20,000-$50,000 on average.
The high costs are driven by:
- Hospital/facility fees
- Physician fees for OB/GYNs and anesthesiologists
- Pediatrician charges for examining newborn
- Labor and delivery room charges
- Medications and epidurals for pain relief
- Operating room charges for C-section
- Hospital stays for 3-4 days on average for vaginal delivery
However, the majority of women in the U.S. do have health insurance coverage for pregnancy and childbirth:
- 49% have private health insurance
- 43% have Medicaid coverage
- 65% of uninsured women gain Medicaid coverage for pregnancy/delivery
For insured women, out-of-pocket costs for childbirth average:
- $4,500 for vaginal delivery with private insurance
- $2,800 for vaginal delivery with Medicaid
- $5,100 for C-section with private insurance
- $3,500 for C-section with Medicaid
So while giving birth in the hospital is expensive without insurance, many options exist to reduce costs for low income women.
Options for Giving Birth for Free or Reduced Cost
Medicaid and CHIP Coverage
Medicaid provides health coverage for millions of low-income individuals and families. To qualify for Medicaid, your household income must be below a certain level, which varies by state. Pregnant women have higher income eligibility limits to qualify.
Many states also provide perinatal CHIP coverage for pregnant women who don’t qualify for Medicaid but meet income criteria above Medicaid levels (200-250% of poverty level).
Medicaid programs cover all costs associated with pregnancy and delivery with no deductibles or copays. Providers are not allowed to bill Medicaid patients the difference between their charges and what Medicaid pays.
Emergency Medicaid for Labor and Delivery
States are required to provide Emergency Medicaid for Labor and Delivery to women who do not already qualify for Medicaid but meet income eligibility criteria. This covers labor and delivery only, for emergency medical conditions.
To qualify, pregnant women must meet the following general criteria:
- Be in labor or postpartum period
- Meet Medicaid income limits (often 200% of poverty level)
- Be uninsured or underinsured
- Provide proof of citizenship/immigration status
Emergency Medicaid provides coverage for the delivery, hospital stay and postpartum care but does not cover regular prenatal visits. Women must apply through the Medicaid office in their state.
Hospital Charity Care and Sliding Scale Fees
Many hospitals provide financial assistance programs to uninsured or underinsured patients, including:
- Charity Care: Full write-off or reduction of hospital bill based on income/assets
- Sliding Scale Fees: Discounted rates for services based on ability to pay
- Payment Plans: Installment payments for medical bills
Eligibility is based on federal poverty guidelines. Uninsured pregnant women below 200-400% of poverty level may qualify. Programs vary by hospital so check options in your area.
Birthing Centers
Birthing centers provide care during low-risk pregnancies and delivery in a home-like setting for lower costs than hospitals. Costs average $2,000-$4,000. Some birthing centers take Medicaid. Others offer sliding scale fees or payment plans.
Home Birth with Midwife
Planned home births with a certified professional midwife range from about $2,500-$6,000 total. Medicaid coverage varies by state. Out-of-pocket is lower but risks may be higher than hospital birth.
Negotiated Self-Pay Rates and Prompt-Pay Discounts from Hospitals
If you are uninsured but don’t qualify for Medicaid/charity care, ask hospitals about negotiated rates or prompt-pay discounts for self-pay patients. Many hospitals offer discounted rates if you negotiate upfront and pay promptly.
Payment Plans
Ask your prenatal care provider and the hospital about payment plan options. Many allow interest-free installments. You can also negotiate costs and slowly pay off the bills.
Crowdfunding
Using GoFundMe or other medical crowdfunding sites is an option to raise money from friends/family for pregnancy/delivery costs. Success varies but it’s worth considering.
Should I Try to Give Birth at Home to Avoid Hospital Costs?
Giving birth at home with a midwife may help avoid costly hospital bills for women with low incomes or lack of insurance. However, the American College of Obstetricians and Gynecologists (ACOG) recommends delivering in a hospital or accredited birthing center.
Consider risks/benefits:
Potential Benefits:
- Avoids high hospital costs
- More comfort/familiarity of home
- Fewer medical interventions
- Lower C-section rates
Potential Risks:
- No access to emergency medical care if needed
- Underlying complications may be missed
- Risks if delivery doesn’t progress normally
- Higher risk if mother has preexisting conditions
- Possibility of neonatal complications requiring hospital care
ACOG states that hospitals and accredited birthing centers are the safest settings for birth in most cases. Home birth may be an acceptable option for low-risk women anticipating uncomplicated deliveries. Women should discuss risks/benefits with their provider before deciding.
Tips for Safe, Affordable Hospital Birth
To make hospital birth affordable for uninsured or low-income women, consider:
- Apply for Medicaid early in pregnancy
- Contact hospital about charity care and discounts
- Use in-network providers with Medicaid/private insurance
- Negotiate self-pay rates and prompt-pay discounts
- Inquire about payment plans
- Use birthing centers associated with hospitals
- Have a patient advocate and negotiate all costs
- Crowdfund to help with costs
Avoiding prenatal care due to costs increases risks to both mother and baby. Work with providers and utilize available aid to achieve the safest, most affordable hospital birth possible.
Conclusion
While giving birth in a hospital can be expensive without insurance, uninsured and low-income women in the U.S. have various options to reduce costs or give birth for free. Medicaid, CHIP and emergency labor and delivery Medicaid provide coverage for women who meet eligibility criteria. Charity care programs, sliding scale fees, birthing centers and negotiated self-pay rates can significantly lower costs. Home birth with a midwife also avoids hospital charges but has more risks. With proper planning, uninsured women can often achieve hospital birth affordably and safely. But women should carefully weigh the risks and medical advice regarding out-of-hospital births.