The average cost of childbirth in the U.S. is close to $19,000, while those with private insurance will pay $3,000 just for the delivery of a baby. Families whose babies require neonatal intensive care pay even higher costs: almost 10% of these families pay more than $10,000 out of pocket for childbirth. Some families are surprised to find that contraceptives and even abortion are covered under their health plan, but not childbirth.
“Maternity care in the United States is uniquely expensive,” Foster and Day write. Ireland guarantees free maternity care at public hospitals, while in Finland childbirth costs are almost free.
Foster and Day’s proposal calculates the financial impact. There are about 3.6 million births each year and paying for each of these births costs on average $5,000, resulting in a total estimate of about $68 billion. They note that 42% of births are already paid for through Medicaid, leaving $39.5 billion unpaid.
“If an additional $60 billion were allocated to assist with perinatal care, baby supplies, and expanded paid leave under the federal Family Medical Leave Act program, the total additional cost to Make Birth Free in America would still be less than $100 billion per year,” their white paper says.
This represents a “mere fraction of the federal budget.” The country has sent $100 billion to Ukraine in the last year, while federal spending for education is $250 billion. The federal health care spending is about $1.6 trillion.
“America’s mothers and infants are worth the marginal spending increase it would take to Make Birth Free,” Foster and Day argue. “There is no better investment than healthy mothers and a thriving next generation.”
Comprehensive funding for free childbirth would reduce pregnancy and childbirth costs overall, they continue, attributing high financial costs to “misaligned financial incentives” in health care. Cesarean section births are performed in the U.S. two to three times more often than medically necessary, even though they are more expensive and riskier than vaginal birth.
Foster and Day also propose to incentivize using midwives or doulas for pregnancies without complications. Home births and birthing centers would lead to more savings, they say.
The two pro-life leaders defend the idea that childbirth should be free rather than subsidized or provided based on proven need. Administrative burdens and scrutiny of personal finances impose “significant barriers” to many pregnant women in need who would otherwise participate.
Further, high costs deter women from seeking prenatal or postpartum care, which increases the risk that needed medical interventions could be delayed. Reported maternal and infant mortality rates in the U.S. are also much higher than in comparable countries.
Several states of very different political leanings already provide pregnancy support funding. Day noted initiatives in Texas, Minnesota, and Arkansas.
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The Texas Legislature expanded Medicaid support for eligible pregnant women from 60 days to six months after giving birth. To promote alternatives to abortion, the legislature more than doubled funding to support pregnant women and pregnancy centers, allocating up to $100 million in its latest two-year budget. Minnesota expanded Medicaid support for eligible pregnant women from 60 days to 12 months after giving birth. Democrats for Life endorsed Arkansas’ Every Mom Matters Act, which passed in 2021 with bipartisan support. The bill funds a telephone hotline to connect pregnant women with public and private resources to support them and their unborn babies.
“We have worked and are working with state and national leaders from both parties on pregnancy and parenting support, including Sen. Mitt Romney and Sen. Marco Rubio,” Day said.
Foster told CNA that federal precedent for such funding includes a Nixon-era program for people suffering from kidney failure, as well as HIV/AIDS prevention efforts.
“Congress is changing. There’s lots of new energy and there are some bold members in both the Senate and the House,” Foster said. “We see a future where making birth free is picked up by a few brave members as a commonsense policy that deserves to ultimately be enshrined as law.”