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The Bizarre Costs of Birth

Photograph by Getty Images

As a recent New York Times article explained, putting a price on your birth experience is an exercise in minutiae. Every pill, procedure and sidelong glance from a nurse has a cost, billing code and pre-negotiated reimbursement rate for those lucky enough to have health insurance.

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This strategy of billing down to a few tiny drops of an over-the-counter antiseptic used on a freshly snipped umbilical cord has created a system in which U.S. births are the costliest in the world, despite the fact that hospital stays are typically shorter and prenatal and postnatal care are less intense than in other countries where birth is significantly less expensive.

Surprisingly, U.S. hospitals may have overlooked a lucrative billable: the screams of laboring mothers. The Washington Post recently reported that hospitals in Zimbabwe have been charging laboring mothers $5 every time they scream.

According to a report from Transparency International, which studies corruption around the world, hospitals in this southern Africa nation justify the screaming fee by saying it raises a false alarm for doctors and nurses. If it sounds like a small price to pay for a little release during the ring-of-fire phase while the baby crowns, consider this for perspective: the average annual income for a family in Zimbabwe is $150 a year. That's a little over $10 a month. Considering a silent birth costs $50, throw in a few irrepressible screams and the family could be out half a year's wages.

It seems this is a bit harder to bear than the burden of American families who are out half a year's (or more!) wages for getting the scream-suppressing epidural and/or a C-section. Average cost of a vaginal hospital birth is about $30,000, while average billing for a C-section is $50,000. Insurers pay out around $18,000 for the former and nearly $28,000 for the latter, according to the Times.

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Now that I put it that way, it seems like a good idea for those studying corruption around the world to pull back the curtain on what Americans get charged to have babies, which practically made me scream when I read it.

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