When Jackie Dorage and her husband, Corey Ellis, first tried to have a baby in mid-2019, the couple’s state of affairs looked vastly different than it does today. Dorage, who is currently unemployed, had just earned her teaching certificate, and Ellis, who is freelance, had plans to get full-time work with benefits. They left their Brooklyn apartment, where they lived with roommates, to buy a house in Atlanta and be closer to family. Four years later, the pandemic has caused them to rethink whether having a baby is still affordable, or even safe.
“Having a baby just seems a lot riskier now, especially with the abortion limitations,” says Dorage, now 35, the age after which a pregnancy is considered “geriatric” in the United States. Dorage, who lives in Georgia, where abortion isbanned at around six weeks, has witnessed the effect of those stringent restrictions. A close friend bled excessively in a bathtub during a miscarriage because a hospital would not admit her. Another friend, she tells me, died during childbirth. Dorage’s concerns align with recent American maternal mortality rates—the highest of any industrialized nation. In 2021, deaths of pregnant womenincreased by 40%in the United States. While COVID-related complications played a part, rates had been steadily on the rise since 2000.
Hiring a birth doula, an individual who assists with labor and delivery, is one way of attempting to ensure a level of care during childbirth.But it’s hardly an affordable option: costs range between $1,600 to $2,000. Factor in the expense of delivering a baby in a hospital, without insurance, and new mothers can expect, on average, to leave with a$18,865bill. (The median cost for a vagin*l childbirth is $14,768 and $26,280 for a C-section.) “If you want to be safe and healthy, you can spend your way out of this broken healthcare system, but it takes a lot of money to do that,” says Philip N. Cohen, a sociologist at University of Maryland. Under her private health insurance plan, it would cost Dorage around $8,000 to give birth in a hospital.(The average out-of-pocket cost for childbirth with health insurance is$2,854, but that varies by plan.)
Some clinics, advertised as luxury retreats, are working to address the maternal mortality health crisis by offering postnatal care geared toward reducing readmission and providing pain management immediately after birth.Boram Postnatal Retreat in New York City, for example, offers its guests a 24/7 care team, recovery support, nutritious meals, therapeutic services, and a plethora of other resources—but for a hefty fee. Guests pay up to $1,400 a night, with the average stay lasting five days,according to the company’s website. It’s a luxury that the typical expecting mother cannot afford, especially many Black and Indigenous women—those most at risk of pregnancy complications.Then there’s pricey postnatal services like massages and acupuncture, specifically designed to aid in recovery after childbirth. AtSparrow’s Nest Massage in Pasadena, postpartum massages range from $185 to $365.