A modern lifestyle brand redefining motherhood

Giving birth means going into debt for some mothers in America, but why?

Print Friendly and PDF

For American parents, the reward in childbirth is, of course, the baby. Yet, the existing incentives in the healthcare industry are all backward: Costs for mothers and babies continue to climb as health outcomes worsen. And behind these statistics are real parents who often feel out of control or unprepared for the bills that follow baby's birth.


When she was expecting her second child in 2009, Jessica Pennington was already well aware of the steep costs associated with giving birth in the United States. Hoping to brace for the financial impact, Pennington and her then-husband set aside close to $2,000 to pay the bills that were sure to follow her hospital delivery—despite their private insurance coverage.

"I had no way of knowing the birth was going to be anything but normal," Pennington tells Motherly.

A 2013 report prepared by Truven Health Analytics based on 2010 data shows Pennington could have expected a bill of approximately $3,400 for a standard vaginal delivery or $5,100 for a cesarean birth.

But all did not go according to plan.

Endometriosis further weakened Pennington's uterus after her first birth and the strain of pitocin, a labor-inducing drug, caused Pennington's uterus to "split like a banana peel."

FEATURED VIDEO

Thankfully her baby was unaffected by the traumatic delivery, but doctors had to fight to first save Pennington's life and then her reproductive system—even though she says a hysterectomy would have been her first choice if she or her husband had been consulted.

"They were using things like brand new technologies they never used before," Pennington says, adding surgeons performed a hysterectomy after exhausting their other options. "One procedure alone was $40,000 and it didn't work."

By the time she was released from the hospital, the costs for her medical care topped $140,000. After petitioning for more insurance coverage, that left Pennington and her ex with a bill of $30,000—an unfathomable amount on their full-time student, part-time employee budgets.

"My education got put on hold so that I could make any kind of money to even buy groceries," Pennington says, adding the couple was initially unable to make the minimum $150 monthly payments. "Now, looking back it doesn't seem like much, but when you're not working and trying to pay for college and trying to raise two kids and maintain a normal house and lifestyle and groceries, it was just unheard of."

Childbirth costs in the United States continue to climb, even as outcomes worsen

Although Pennington's experience was more dramatic than most, even by-the-books deliveries come with growing price tags for American families: According to the report prepared by Truven Health Analytics, out-of-pocket costs for maternal care quadrupled from between 2004 and 2010.

Upon a close inspection of bills, some medical charges may seem exorbitant—such as a single pill of acetaminophen (or Tylenol) topping $30, according to the 2016 Trends in Hospital Inpatient Drug Costs report from NORC at the University of Chicago.

Other charges may even be inexplicable. That was the case for Amy Sallie, a mother of four, who delivered her second baby on the floor of the emergency room minutes after walking into the hospital.

"Here's the fun thing, I got billed for all of the normal expenses," Sallie tells Motherly. "Labor and delivery room, all the normal stuff. And I'm just thinking like, 'I literally gave birth in your hallway. What are you talking about?'"

For parents who are trying to navigate life with a newborn, it can be hard enough to scan the intrapartum bills in detail—let alone figure out how to start debating charges or requesting more insurance coverage. To limit potential surprises, Hector De La Torre, executive director of Transamerica Center for Health Studies (TCHS), tells Motherly that expectant families should consider their health insurance options and make sure they will be in-network for care.

"A substantial subset of millennials do not feel very informed about the health insurance options available to them and find decision making about health insurance plans difficult," he says.

While costs have been rising, outcomes for mothers have been worsening: According to a 2017 report from the Centers for Disease Control and Prevention, the maternal mortality rate in the United States has steadily climbed since the mid-1980s. This gives America the distinction of having the worst rate of maternal deaths in the developed world, according to a 2016 report published in the journal The Lancet.

The current maternal healthcare system rewards complications

The current rate of cesarean births in the United States is nearly 32%, which is more than double the number that is estimated to be medically necessary by the World Health Organization. This single data point is representative of the larger trend of intervention-intensive maternity care, which is often not in the best interest of low-risk mothers—or their bank accounts.

"Birth costs are inflated by probably a lot of things that people don't need and things that can also unintentionally pose harm," says Carol Sakala, Director of Childbirth Connection Programs at the National Partnership for Women & Families, which collaborated with Truven Health Analytics on the 2013 report. "You have a greater likelihood of things like bleeding and infection and so forth when you're taking surgical steps and giving powerful drugs."

While options such as medically inducing labor or offering an epidural are often presented as "not an issue" to mothers, Sakala says these steps may be the start of "a very intervention-intensive birth for a population that is by and large low-risk and healthy."

However, the dominant healthcare structure doesn't actually offer incentives for positive outcomes.

"The essential point is that the fee for service system we have now, adding up all these different fees from all these different services, is not tied in the least to value," Sakala says. "It doesn't matter if you did something that was a good thing to do or not, it doesn't matter if you got a good outcome or not."

'We're heading in the direction' of a better option

Although it hasn't yet been reflected by healthcare costs or outcomes, Sakala says there is reason to be optimistic due to a growing movement behind "bundled" or episode-based care. Currently offered through Medicaid programs in Ohio, Tennessee and Arkansas, as well as with some Cigna plans, this payment structure controls the costs for families and encourages better outcomes from the very start of maternal care.

Unlike the current standard, this system rewards healthcare providers for positive outcomes—such as lower rates of C-sections and higher rates of breastfeeding—or, in some cases, penalizes them for negative outcomes.

"Now it gets their attention that they're not only providing services and business as usual, as we are accustomed to in the current cultural ethos of maternity care," Sakala says, "but they are paying attention to what is going to get the best outcome and trying to work together to do that."

What can expectant parents do to control costs?

For what it says about transparency in the healthcare system in general, it is actually difficult to find estimates for childbirth costs in the United States. De La Torre recommends expectant parents familiarize themselves with their insurance policies from the beginning of maternal care. And tools such as that provided by the non-profit consumer group FAIR Health can help individuals estimate childbirth costs in their own states.

Beyond that, remember you are your best advocate. One surprising finding from the Truven Health Analytics report is that uninsured women paid less on average for childbirth services than mothers with insurance. The reason behind that may be twofold—and comes with a lesson for all families: For one, uninsured women may be slower to accept unnecessary interventions, which lowers their overall costs.

They may also be more proactive about petitioning their bills, which is something all families can do. As Sakala says, "This figure told me that hospitals by and large are ready to negotiate."

Looking back on her experience, Pennington says her insurance company was also easy enough to work with—but it was the pure scope of their debt that cast a shadow over a time that should have been happier.

"To be honest, the whole first year after that was a blur," she says. "It was rough. I think we have everything paid off now, eight and a half years later, but every once and a while something will creep up from 2009 and we're like, 'Oh my gosh.'"

You might also like:

Who said motherhood doesn't come with a manual?

Subscribe to get inspiration and super helpful ideas to rock your #momlife. Motherhood looks amazing on you.

Already a subscriber? Log in here.

I honestly can't remember how I used to organize and share baby photos before I started using FamilyAlbum. (What am I saying? I could never keep all those pictures organized!) Like most mamas, I often found myself with a smartphone full of photos and videos I didn't know what to do with. My husband and I live states away from our respective families, and we worried about the safety of posting our children's photos on other platforms.

Then we found FamilyAlbum.

FamilyAlbum is the only family-first photo sharing app that safely files photos and videos by date taken in easy-to-navigate digital albums. From documenting a pregnancy to capturing the magical moments of childhood, the app makes sharing memories with your family simple and safe. And it provides free, unlimited storage—meaning you can snap and snap and snap to your heart's delight without ever being forced to choose which close-up of your newborn's tiny little nose you want to keep.

Try FamilyAlbum for Free

And, truly, the app is a much-needed solution for mamas with out-of-state family. Parents can share all their favorite memories with friends and relatives safely within the app without worrying about spamming acquaintances with every adorable baby yawn the way you might on a social network or a long text thread. (Did I mention I have a thing for baby yawn videos? I regret nothing 😍) It's safe because your album is only visible to the people you share it with. The app will even notify album members when new photos have been posted so they can comment on their favorite moments and we can preserve their reactions forever. It's also easy for my husband and I to share our photos and videos. All of our memories are organized in one place, and we never have to miss out on seeing each other's best shots.

And because #mombrain is real, I especially appreciate how much work FamilyAlbum takes off my plate. From automatically organizing photos and videos by month and labeling them by age (so I can skip doing the math in my head to figure out if my daughter was five or six months when she started sitting up) to remembering what I upload and preventing me from uploading the same photo four times, the app makes it easy to keep all my memories tidy—even when life feels anything but.

FamilyAlbum will quickly become your family's solution for sharing moments, like when you're sending a video to the grandma across the country. Grandparents need only tap open the app to get a peek into what is going on with our girls every day. When my sister sends her nieces a present, the app has become where I can share photos and video of the girls opening their gifts so she never feels like she's missing a thing. The app will even automatically create paper photo books of your favorite shots that you can purchase every month so you can hold on to the memories forever (or to share with the great-grandma who has trouble with her smartphone 😉). Plus, you can update the books with favorite photos or create your own from scratch. No matter what, the app keeps your photos and videos safe, even if your phone is lost or damaged.

But what I love most about FamilyAlbum is that it's family-first. Unlike other photo sharing platforms, it was designed with mamas (and their relatives!) in mind, creating a safe, simple space to share our favorite moments with our favorite people. And that not only helps us keep in touch—it helps us all feel a little bit closer.

Download FamilyAlbum Now


This year marks FamilyAlbum's 4th anniversary! Click here to celebrate and learn more about their "Share your #FamilyAlbumTime" special promotion running until March 31, 2019.

Today's moms spend more time with their kids than ever before, but we're also working a ton in paid and unpaid roles. According to a recent study out of the UK, mothers who work full-time and are raising two or more kids are 40% more stressed than working women with no children.

So many moms feel like if they could just add more hours to the day so they do could more they would be less stressed, but the key to decreasing our stress and maximizing our potential might actually be doing less, not more.

Tiffany Dufu is a mother of two, the founder and CEO of The Cru; a peer coaching service for professional women, and the author of Drop the Ball: Achieving More By Doing Less. On the latest episode of The Motherly Podcast, sponsored by Prudential, Dufu tells Motherly co-founder Liz Tenety that the key to achieving more, in motherhood and our careers, is making strategic choices about what you can drop.

For Dufu, who witnessed her own mother fall into poverty, financial stability was an important part of what she felt would make her a good mom. "Some women have children and they want to be at home. They want to stay at home. I had children and I wanted to put my foot on the gas pedal in terms of my career. I wanted to make money," she explains.

FEATURED VIDEO

And before her kids arrived, she had an idea of what that would look like. In her mind's eye she saw herself keeping a clean house, sitting down to dinner with her family each night and still breaking boundaries in her career. But her first day back at work after her maternity leave was shockingly different than how she'd pictured working motherhood.

She found herself sitting on the floor of the bathroom, expressing breast milk into the toilet because she "couldn't handle both the pump and the bottle."

"It was like literally a mess and I was crying on my way home in my designer suit with like gross milk on my nice silk blouse," she explains. "It was a huge turning point because it was the first time that reality hit."

In the 12 years since that episode, Dufu has been redefining working motherhood in a way that works for her, rewriting the cultural programming girls grow up absorbing. "From the moment that you were wrapped in a pink blanket you've been receiving messages about who you are and what you should be. And that's a very kind of daunting realization for someone who feels like I did, that you're in the driver's seat of your own life."

Dufu's used that driver's seat to clear a road for other women. She's run a national women's leadership organization that's trained thousands of women to run for office, and helped so many women develop careers they are passionate about. But in order to do this, Dufu had to decide which metaphorical balls she was going to drop.

"I don't manage my kid's social calendar and that usually means that my kids miss a lot of birthday parties because we don't live in an evolved world in which people send birthday party invitations to children's fathers," she explains. "So when it comes in my inbox and I have to ask myself my 'dropped the ball' question, [I ask] is responding to this birthday party invite my highest and best use in raising a conscious global citizen?'"

If the answer is no, they skip the birthday party.

For Dufu, motherhood isn't about doing it all, it's about choosing what to do by being real about how much time is in the day and being strategic about how she invests that time. "It means that we hedge our bets and we decide I'm not going to puree this baby food today because I'm working on a better future for this child," says Dufu.

Sometimes being the mom and person you want to be means you won't be following a script pre-approved by society, but you will be free to write your own story.

To hear more about Tiffany Dufu's experiences in motherhood and her career listen to The Motherly Podcast, sponsored by Prudential, for the full interview.

You might also like:

For some celebrities, pregnancy is a time to retreat from the public eye and be more strategic about what they share online. They guard their personal lives a little closer, and their social media presence gets a little more curated.

But when Amy Schumer announced her pregnancy in October, she didn't stop sharing. We saw—and heard, in some of her more graphic Insta stories—just how hard this pregnancy and the resulting hyperemesis (an extreme form of morning sickness) have been on Schumer.

Schumer's humor has always been real, and her new Netflix special, Growing, is one of the realest descriptions of pregnancy I've ever seen on my TV.

As a mom who didn't glow as much as I groaned through my pregnancy, I laughed so hard I cried. And as a mom of a child diagnosed with autism spectrum disorder, I cried tears of relief.

In one hour Amy Schumer simultaneously made me feel seen and helped me see a happy future for my son, and I can't thank her enough.

[Warning, light spoilers ahead]

Amy Schumer: Growing | Official Trailer [HD] | Netflix www.youtube.com


The Netflix description for this special describes it as "both raunchy and sincere" and that's totally accurate. If you've seen Schumer's previous Netflix special, you know you can't watch this until the kids are in bed.

FEATURED VIDEO

In Growing Schumer proves that pregnancy didn't make her a different person or take the curse words out of her vocabulary. She is who she is, she just happens to be becoming a mom, too.

And becoming a mom has not been easy. Schumer's description of yeast infections, and vomiting and hemorrhoids and all the parts of pregnancy that nobody puts on a felt letter board gave me flashbacks and validation.

In Growing, Schumer is saying that it's okay not to love being pregnant and that it doesn't mean you don't love that baby growing inside you. It's a message more women need to hear because it's hard to see photo after photo of smiling mamas sporting cute bumps and wonder if you're the only woman who doesn't love feeling someone sit on your bladder.

That feeling (the emotional one, not the bladder one) made me feel alone in my pregnancy, but it's been three years since I wondered if there was something wrong with me. These days, I'm more worried about whether my son, who is now a preschooler, will grow up to think there's something wrong with him.

As the mother of a kid on the spectrum, I gasped when Schumer explained that her husband, Chris Fischer, is too. I sobbed when she described some of her husband's quirks, because I see them everyday in my son.

I don't want to spoil the special too much, but let me tell you this: In revealing that her husband, the father of her future child, is on the spectrum, Schumer gave me so much hope.

I'm so grateful that Schumer (and Fischer, who must be on board with this) shared that bit of info because sitting there in front of my TV all the versions of my son's future that got erased when we got our ASD diagnosis came flooding back.

I could see him as a grown man, and he wasn't alone. He was falling in love with a partner like Schumer. He was becoming a father like Fischer. He was happy (and different, in the way Schumer describes her husband) but he wasn't alone.

Schumer's trademark raunch isn't for everybody, but her authenticity and vulnerability sure is for me. For 60 minutes I watched a woman stand alone on a stage and I felt less alone.

You might also like:

It's been four years since the Zika virus outbreak had health officials warning pregnant women to stay out of certain regions where the mosquito-borne virus was flourishing, but now health officials around the world are downgrading those warnings.

Stateside, the Centers for Disease Control (CDC) has eased warnings that previously advised women who were pregnant or trying to conceive to avoid traveling to dozens of countries and regions.

Now, the CDC guidelines simply recommend "pregnant women and couples planning a pregnancy within the next 3 months consult with a health care provider" before traveling to areas where Zika has previously been reported.

Only one region in the world has an active Zika outbreak. The Indian state of Rajasthan has that unfortunate distinction and the CDC recommendations still urge against visiting that area if you're pregnant or trying. The rest of the world though? That's your call.

The CDC's downgrade follows a similar move in February by Public Health England, and precedes an expected announcement from the World Health Organization, the Washington Post reports.

Zika activity around the globe has calmed considerably in recent years. Brazil, which saw hundreds of thousands of cases of Zika infection in 2016, had more than 2,000 babies who were impacted by "developmental and growth alternations possibly related to Zika virus infection," including microcephaly, "a condition where a baby's head is much smaller than expected," according to the CDC.

FEATURED VIDEO

There is no vaccine for Zika, and while pregnant women can take precautions, like wearing long sleeves and insect repellent to protect from mosquitos and avoiding outdoor activities at dawn and dusk, the easing of the travel advisories does not mean there is zero risk, just that it has been greatly diminished since 2015/2016.

"Where there are those big outbreaks, we're definitely going to tell you not to go," Martin Cetron, the director of the CDC's Division of Global Migration and Quarantine said in an interview with the Washington Post. "Where there is a range of possibilities, from no Zika to low-level background Zika, we're going to tell you there's been virus there before; it could still be there. If you're a zero-risk person, don't go. If you're not, you decide."

Some high profile mothers had already been making that call even before the CDC lightened up the guidelines. Last fall the newly pregnant Duchess of Sussex, the former Meghan Markle, traveled to areas previously impacted by Zika, Fiji and Tonga.

There is no word yet on exactly when the WHO will ease its guidelines, and even when it does, pregnant women should still talk to their doctor before traveling internationally.

You might also like:

It may seem like there are more recalls than ever these days, but that's actually a good thing for parents. It means fewer potentially dangerous products are making it to our dinner tables and medicine cabinets.

According to food safety experts, the spike in recall notices for everything from broccoli to baby toys in recent years suggests companies are doing a better job of self-reporting, and we're actually safer than we were in the days when recalls were rare.

"It reflects a food industry that takes contamination and foodborne illnesses seriously. Increasingly companies are willing to recall their products rather than expose customers to potential harm," Dr. William Hallman, professor and chair of Rutgers Department of Human Ecology, said in an interview with Food Drive."So more companies are taking a cautionary approach."

Here are the recalls parents need to know about this month:

Dollar General baby cough syrup

The FDA announced a recall of 2-fluid ounce (59 mL) bottles of DG/health NATURALS baby Cough Syrup + Mucus sold at Dollar General stores.

The manufacturer is recalling lot KL180157 because the medicine is possibly contaminated with Bacillus cereus, which can lead to two forms of gastrointestinal illness and cause vomiting or diarrhea.

"Most often, illnesses are mild and self-limiting, although more serious and even lethal cases have occurred. Individuals at risk for more severe forms of illness include infants, young children, and others with weakened immune systems," the FDA notes.

So far, no babies have become ill after taking this product, but if you have it in your home you should return it to the store or call 1-844-724-7347.

Dollar General Baby Gripe Water

The above cough syrup recall follows another recall of a Dollar General product. Last month the FDA issued a recall notice for "DC Baby Gripe Water herbal supplement with organic ginger and fennel extracts" after the company received one report of a one-week old baby who had difficulty swallowing the product, and there were three other complaints "attributed to the undissolved citrus flavonoid."

The FDA says "the product should not be considered hazardous but could result in difficulty when swallowing the product for sensitive individuals."

Basically, it's not harmful if swallowed but the undissolved flavonoid makes it a choking hazard.

The gripe water was sold at Dollar General stores in four ounce bottles with the UPC code 8 5495400246 3.

69,000+ pounds of Tyson chicken strips are being recalled: What parents need to know 

Another chicken product is being recalled. On March 20, 2019, the United States Department of Agriculture's Food Safety and Inspection Service announced a recall classified as high risk. Some 69,000 pounds of Tyson frozen, ready-to-eat chicken strip may be contaminated with pieces of metal.

Earlier this year Tyson recalled 36,420 pounds of nuggets for a similar reason.

All the recalled products have a use-by date of November 30, 2019. The recall includes the following varieties:

  • Tyson FULLY COOKED BUFFALO STYLE CHICKEN STRIPS CHICKEN BREAST STRIP FRITTERS WITH RIB MEAT AND BUFFALO STYLE SAUCE" case codes 3348CNQ0317 and 3348CNQ0318
  • Tyson FULLY COOKED CRISPY CHICKEN STRIPS CHICKEN BREAST STRIP FRITTERS WITH RIB MEAT" case codes 3348CNQ0419, 3348CNQ0420, 3348CNQ0421, and 3348CNQ0422
  • SPARE TIME FULLY COOKED, BUFFALO STYLE CHICKEN STRIPS CHICKEN BREAST STRIP FRITTERS WITH RIB MEAT AND BUFFALO STYLE SAUCE" with case code 3348CNQ03.

"The problem was discovered when FSIS received two consumer complaints of extraneous material in the chicken strip products," the agency notes. "There have been no confirmed reports of adverse reactions due to consumption of these products. Anyone concerned about an injury or illness should contact a healthcare provider."

If you have these chicken strips, throw them away or call Tyson at 1-866-886-8456.

[A version of this post was originally published February 21, 2019. It has been updated.]

You might also like:

Motherly provides information of a general nature and is designed for educational purposes only. This site does not provide medical advice, diagnosis or treatment.Your use of the site indicates your agreement to be bound by our  Terms of Use and Privacy Policy. Information on our advertising guidelines can be found here.