As birth rates in America continue to fall, the Trump administration is mulling over offering baby bonuses.
But I have a better idea: Let’s simply make births free. That way, young couples can walk out of the hospital with their cuddly newborn without worrying that a huge bill from the hospital will be waiting in their mailbox when they get home.
This is personal for my husband and I, since we’re expecting our first child. In fact, our baby boy is due in just a few weeks.
Early on in my pregnancy, I calculated the estimated cost for my prenatal care and delivery at a local birth center. After insurance, the total came to a little over $2,500. Not bad, I thought, knowing that it could easily have been several times that amount in a hospital setting.
The average American, who hasn’t had a baby recently, doesn’t realize how much birth costs in today’s America, even with good, private insurance, which my husband and I have.
So while Washington debates whether pro-natal policies are necessary, let’s answer the question that weighs on many couples’ minds: How much does it actually cost to have a baby in the United States?
Before we dive into the numbers, it’s worth noting that my husband and I aren’t ones to put a price on bringing a new baby into this world. In fact, we’re hoping to be blessed with a large family, with the faith that God will make this possible for us if it’s His will.
But that doesn’t mean we’re oblivious to the financial aspect of childbirth. We’re also aware that the cost can be a make-or-break factor for many.
A recent survey found that over half of Millennials and Zoomers (Gen. Z) have decided to delay having children. Of this number, 86% cite finances as the primary reason.
Another survey, this one from Pew Research, asked childless adults over 50 and childless adults aged 18-49 why they don’t have children. For adults over 50, about 1-in-10 (12%) cited finances as the main reason they did not have any children. From those aged 18-49, this figure was three times higher at 36%. Most of this age group would still be able to have children if they wanted to, but they don’t. And the main reason they don’t, they say, is because they “couldn’t afford to raise a child.”
Knowing these facts, are we surprised that the fertility rate in the U.S. is still falling? As of 2024, our nation’s fertility rate sits at a meager 1.63, well below the replacement rate fertility of 2.1 children per woman.
Having a baby in the U.S. is expensive right off the bat.
Without insurance, the cost of birth at a hospital can range from $14,000 to $30,000, assuming no complications. A natural (vaginal) birth averages $14,768, while a cesarean section runs to $26,280 or so.
Private insurance reduces the average out-of-pocket cost for a natural birth to $2,655 and a cesarean section to $3,214.
However, keep in mind that these are averages, and many couples will wind up paying more. According to a study by the American Academy of Pediatrics, about 17% of couples with private insurance will still face a bill of over $5,000 for a birth. And heaven help couples whose babies require extra care in the hospital’s neonatal intensive care unit (NICU). They will be taking a five-figure hit to the family economy.
Medicaid covers 42% of all births, but the relief it offers from the high costs of childbirth mostly goes to low-income, single moms. The Institute for Family Studies points out that “the benefits cliff and marriage penalty associated with Medicaid means that a mother with a lower income gets free care, while married women… whose moderate income may put them just above the eligibility threshold—might pay thousands of dollars to give birth.”
At the end of the day, a majority of mothers don’t receive Medicaid assistance for childbirth and most, if not all, married mothers are left out. Of course, married moms are exactly the ones you want having more children.
Could making all births free in the U.S. for all mothers positively impact our birth and fertility rate?
I’m not the only one who thinks so.
Pro-life groups have been pitching this idea for a while now. As one example, Americans United for Life wrote up a full Make Birth Free report in 2023, outlining the costs and benefits, as well as a “roadmap” for rolling this policy out at the Congressional level.
That same year, then-Senator J. D. Vance voiced support for the concept in a post on X that stated, “We sent over $100b to Ukraine in the last year. For half that, we could make birth free in this country, end the surprise billings that devastate families with newborns, and possibly save the lives of a lot of new moms.”
Childbirth incurs the biggest, upfront cost for having a child. Eliminating this cost for U.S. couples who see it as a major obstacle to having children would make more of an impact than an unconditional baby bonus, which may not even cover the hospital bill.
Making birth free won’t magically raise the U.S. birthrate back to replacement, but it would be a good place to start.
