Six-figure baby: The hidden cost of a high-risk pregnancy

In May 2024, two months before her due date, my wife’s water broke, beginning our daughter’s birth story with an introduction that led to a six-figure ending.

As we raced to the hospital, fear filled our hearts. Based on age and data showing Black women experience high rates of pregnancy complications, we knew this was a high-risk pregnancy—geriatric, doctors called it.

When we arrived at the hospital, doctors quickly ushered us to the high-risk delivery wing. A flurry of tests, specialist visits and scary conversations followed. Our questions were focused on health, we never asked how much anything would cost. Healthcare is one of the few purchases people routinely make without knowing the cost in advance.

Although Tosha’s water broke, she wasn’t in labor. That was good news. Doctors said every moment the baby remained in the womb would help. The one caveat was heart rate disruptions. Any sign of trouble and they would perform an emergency C-section.

The average cost for pregnancy, childbirth and postpartum care in the U.S. is about $20,000, with out-of-pocket costs averaging about $2,700, according to the Health Care Cost Institute. Complications such as emergency surgery, extended hospital stays or NICU care can cause expenses to skyrocket.

The journey from conception to delivery can also be expensive. We said yes to pretty much every test we were offered from the moment we learned Tosha was pregnant.

In the first trimester, a test revealed that Tosha had uterine synechiae, or scar tissue in her uterus, which could threaten the pregnancy. I can still remember the fear in Tosha’s voice when we discussed the news at our kitchen table. “We’re not out of the woods,” she said as tears that were building behind her eyes began to fall.

The diagnosis led to a recommendation to see a specialist who wasn’t covered by insurance. We got the test and were told the synechiae would likely have little to no impact on the pregnancy.

Soon we forgot about the fear we felt at the kitchen table and the test. But the billing department at the specialist’s office remembered.

The remainder of the pregnancy was marked by typical occurrences—midnight cravings, back pain, and crib assembly.

Then, on a warm summer night, Tosha’s water broke at the same kitchen table—still stained with the tears from the first time we felt the fear of a pregnancy in peril.

On May 22, after Tosha spent two weeks tied to hospital monitors, doctors decided it was time to perform a C-section.

Avery Kiekow entered the world and became our world the way the sun rises: slowly, and then all at once.

She weighed only 4 pounds. We didn’t get to hold her in the delivery room. She went straight to the NICU. When we finally got to hold our daughter, a feeding tube was wrapped around her tiny frame. Avery spent two weeks in the NICU, bringing our total time in the hospital to nearly a month. Still, we never discussed the cost. None of it ever felt like a choice.

In the end, our pregnancy price tag topped $200,000. Thankfully, insurance covered most of the cost, but some families aren’t as fortunate. Medical debt is a leading cause of bankruptcy in the U.S. Navigating a high-risk pregnancy and premature birth is a fast way for the bills to mount.

If you’re expecting a baby, prepare for the unexpected, including the cost. Research delivery costs at your hospital, understand your insurance plan and, most importantly, discuss the potential costs before you’re in the delivery room.

Aside from the scary start, our six-figure baby’s life has been pretty normal—first steps, first words and many moments that remind us why she’s priceless.

Anthony J. Kiekow is an Associated Press award-winning writer.