The cost of giving birth in America is now more than an average month’s salary

"These are not small co-pays. The costs are staggering," says Dr. Michelle Moniz, M.D.,M.Sc., an obstetrician-gynecologist at Michigan Medicine's Von Voigtlander Women's Hospital and researcher with the U-M Institute of Healthcare Policy and Innovation.

The cost of giving birth in America is now more than an average month’s salary

There have been a lot of headlines about birth this week. Media outlets at the local, state and national level are reporting on the declining birth rate in America after a new report from the CDC, and at the same time, a new study published in the journal Health Affairs shows the out-of-pocket cost for giving birth in America has gone up significantly in recent years.

The CDC report doesn't explain why birth rates are declining, and there are clearly multiple factors influencing the trend, but we cannot ignore how much it costs simply to give birth. For most women, the co-pay is more than a month's salary.


In America, 98% of mothers with an employer-sponsored health care plan can still expect to pay out-of-pocket for birth costs. The average cost is $4,500, while the average American woman's monthly salary is $3,300, according to the Bureau of Labor Statistics.

The Affordable Care Act requires big employer-based health plans to cover maternity care, but a mother who has health insurance through work can still expect to pay more than a month's worth of salary to have a baby.

"These are not small co-pays. The costs are staggering," says Dr. Michelle Moniz, M.D.,M.Sc., an obstetrician-gynecologist at Michigan Medicine's Von Voigtlander Women's Hospital and researcher with the U-M Institute of Healthcare Policy and Innovation.

As the lead author of the study, Moniz was surprised to see that most women who have an employer-sponsored health care plan are still paying thousands of dollars to give birth. She wants to see policymakers consider alternatives to the current system. "Maternity and childbirth care are essential health services that promote the well-being of families across our country. Reducing patients' costs for these high-value services makes sense. We all want babies to have the best possible start in life," says Moniz explains in a university release.

Moniz worries that rising costs for maternal health care are not only burdening families but also pushing mothers to limit or skip prenatal care.

Health care costs for families are growing

Even for those who have uncomplicated births and health insurance at work, giving birth in America is expensive. And taking care of that baby's health (as well as mama's) doesn't get cheaper. In 2018, the average American family spent $5,000 per person on health care. If you're a two-parent family with two kids you're looking at $20,000. Costs are reduced for those with employer-based health care, but parents are still paying $6,015 in out-of-pocket expenses, CNBC reports.

"There is growing evidence that cost protections have eroded for those who have employer-sponsored health coverage, putting the burden of health care costs on workers and their families," David Blumenthal, president of the health care policy foundation The Commonwealth Fund, tells CNBC.

Families are not growing

To replace the population, American families need to have 2.10 kids, but the average is now at 1.73. The birth rate for women under 34 is falling, while rates for women over 35 are increasing.

Concerns over climate change are a factor for some choosing to have fewer or no children, but for many people having a baby (especially before 35) just isn't financially feasible. Millennials have more student debt than previous generations but make about the same the young adults of Gen X were making in 2001. Salaries have not kept up with the cost of living, and millennials are more likely than older people to have a second job in the gig economy.

"Millennials are more risk averse than earlier generations at the same age. People 50 or even 25 years ago didn't wait to be 'financially well established' before starting a family. Now it's considered irresponsible not to," Richard Jackson the president of the Global Aging Institute, told Axios last year.

Diane Mulcahy is the author of "The Gig Economy" and an adjunct lecturer at Babson College She tells Bankrate that when she speaks with millennials they point to two factors that make them feel insecure financially:

"One is that they're very aware there's no job security, so they're the least likely generation to kind of settle into a full-time job and assume that everything's going to be OK," Mulcahy explains. "The other reason is clearly economic. Most millennials—at least on the professional end who have been to college—have significant debt and a lot of them are looking for ways to either build a financial cushion or reduce their debt faster."

Josie Kalipeni, the policy director of the caregiving advocacy organization Caring Across Generations tells The Atlantic a similar story, adding that soaring childcare costs are another factor pushing down on a generation of would-be parents. "Economic instability and unaffordable care could be factors for people deciding to have children later in life, or not at all," Kalipeni explains.

Employer-based health care needs improvement, but so does employment in general

When millennials do find full-time employment it often isn't conducive to raising kids. As Motherly previously reported, the current status for many working Americans—inflexible schedules, long work hours and a lack of legislated parental leave—is not likely to result in a rising birth rate.

The United States is the only member country of the Organization for Economic Cooperation and Development (OECD) without a national paid leave program for parents, and that's one of the reasons why America's moms are among the most stressed in the world.

Today's mothers do not feel society supports them and that makes supporting a family so much harder.

We do love being mothers, regardless of how challenging it is

The truth is, it is hard and expensive to be a parent in America, but so many are still trying.

This generation is not having as many kids as previous generations did, but it is putting so much love into the ones it does have. While 88% of parents today say it's harder for us than it was for our parents, 99% of us really love being parents.

We want this, we want it so much. But if society wants the birth rate to rise, the costs have to go down.

We have to figure out how to reduce the costs to the planet, the time spent in cubicles and commutes and the cost of healthcare. When a co-pay for birth costs a mama a month of her salary (or worse, means going into debt) we can't be surprised when fewer people are giving birth.

This year many of us have a tighter budget than usual given (looks around) everything that has happened. Coupled with the uncertainty of what Halloween might look like, many of us are reluctant to spend money on brand new costumes that our kids will outgrow by next year. I get it. But I also know that many, like me, love Halloween so much. I thought about skipping the celebration this year, but that just feels like too big of a disappointment in an already disappointing year.

That's why I started looking into alternative costumes—something my kids will be able to wear once the clock hits November, and maybe even hand down to siblings and cousins in the coming years. At the same time, I'm not a DIY person, so I wanted outfits that didn't require any sewing or hot glue. Last year I attempted using one to build my son's Care Bear costume, and of course, I burnt my hand.

So with some creativity (and the brainpower of my colleagues), we came up with these costumes that are both fun and practical, made with items that your children will be able to (and want to!) wear year around:

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Time-saving formula tips our editors swear by

Less time making bottles, more time snuggling.

As a new parent, it can feel like feeding your baby is a full-time job—with a very demanding nightshift. Add in the additional steps it takes to prepare a bottle of formula and, well… we don't blame you if you're eager to save some time when you can. After all, that means more time for snuggling your baby or practicing your own well-deserved self-care.

Here's the upside: Many, many formula-feeding mamas before you have experienced the same thing, and they've developed some excellent tricks that can help you mix up a bottle in record time. Here are the best time-saving formula tips from editors here at Motherly.

1. Use room temperature water

The top suggestion that came up time and time again was to introduce bottles with room temperature water from the beginning. That way, you can make a bottle whenever you need it without worrying about warming up water—which is a total lifesaver when you have to make a bottle on the go or in the middle of the night.

2. Buy online to save shopping time

You'll need a lot of formula throughout the first year and beyond—so finding a brand like Comforts, which offers high-quality infant formula at lower prices, will help you save a substantial amount of money. Not to mention, you can order online or find the formula on shelves during your standard shopping trip—and that'll save you so much time and effort as well.

3. Pre-measure nighttime bottles

The middle of the night is the last time you'll want to spend precious minutes mixing up a bottle. Instead, our editors suggest measuring out the correct amount of powder formula into a bottle and putting the necessary portion of water on your bedside table. That way, all you have to do is roll over and combine the water and formula in the bottle before feeding your baby. Sounds so much better than hiking all the way to the kitchen and back at 3 am, right?

4. Divide serving sizes for outings

Before leaving the house with your baby, divvy up any portions of formula and water that you may need during your outing. Then, when your baby is hungry, just combine the pre-measured water and powder serving in the bottle. Our editors confirm this is much easier than trying to portion out the right amount of water or formula while riding in the car.

5. Memorize the mental math

Soon enough, you'll be able to prepare a bottle in your sleep. But, especially in the beginning or when increasing your baby's serving, the mental math can take a bit of time. If #mombrain makes it tough to commit the measurements to memory, write up a cheat sheet for yourself or anyone else who will prepare your baby's bottle.

6. Warm up chilled formula with water

If you're the savvy kind of mom who prepares and refrigerates bottles for the day in advance, you'll probably want to bring it up to room temperature before serving. Rather than purchase a bottle warmer, our editors say the old-fashioned method works incredibly well: Just plunge the sealed bottle in a bowl of warm water for a few minutes and—voila!—it's ready to serve.

Another great tip? Shop the Comforts line on to find premium baby products for a fraction of competitors' prices. Or, follow @comfortsforbaby for more information!

This article was sponsored by The Kroger Co. Thank you for supporting the brands that support Motherly and mamas.

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My 3-year-old is eating peanut butter toast with banana for breakfast (his request), and we are officially running late for preschool. We need to get in the car soon if we want to miss the morning traffic, but he has decided that he no longer wants the food that he begged for two minutes earlier. What started off as a relatively calm breakfast has turned into a battle of wills.

"You're going to be hungry," I say, realizing immediately that he could care less. I can feel my frustration rising, and even though I'm trying to stay calm, I'm getting snappy and irritable. In hindsight, I can see so many opportunities that fell through the cracks to salvage this morning, but at the moment… there was nothing.

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