The Financial Toll of Pregnancy and Childbirth: How Medical Debt Impacts New Parents

Medical debt is a common issue that many new parents face, as highlighted by the experience of Heather Crivilare and her family. Heather’s emergency cesarean section led to thousands of dollars in medical bills, causing financial stress for her and her husband. This situation is not unique, as many new parents find themselves in a similar predicament after the birth of a child.

Research shows that a significant percentage of adults with health care debt attribute at least some of it to pregnancy or childbirth. This debt can lead to difficult trade-offs for families, such as cutting spending on essentials or delaying important life milestones. The financial burden of medical debt related to pregnancy and childbirth can have long-lasting consequences for families.

Calls have been made to limit out-of-pocket costs for medical care related to pregnancy and childbirth to alleviate the financial strain on families. Legislation has been proposed in some states to exempt these bills from copays and deductibles, similar to federal rules for preventive services. However, concerns about rising costs have been raised by health insurers.

Heather Crivilare’s experience sheds light on the challenges that new parents face when dealing with medical debt. Despite paying off the debt from Rita’s birth, the family found themselves back in debt after Rita needed surgery for recurrent ear infections. This ongoing financial stress has influenced their decision not to have another child.

In conclusion, the issue of medical debt related to pregnancy and childbirth is a significant concern for many families. Finding ways to alleviate this financial burden is crucial to ensure that families can focus on the well-being of their children without the added stress of mounting medical bills.
Medical debt is a common issue for new parents, with about 12% of U.S. adults attributing some of their health care debt to pregnancy or childbirth. Women between 18 and 35 who have recently given birth are twice as likely to have medical debt compared to those who have not. This debt can lead to financial struggles, forcing families to make sacrifices and cut back on essentials. The average out-of-pocket costs for families with private health coverage related to pregnancy and childbirth are over $3,000, with even higher costs for those with newborns in neonatal ICUs.

For many families, these high medical bills can have devastating consequences, leading to cuts in spending on essentials, delays in education, and other financial hardships. Calls have been made to limit out-of-pocket costs for medical care related to pregnancy and childbirth, with proposed legislation in Massachusetts to exempt these bills from copays and deductibles. However, health insurers have raised concerns about potential cost increases.

One family’s experience highlights the challenges of dealing with medical debt after childbirth. The Crivilare family faced thousands of dollars in bills after the birth of their daughter, Rita, and struggled to keep up with payment plans while juggling other expenses. Despite eventually paying off the debt, they found themselves back in debt after Rita required surgery for recurrent ear infections.

The stress of medical debt has made the family hesitant to seek medical care, even for Rita, and has influenced their decision not to have more children. The hope is to put the financial burden behind them and provide Rita with the life they want for her. Overall, the issue of medical debt related to pregnancy and childbirth highlights the need for policy changes to alleviate the financial strain on families during this critical time.
Medical debt is a common issue for new parents, with many facing thousands of dollars in bills after childbirth. Heather Crivilare, a high school teacher in Illinois, experienced this firsthand after an emergency cesarean section. She and her husband struggled to keep up with multiple payment plans to cover their medical debt. A KFF poll found that about 12% of U.S. adults with health care debt attribute some of it to pregnancy or childbirth, leading to financial sacrifices and challenges.

Women between 18 and 35 who have recently given birth are twice as likely to have medical debt compared to those who have not given birth. Pregnant women often face anxiety about going into debt, especially if they already have existing financial pressures. The financial burden of medical debt can lead to difficult choices, such as forgoing necessary services or medications for themselves or their fetus. This highlights the need for better support for new parents facing medical debt.

Heather Crivilare and her husband, Andrew, anticipated some of the costs associated with pregnancy and childbirth, but were still overwhelmed by the medical bills that followed. Despite having robust health insurance, they faced thousands of dollars in out-of-pocket costs. Families with newborns in neonatal ICUs often face even higher medical bills, forcing them to make difficult trade-offs in their spending. Calls have been made to limit out-of-pocket costs for medical care related to pregnancy and childbirth to alleviate the financial burden on families.

The financial strain of medical debt related to childbirth can have long-lasting consequences for families, with many having to cut back on essentials like food and clothing. Parents may delay important life milestones like buying a home or pursuing education due to the financial impact of medical bills. Some states, like Massachusetts, are considering legislation to exempt pregnancy and childbirth-related medical bills from copays and deductibles to ease the financial burden on families. The goal is to ensure healthy mothers and children by reducing the financial stress associated with medical debt.

Heather Crivilare and her family were able to pay off the medical debt from Rita’s birth within a year, but they are now facing new medical bills due to Rita’s surgery for recurrent ear infections. The stress of ongoing medical debt has made Crivilare hesitant to seek medical care, even for Rita. Despite their challenges, the family remains hopeful that they can overcome their financial burdens and provide a good life for their daughter.
Medical debt is as much a hallmark of having children as long nights and dirty diapers. The Crivilare family, Andrew, Heather and Rita, 2, are pictured at their kitchen table in Jacksonville, Ill.

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JACKSONVILLE, Ill. — Heather Crivilare was a month from her due date when she was rushed to an operating room for an emergency cesarean section. The first-time mother, a high school teacher in rural Illinois, had developed high blood pressure, a sometimes life-threatening condition in pregnancy that prompted doctors to hospitalize her. Then Crivilare’s blood pressure spiked, and the baby’s heart rate dropped. “It was terrifying,” Crivilare said. She gave birth to a healthy daughter. What followed, though, was another ordeal: thousands of dollars in medical debt that sent Crivilare and her husband scrambling for nearly a year to keep collectors at bay.

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The Crivilares would eventually get on nine payment plans as they juggled close to $5,000 in bills. “It really felt like a full-time job some days,” Crivilare recalled. “Getting the baby down to sleep and then getting on the phone. I’d set up one payment plan, and then a new bill would come that afternoon. And I’d have to set up another one.” Crivilare’s pregnancy may have been more dramatic than most. But for millions of new parents, medical debt is now as much a hallmark of having children as long nights and dirty diapers. About 12% of the 100 million U.S. adults with health care debt attribute at least some of it to pregnancy or childbirth, according to a KFF poll. These people are more likely to report they’ve had to take on extra work, change their living situation, or make other sacrifices.

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Overall, women between 18 and 35 who have had a baby in the past year and a half are twice as likely to have medical debt as women of the same age who haven’t given birth recently, other KFF research conducted for this project found. “You feel bad for the patient because you know that they want the best for their pregnancy,” said Eilean Attwood, a Rhode Island OB-GYN who said she routinely sees pregnant women anxious about going into debt. “So often, they may be coming to the office or the hospital with preexisting debt from school, from other financial pressures of starting adult life,” Attwood said. “They are having to make real choices, and what those real choices may entail can include the choice to not get certain services or medications or what may be needed for the care of themselves or their fetus.”

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Crivilare and her husband, Andrew, also a teacher, anticipated some of the costs. The young couple settled in Jacksonville, in part because the farming community less than two hours north of St. Louis was the kind of place two public school teachers could afford a house. They saved aggressively. They bought life insurance. And before Crivilare got pregnant in 2021, they enrolled in the most robust health insurance plan they could, paying higher premiums to minimize their deductible and out-of-pocket costs. Then, two months before their baby was due, Crivilare learned she had developed preeclampsia. Her pregnancy would no longer be routine. Crivilare was put on blood pressure medication, and doctors at the local hospital recommended bed rest at a larger medical center in Springfield, about 35 miles away. “I remember thinking when they insisted that I ride an ambulance from Jacksonville to Springfield … ‘I’m never going to financially recover from this,'” she said. “‘But I want my baby to be OK.'”

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When she and Rita finally came home, a stack of medical bills awaited. One was already past due. Crivilare rushed to set up payment plans with the hospitals in Jacksonville and Springfield, as well as the anesthesiologist, the surgeon, and the labs. Some providers demanded hundreds of dollars a month. Some settled for monthly payments of $20 or $25. Some pushed Crivilare to apply for new credit cards to pay the bills. “It was a blur of just being on the phone constantly with all the different people collecting money,” she recalled. “That was a nightmare.”

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The Crivilares’ bills weren’t unusual. Parents with private health coverage now face on average more than $3,000 in medical bills related to a pregnancy and childbirth that aren’t covered by insurance, researchers at the University of Michigan found. Out-of-pocket costs are even higher for families with a newborn who needs to stay in a neonatal ICU, averaging $5,000. And for 1 in 11 of these families, medical bills related to pregnancy and childbirth exceed $10,000, the researchers found. “This forces very difficult trade-offs for families,” said Michelle Moniz, a University of Michigan OB-GYN who worked on the study. “Even though they have insurance, they still have these very high bills.”

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For her part, Crivilare said she wishes new parents could catch their breath before paying down medical debt. “No one is in the right frame of mind to deal with that when they have a new baby,” she said, noting that college graduates get such a break. “When I graduated with my college degree, it was like: ‘Hey, new adult, it’s going to take you six months to kind of figure out your life, so we’ll give you this six-month grace period before your student loans kick in and you can get a job.'” Rita is now 2. The family scraped by on their payment plans, retiring the medical debt within a year, with help from Crivilare’s side job selling resources for teachers online.

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But they are now back in debt, after Rita’s recurrent ear infections required surgery last year, leaving the family with thousands of dollars in new medical bills. Crivilare said the stress has made her think twice about seeing a doctor, even for Rita. And, she added, she and her husband have decided their family is complete. “It’s not for us to have another child,” she said. “I just hope that we can put some of these big bills behind us and give [Rita] the life that we want to give her.”