Hidden Costs of Pregnancy for Women

All you read about are the joys of pregnancy - creation of a new life, that pregnancy glow, maternal bond with the baby, blah, blah, blah,. I don't want to be the downer, but I have yet to read anything that talks honestly about the financial issues women, specifically, will face due to pregnancy and childbirth. Much is written about how much you need to spend to outfit a baby and figures about how much it costs to raise a child from infancy through college, but nothing about what I call the woman's hidden costs of pregnancy - those costs that make pregnancy expensive in the unglamorous ways you had never thought about until you're actually living it.

I think about the women I know and their diverse situations - high-paying jobs, low-paying jobs, kids, no kids, thinking about kids, married, in a relationship, living with a partner or not. Some of them talk openly with me about money, not necessarily as it pertains to kids, because so few of my friends have kids yet, but about general budgeting and saving and about how they approach sharing household expenses with a partner. Most split directly down the middle, as Chris and I do, while one couple I know does a give and take - he pays the electric bill, she pays the Internet, he pays for groceries when he goes to store, and she the next time. Another couple calculated that of their combined income, he makes 60%, and she makes 40%, so that's how they split each one's share of the mortgage and other bills. But how will the couples in my social circle handle a circumstance that financially burdens one person more than the other, but is really the financial responsibility of both?

Actually being pregnant has allowed me to see how women can be impacted financially by pregnancy, in small and big ways. If you're married or in a committed relationship, having a baby sparks a new set of budgeting discussions, but the increased costs of pregnancy, and then beyond, (daycare, increased household expenses, schooling, etc.) become absorbed into the family expenditures. For women who are on their own, or are in relationships where finances have remained relatively separate, the hidden costs might be more of a burden.

1. New Wardrobe

If you've noticed patterns in my dress the past few months, it's true, I wear the same few outfits over and over again. The Bella Band gave me a few extra weeks in my pre-pregnancy pants and I was able to wear a few shirts and t-shirts with looser cuts for awhile after I started showing. But by the third trimester, the only pre-pregnancy clothes that still fit are my socks, my soccer shorts (worn so low I look ridiculous) and one skirt that has an elastic band and might have been a tad loose on my anyway when I was at my lowest weight. Everything else has been purchased since then and my old clothes are literally collecting dust and probably going out of style (that is, if I were ever in style to begin with). So I've bought as few clothes as I can get away with in an attempt to save money. And I've gotten away with fewer purchases because most of my growing has taken place during the warmer months, including September, which has been unseasonably warm for Minnesota. But although I've survived on a minimal wardrobe for now, fall will eventually be here and I'm facing having to buy yet another set of clothes to get me through the last few weeks of pregnancy and the first few weeks post partum (where, sorry, I've been informed, I'll still be wearing maternity clothes).

If I weren't pregnant, I wouldn't have gone nine months without buying any new clothes, but it is expensive (and time consuming and overwhelming) to need to replace an entire wardrobe in such a short time span. Imagine, too, if your professional requires formal attire, like a suit. My running shoes would have needed replacing by this point anyway, pregnancy-related feet woes or not, but by the third "upgrade" in intimate apparel, I was swiping the joint debit card at the register, not the one on my personal account.

2. Lost time at work/lost wages

For those who have jobs that aren't salaried, lack adequate paid time off or don't have flexible work hours, attending doctor's appointments or missing work because you're feeling ill or are experiencing complications during your pregnancy can add up to lost wages. It will depend upon what you do for work, whether you need to expend a lot of energy, be on your feet a lot or just be creative - all difficult even with mild nausea. Even if you have a desk job, the healthiest of pregnancies still require monthly and then bi-monthly doctor's appointments. Unlike the dentist, which you can schedule six months out and snag an early-morning appointment and still be to work reasonably on time, most obstetrician's offices I've encountered schedule appointments between 8 a.m. and 4 p.m., and you have little leeway to postpone an appointment by any more than a week or so to accommodate your work schedule. If you don't get paid for the hours you're not at work, or can't make up the hours, your income goes down. The writer of the memoir, Rattled! relied on freelance work to supplement her low editor's salary, but the ability to put in the extra hours was threatened by pregnancy fatigue. Her checking account dipped dangerously low as she scraped by in New York City, while her ex-boyfriend continued to live a life she could no longer afford of nights out with friends, expensive clothes and splurge purchases.


3. Health care costs

Because of all the attention paid to rising out-of-pocket costs for healthcare and the growing prevalence of high-deductible plans, I was surprised and relieved to learn that pregnancy is 100% covered (and not subject to the deductible) on my plan, just as preventative care like your annual physical is. I have never paid a co-pay at an office visit or received a bill in the mail for my prenatal care. But I've also experienced no complications. The routine care is covered, even the first and second trimester screenings, which are optional, but had I gone on medication for high blood pressure, or needed extra care related to gestational diabetes, (examples of common conditions that can pop up in pregnancy) my understanding is that I would have been responsible for some of these costs according to the terms of my health plan. Therefore, I'm waiting to see how much they charge me for those lovely wrists splints I was given (which aren't working by the way).

Then months into my pregnancy, I learned that pregnancy is covered, but that labor and delivery are considered separate from "pregnancy" and that this along with your hospital stay, are treated by your insurance company as would costs incurred if you visited your doctor for an illness, or went to the emergency room for a broken leg. Where I had previously misunderstood that I wouldn't be paying a cent for any medical costs related to pregnancy, I'm facing an undetermined bill that could be in the low thousands once the deductible and out-of-pocket maximum is factored in.

At some point during delivery the creature that's been stirring around inside of you is considered by the insurance company a separate human being in need of its own coverage. So you'll actually get two bills, one for you and one for the baby (who now has its own deductible). You instantly go from single coverage to "employee + dependent," or "employee plus spouse" to "family coverage," complete with increased monthly premiums.

My earlier rant about the costs borne by women for maternity wardrobes may seem superficial, and as for the potential for lost wages, you'll most likely have a healthy pregnancy with little time off needed from work. But unless you give birth at home without professional help, you and your new child could incur thousands of dollars in hospital costs. How will you and your partner split what insurance doesn't cover? If you've each spent years contributing to a health savings account, how much from each account will you tap into? Some people are lucky to have an employer who offers great coverage with a low monthly premium, while others don't have health insurance at all. If you're married, your options open up, but if you are not married and are about to have a baby, the question of how to make sure you and your baby are covered and how you will split those costs is a lot more complicated.

4. Maternity Leave

You will need to take time off after you've given birth, but unfortunately for those of us working in the United States, maternity leave is not paid (and not even guaranteed). It seems the common scenario is that new moms only receive a full salary during maternity leave by using up any vacation time and sick time,(so limited in the States, and again, not even guaranteed) then a partial salary by applying for disability and then when that runs out, they round out maternity leave by taking unpaid time off. Realizing that your household may go weeks without a second paycheck is a financial shocker for many couples, but if paychecks in your relationship are still seen as "her" money and "his" money, where does that leave the woman when her income is non-existent for a few weeks or months?