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For pregnant Americans, giving birth is only half the challenge—the other half is paying for it. The Peterson-Kaiser Family Foundation Health System Tracker estimates the average cost of pregnancy, childbirth, and postpartum care for Americans with insurance is $18,865. Nearly $3,000 of that is paid for out-of-pocket.
While every baby is different, the cost of giving birth in the United States is consistently high. Shouldering that cost can be a challenge for many families, especially those who are uninsured or underinsured, but knowing what expenses to expect can help you prepare.
While it is not the only bill associated with having a baby, birth is often the largest.
In the U.S., the average cost of childbirth in 2020 was $13,393. However, costs vary significantly depending on how and where the baby is delivered. The median cost of vaginal delivery ranged from $6,557 in Mississippi to $16,668 in California. Cesareans, or C-sections as they are commonly called, are more expensive across the board, with costs ranging from $9,377 in Mississippi to $24,656 in California.
The exact cost of having a baby is rather hard to predict. Factors like pre-existing health conditions and the baby’s spinal development can dramatically increase costs for an otherwise standard birth. Further, having multiple babies will also increase the bill. Don’t forget the cost of doulas, who are not covered by most health insurance, as well as any postpartum support like lactation specialists and therapists for postpartum depression.
Twins or multiple deliveries can cost double or triple the stated figures.
It may come as no surprise that the U.S., which spends more on healthcare than any other OECD country, is one of the most expensive places in the world to give birth.
A report comparing medical care costs across ten countries found the median cost of a C-section and vaginal delivery in the U.S. in 2019 was $11,326 and $7,500, respectively. In Switzerland, the next most expensive country, those procedures cost $7,948 and $5,634 on average. The study found Americans spent nearly twice as much as Australians for childbirth and more than three times as much as their German peers. 
And in some countries, giving birth is nearly free. In Finland, for example, visits to public maternity and child health clinics are free, and a public hospital can charge no more than €49.60 a day for occupancy.
In the U.S., the type of birth you have can significantly impact how much it costs.
According to the Peterson-KFF study, the average cost of a pregnancy that results in vaginal birth is $14,768, of which about $2,655 is usually paid out-of-pocket. And the median cost of vaginal birth alone is over $10,000 in more than half of U.S. states. Vaginal birth expenses include the cost of using a delivery room and nursery, lab work, and medications. 
For the uninsured, FAIR Health maintains a tool that estimates healthcare expenses based on zip code.
The average cost of a pregnancy resulting in a C-section is $26,280, of which $3,142 is paid out-of-pocket. The median cost of a C-section is more than $10,000 in all but 5 states and over $15,000 in 20 states.
A C-section significantly increases the cost of delivery, which requires an operating room, surgeon and anesthesiologist, and overnight hospitalization. Pregnancies that result in C-sections may also come with higher costs because of the need for more intensive care resulting from complications or pre-existing conditions that make the C-section necessary.
Home births are a low-cost option for those who do not have a history of medical complications. One study estimates the average cost of home birth—including prenatal, delivery, and post-partum care—was $4,650 in 2021. Home births incur no facility costs and are often performed without medication, which is why they are typically far less expensive than hospital births.
However, since many insurance plans do not cover home birth, people who choose this option may need to pay supervising healthcare providers out-of-pocket. Those who give birth at home also miss out on potential savings from having other expenses, like infant inoculations or circumcision, bundled in hospital charges. And, of course, anyone planning to give birth at home should budget for the unexpected.

Birthing centers can be a middle-of-the-road option. They are usually more expensive than home birth, but less expensive than hospitals. Some accept health insurance, which significantly reduces out-of-pocket costs.
According to the U.S. Department of Health and Human Services, adoption costs can range from $0 to $40,000. The wide range covers a variety of adoption procedures, from foster care at the low-cost end ($0 except for legal fees) to private and international adoptions at the high end ($20,000+).
Costs include legal fees, medical care for the birthing parent, travel fees, medical evaluations, and even training for the adoptive parents.
The Affordable Care Act requires that all qualified employer-sponsored and private health insurance plans cover maternal care and childbirth. Though what exactly is covered and how much you pay out-of-pocket depends on the plan, health insurance significantly reduces the cost of pregnancy. Without insurance, birth parents are expected to pay the full cost of doctor’s visits, medications, and childbirth, which can easily add up to tens of thousands of dollars without financial assistance.
According to data from FAIR Health, providers consistently bill much more for childbirth than insurers and insured patients pay. The median allowed cost of a C-section in the U.S. is about $15,900, but the median amount charged by providers is over $35,500.  
For the uninsured, Medicaid covers pregnancy for low-income people in every state, though eligibility criteria vary widely. Some states even cover pregnancy through Children’s Health Insurance Program (CHIP), accommodating more people with an income eligibility cutoff higher than Medicaid.
Although patients are expected to pay for childbirth, there are more ways to lower healthcare costs than most people think.
Every hospital should have financial assistance policies, and it’s possible to negotiate healthcare costs. Plus, several states have enacted laws that require hospitals to provide free or discounted services to patients below certain income thresholds. Familiarize yourself with these and other laws, outlined in the National Consumer Law Center’s state-by-state guide to medical debtor protection laws.
In addition to financial assistance obtained through the hospital or mandated by law, several federal and state-level programs can assist with medical expenses related to pregnancy.
In addition to serving children under 5 years old, WIC is a nutrition assistance program that serves pregnant, breastfeeding, and postpartum people.
CHIP offers low-cost health coverage for children in families that earn too much to qualify for Medicaid. CHIP eligibility varies by state, but CHIP covers pregnant people in nearly half of all states.
The Department of Health and Human Services can connect you with your area’s health department to find financial assistance programs.
Peterson-Kaiser Family Foundation Health System Tracker. "Health Costs Associated with Pregnancy, Childbirth, and Postpartum Care."
Health Care Cost Institute. "The Price of Childbirth in the U.S. Tops $13,000 in 2020."
OECD. "Health Spending."
Health Care Cost Institute. "International Health Cost Comparison 2022 Report."
EU-healthcare.fi. "Treatment Costs in Public Health Care."
Anderson, David A. and Gabrielle M. Gilkison. "The Cost of Home Birth in the United States." International Journal of Environmental Research and Public Health.
Children's Bureau. "Planning for Adoption: Knowing the Costs and Resources."
Healthcare.gov. "Health Coverage If You're Pregnant, Plan to Get Pregnant, or Recently Gave Birth."
Kaiser Family Foundation. "Medicaid and CHIP Income Eligibility Limits for Pregnant Women as a Percent of the Federal Poverty Level."
National Consumer Law Center. "Guide to Reducing Hospital Bills for Lower-Income Patients."
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