I’m Pregnant. What Would Happen If I Couldn’t Afford Health Care?

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Hanna Barczyk for NPR

Hanna Barczyk for NPR

On Christmas Day, I found out that I was fraught. It was the best present I could have hoped for. My conserve and I have wanted to start a syndicate for years, and we could not wait to share the news with our love ones.
But my initial exhilaration cursorily turned to anxiety. As a doctor, I knew many of the things that could go amiss. I wanted to do everything I could do to have a healthy baby. I found an obstetrician and made an appointment for my inaugural prenatal inflict. I was sol relieve when I saw the baby ‘s heartbeat on the sonography. My lineage was drawn to check for anemia and thyroid problems. I had the rest of my recommended first clean-cut tests, including a Pap smudge and testing for HIV and sexually-transmitted infections. The appointment besides provided other valuable information. I talked to my sophisticate and his nurse practitioner about combating dawn illness and eating alimentary meals. I do n’t smoke, but if I did ( as 1 in 10 pregnant women do ), they would have counseled on why and how to quit. My providers asked extra questions to assess for domestic violence, a concern for up to 1 in 6 pregnant women .

tied though I ‘m a relatively healthy 34-year-old, I have several checkup conditions that call for more patronize monitor. My doctor recommended that I return every two weeks for a physical examination and sonography. Closer to delivery, I should plan to see him every workweek. I did n’t hesitate to follow my doctor ‘s recommendations. I have excellent health insurance with no copay for sophisticate ‘s visits and a minimal price for tests. But what would I have done if I did n’t have indemnity ?

One obstetrician visit would cost $ 150. With an sonography each time, it would be $ 400. A soft diet defame would cost $ 53. One set of rake tests would add another $ 300. All told, my prenatal caution with all visits and tests included would be over $ 10,000. This is not counting parturiency and pitch, which in my area is estimated to be up to $ 30,000 for a vaginal give birth and $ 50,000 for a cesarean section. Facing these astronomic costs, would I be forced to pick and choose care based on my ability to pay, rather than the best available medical evidence ? What services would I forgo, and with what consequences ? These are not hypothetical questions. The Republican proposal to replace the Affordable Care Act would drastically cut Medicaid, which provides health coverage for women, children, seniors, and individuals with disabilities. In Baltimore, where I serve as the health commissioner, the majority of fraught women are insured through Medicaid. Thousands of low-income women could lose coverage and have to pay out-of-pocket for services ; others who have insurance may only be able to afford bare-minimum plans that do n’t cover needed services .

As a doctor who worked in the ER before the Affordable Care Act went into effect, I have seen what happens when patients forgo needed interventions because of cost. I have treated patients who end up in irreversible coma because they could n’t afford capture medications. I have treated people who died from drug overdoses because their indemnity did n’t cover addiction treatment. And I have treated women who were priced out of prenatal care, whose babies suffered the consequences in the human body of preventable diseases, prematureness, birth defects, and even death. Prenatal and motherliness worry are considered an necessity benefit under the Affordable Care Act ; the American Health Care Act introduced in Congress last workweek does n’t address that because it can only cover fiscal topics. however, the bill does propose cutting essential benefits for Medicaid recipients. And it aims to defund services to Planned Parenthood clinics that provide parentage control and generative services. That will only result in more unintended pregnancies. There are those who attribute these consequences to choice : Is n’t it a woman ‘s option to become fraught ? But closely 1 in 2 pregnancies in the United States are unintended. For women whose insurance stops offering motherliness coverage, and for the others who do not have at all, what kind of “ choice ” do they actually have, and at what price ? Women without prenatal caution are seven times more probably give birth to premature babies, and five times more probably to have infants who die. The consequences are not alone poor health, but besides higher monetary value passed down to taxpayers. The average aesculapian cost for a pamper with problems of prematureness is $ 79,000, compared to $ 1,000 for a healthy neonate. Hospitalizations for a premature baby in the first year can be upwards of $ 500,000 ; intensive care can cost in the millions.

conversely, studies have shown that for every dollar spent on prenatal care, there are expected savings of about $ 5. early interposition saves lives and cuts price. Our health concern organization should incentivize prevention and deter rationing of needed services. Like other expecting moms, I hope more than anything to have a healthy child. I am fortunate to have access to high-quality, low-cost health care. unfortunately, that ‘s not the case for all mothers of the closely 4 million babies born in the U.S. each class. Our nation needs to safeguard the wellbeing of our families. The future coevals, and the generations to come, depend on it. Dr. Leana Wen is an hand brake doctor and the health commissioner of Baltimore City. She is the author of When Doctors Do n’t Listen : How to Avoid Misdiagnoses and Unnecessary Care. And she ‘s on chirrup : @ DrLeanaWen