Having a Baby in America?

[QueenofWhispers]

Hello Ladies,

I'm an American transplant in London and I had my fist DS in London. I had him privately as my insurance covered it. Husband has since changed companies and our current insurance will not cover maternity (very sad). 

I am now contemplating having my second child in Texas closer to my parents (mother is a doctor and I would feel more comfortable with her around). I'm expecting a private birth in Texas to be far cheaper than a private birth in London but I don't know how how much they would cost. I haven't spoken to my mother about it just yet as I am not sure if this is just too drastic a choice.

does anyone have any experience?

It depends on how much of your antenatal care you would need in the US I would think...

Private low-risk in London ranges from 5k-10k with complicated caesarian etc being upwards of that in some centres. However, that would cover your antenatal care as well. Have you factored in the cost of travel and/or relocation for yourself and family to the US for at least 2 months?

Also - check your policy carefully.
My DH's private insurance won't cover routine maternity, but will cover complications (eg if I need an emergency caesarian, I can be nursed in a private ward).

Worth a look...

If I go to Texas, I'll just stay with my parents or at an empty family property. Housing won't really be a problem. I'll have transport since my parents have a few extra cars.

As far as London:

£6k for hospital fees at the kensington wing at chelsea and westminster hospital

£7k for antenatal+ elective c-s

*£1k for every additional night spent in hospital

I had pre eclampsia last time around and I'm at risk again this time.

As far as I can tell:

American Hospital Price for a c-section will be:

$5,500 including two nights

Doctor one has specified: $2,250 for c-section and aftercare

epidural will be an additional $1k

**I am absolutely not sure if what doctor one has quoted me is indeed the right price as it seems quite slow.

husbands policy will only cover me if i have a termination. (totally anti-baby is this insurance)

Cripes... that's a horrendous policy!!!

It would seem on the face of it to be cheaper in the US - but where will you have all the scans etc? Are you happy to have those on the NHS (I assume you're entitled to NHS care if you are permanently resident in the UK?). Otherwise you'll need to factor those in. Also American OBs have a habit of liking to repeat things themselves and the costs add up (I was pregnant in the US 2 years ago, though sadly lost the baby before delivery).

I guess when I said costs, I mean not just housing, but time off work for you and other half, disruption to child care for your other DC. Flights if taken last-minute might be better taken in business class as you won't want to be cramped in economy beyond 32 weeks I wouldn't think...

If there have been complications such as pre-eclampsia in the past, you also need to have thought about what pre-term delivery might mean. It might mean an emergency NHS delivery. It might mean 5 weeks in a US NICU which runs to many 10s of thousands of dollars...

Don't envy you the choice. What does your mum say? COuld she be persuaded to take a leave of absence and stay with you for 6 weeks in London?

The bluebook price seems to be $8755 but that is based on a 4 night stay ( link ).

UK or US it probably comes down to if you get pre-eclampsia and how long your recovery is which is very hard to predict.

even if I do develop pre-eclampsia my insurance will kick in once the delivery is over; as long as I make it through delivery alive; insurance can then pay to save my life (this sounds so fatalistic).

The last time I ended up having to stay for 5 days...but that was because DS developed jaundice.

the costs and risks to the baby are likely to be higher... would check on your coverage here... and how you need to register a new dependent on the policy... the last thing you need is to have to fork out $50000 up front!!!

I had DS in NY four months ago. Our insurance covered it all, but it would have been about $7k it we'd paid. This was a straightforward vaginal birth (no drugs) and a two night hospital stay.

This was only the cost for the hospital though: the OB's services were extra (albeit a one-off cost for care throughout pregnancy and labor).

No idea if costs would have increased had I needed an EMCS or a longer stay...

I believe that if there had been a problem with DS then the related costs would have depended on his coverage as a dependant on our policy, rather than under the 'labor/delivery' part (since the instant he was born he became his own 'person' for the sake of the insurance).

Personally I'd avoid having ANY medical treatment in the US without insurance. Costs can escalate dramatically and you're not in a position to refuse tests/medicine. It could get very very expensive, very very quickly.

I'd rather fork out $5,000 than £5,000. The difference alone would cover a bugaboo and a rocking chair.

But would I really be saving?

Either way, I won't be having baby on NHS. (No offense to the NHS or anyone who has used the NHS--they are known to be wonderful, just not in my area).

Two things to remember:

a) airlines won't carry you after about 36 weeks, and it may take some time after the baby is born to do the admin to get the documents needed to fly him/her back. Now, I'm assuming that staying at your parents is a low cost option, but presumably not no-cost. How much is a trip of 4-6 weeks going to cost?

b) I hope this doesn't happen, but if your baby needs immediate paediatric treatment, how much could this cost?

I had a very straightforward birth in the US eleven years ago. I think it was roughly $2000 to the midwife/Ob for prenatal care, L&D, and postnatal, and $2000 to the hospital (18 hours, room, a nurse, and breakfast). I declined most tests and services, but didn't save any money as maternity is usually a package deal.

I had insurance, so it was a copay of about $200.

You should be able to track down typical charges via Google.

I would avoid. What if completions with you or baby?

A friend in America had her baby in January and he was born with a serious skin condition. He is American and luckily they have insurance but the bills are around £12 million already!! He's has to have private medical flights etc to specialist hospitals etc..

At least in the uk it's x price and any problems you can go NHS. If you have scans and antenal not private it would e cheaper.

The antenatal packages here aren't too bad, it's just that it doesn't seem to be much different to America and America is at 30%-60% cheaper upfront.

My parents have already offered to cover any extra costs (I generally don't leach off my parents but this could really help me save). I've got private antenatal care right now as it is--I'm just wondering if I could handle another missed hypertensive crisis here.

I'm in NM and had a child in December. it was an emergency c section, with a two night stay, pediatrician costs, it was just under $20k. (paid by insurance).
However, I think without insurance if you speak with the Dr ahead of time it could be a lot less.

Don't forget the pediatrician costs, as that part of the birth is not performed by the OB.GYN. That part of the bill was $1,900. Again on insurance, so I'm sure it would be cheaper cash.

Make sure you know what the actual hospital costs will be, as those may not be as flexible. my two nights cost about $5k.

Thanks Monsterchild

thats a really good tip. My mother has been saying similar, but I'm not entitled to the same prices she always quotes at me. 

For example, when she had us all her medical fees were often waived because she herself is a doctor and her doctors were her friends. So when she says 'they'll not charge you as much if you don't have insurance ' I do get a little worried. You mentioning it is making me relax a bit.

I might be speaking out of turn here but as an individual who works in the NHS I find your attitude to our healthcare system offensive. The NHS is one of the best in the world and is free. You are implying that you don't trust the NHS to care for you and deliver your baby safely. What part of the UK are you in for the NHS to be so poor in your local area? Should something happen before you are due to fly to the US, I suspect that when the NHS saves your life, you might think differently about our terrible health care system.

It is great that you have the money to go private if need be, but costs could be huge if something goes wrong, and you are likely to have to be in the US for over 2-3 months given travel issues (both yours and a newborn). Can your DM not come to the UK to support you, especially if you have one child already to care for? I wouldn't want to be alone for several months without DH, could he get this much time off work?

My private ob gyn tells all of his patients to give birth in an nhs hospital under nhs care.

He says this is the same for cancer care.

You won't get a private provider with the experience, expertise or facilities that you will with the nhs.

Oh and I agree with the great NHS care.

The only reason we went private but within a NHS hospital was that I wanted a private room and dh to stay as terrified of hospitals

orangeone

I'm happy that you work for the NHS and think highly of it. I am not a fan. It's my opinion and after living in this country and paying the tax I do---I feel it's my personal right to have my child where and how I like. I am asking people to tell me what their financial experiences of having a baby in America vs private birth here in the UK. If you have no experience then either lurk or leave.

The NHS has never helped me, my son or my DH. They failed to catch my pre-eclampsia last time around which is why I had to go private. They failed to check my son who had a horrendous staph infection and told us it was 'chicken pox'.

I find your attitude towards my needs offensive and feel like if you can't post positively you shouldn't post.

Careful about being too mean here, OP, or I might be tempted to tell you about the US private OB who failed to
Spot my ectopic or the UK private anaesthetist who failed to reverse my paralysis before he woke me from anaesthesia, leaving me with profound fear of doctors (I am one myself).

Everyone can have bad experiences in every system.

I'm sorry you felt things were missed by your care providers and I totally support your choice to pay whatever you feel you need to to feel confident in the care you receive. But please don't go around slagging off the whole of the NhS as if your experience is representative.

I am genuinely sorry that your experience of the NHS has not been positive and I am glad that you are in a position to have private medical insurance which means that you will never need to call upon the NHS for any possible health need that you might have. I sincerely hope you never need to use the NHS but being so negative and immediately dismissive about it is actually what I found offensive in this thread.

It is this attitude towards the NHS as a whole that undermines the system and perpetuates the myth that private is always better. This puts the NHS under threat at a time in the UK when it has never been more in danger of being causally thrown away for those that need it by those that have the money not to need it.

What you and many others probably don't realise is that most of the private doctors in the UK trained in the NHS and continue to work within it to some degree.
That most NHS hospitals despite not looking pretty have more up to date and research validated equipment and personal than their private counterparts.
And should anyone develop complications in a private hospital it will be the local NHS emergency room that picks up the pieces.

Consequently given your blanket refusal to consider anything NHS related, I would think your best option would be to return to the US to have your second child regardless of whether this might save you the price of a Bugaboo.

I shall shuffle off this thread now, apologies if my 39+6 pregnant self has offended. I just hope I'll be alright giving birth to my second child in the NHS in the next few days as unfortunately I'm too poor to have any other option but to give birth within the UK's terrible healthcare system...

I've had 5 births with care from the NHS plus neurosurgery and care for meningitis not to mention family members alive because of the NHS, I think the NHS are brilliant but it is anyone's right to go private if they wish and that is an important right.

The OP hasn't slated the NHS, only said that she doesn't like the experience she had in her area, that's her experience and her opinion, I'd hope she is allowed that.

The OP didn't slag off the whole NHS, she said "No offense to the NHS or anyone who has used the NHS--they are known to be wonderful, just not in my area."

I had baby #1 under the NHS in London and then, as already said, #2 in the US.

The obstetric care under the NHS was wonderful during labor/delivery: cannot fault it.

Having had private care in the UK for non-obstetric issues, I naively expected medical care in the US to be similar. It really wasn't. I could easily have been giving birth in an NHS hospital in terms of things like decor, food, quality of bed sheets, wait for scans (not during labor but H had a 3hr wait for my 20wk scan for example...). The only difference was that it was my OB (whom I'd worked with throughout my pregnancy) who delivered my baby: none of the NHS randomness.

Medically I don't think there was any difference whatsoever.

My point is that if you're going private for a 'better' experience, then you may well be very disappointed.

And aren't you allowed to elect which NHS hospital you want to give birth at? So the OP could choose a different hospital to the one she gave birth at first time around?

Also factor in wait time for a passport. US hospitals submit the birth certificate application whilst you're still there after the birth, and we then paid for an expedited passport service, but it still took around a month. You could be hanging out in the US for a long time.

Another thought: who's going to pay for your 6wk check up (you're likely to still be in the country then)? For the regular pediatrician appointments for the baby? What happens if, for example, your stitches don't heal and you need to be seen? Or you develop PND? Not nice to think about, but how will you get (and pay for) treatment?

The more I think about it, the more I think it's a silly idea to be honest unless you have unlimited funds...

When I had my baby in the USA, I tried really hard to recreate my NHS experiences.

Sadly, I was not able to engineer a home birth. Completely verboten in my state.

Antenatal care was really backward - similar to what I experienced with my PFB 10 years earlier. I seemed to spend a lot of time declining unnecessary tests.

I was lucky to have a midwife (CNM), who respected most of my wacky British choices (although could not muster a cup of tea and bacon sandwich at 10pm on a Sunday night).