Posted by: Habladora | August 4, 2008

Paying for Pregnancy: Health Insurance and Motherhood

When I put out a call for submissions for a new series at The Feminist Underground on feminism and parenting, I thought I had a pretty good idea of what the issues would be – maternity and paternity leave, balancing work and family, and helping kids cope with the toxic gender and racial stereotypes rampant in our society. Then my friend Maggie sent me an article that introduces an issue I’d never even considered – the difficulties many women have obtaining the type of health insurance that could make pregnancy and childbirth safe and affordable. Maggie explains how her own struggles with this issue surprised her:

I’d been careful to choose a plan that provided maternity coverage, many don’t cover it at all. But there was fine print. No maternity benefits at all for the first twelve months, regardless of when the pregnancy starts. And after the first twelve months, I could only get maternity benefits if I had a family contract, meaning I had to have some other dependent on my plan, such as a child, spouse, or domestic partner. Otherwise I would have to apply for and pay extra for a maternity rider, which would still only kick in after those 12 months.

I had to wonder, why all the hoops? Whether it’s a boyfriend or a husband, joining a health insurance policy as a domestic partner seems like a pretty big decision. Moving back and forth between insurance plans isn’t something you do lightly and it involves a lot of factors. I was in no position to add my husband to my plan. Worse, I wondered what I would do if he wasn’t my husband. What if he wasn’t around at all?

You may be thinking this isn’t legal, but it is. In 1978, the Pregnancy Discrimination Act required business with 15 or more employees to have health insurance with maternity coverage. But it doesn’t cover individual plans like mine. It also may not cover a dependent spouse. And I’m not alone, approximately 9% of people in the US have these insurance plans that aren’t provided by their employers. That’s not counting the 15% of people who are uninsured. (Stats come care of the US census.) If you’re already pregnant and are looking for coverage, you’ll be denied. Pregnancy is generally considered one of those nasty “pre-existing conditions.”

You can read the rest here. I’m very interested in knowing how other women have dealt with this issue. Did you have insurance when you got pregnant? How was the pregnancy covered – were the co-pays reasonable? Were you on your own plan, or on your partner’s or parents’? In deciding whether or not to become pregnant, was health insurance an issue? What can we do to make sure that all women have access to affordable health care during pregnancy?



  1. When I was looking for health insurance after I graduated, I saw a few policies that would not pay for prenatal care, but would pay for hospital visits resultant from pregnancy complications. We won’t pay for preventative care–only for the care necessary because we didn’t cover anything.

  2. This is a huge problem – it encourages women not to go to the doctor during pregnancy unless there is an emergency. We should not be putting obstacles in the way of women getting the diagnostic and preventative care they need. It would be kinder and likely more cost effective to provide easy access to preventative care than to let problems progress unchecked. If conservatives still want to talk about ‘family values’ and a ‘culture of life,’ this is something that they need to address. In the meantime, let’s do what we can to get Obama elected so that we can start working on that universal health care.

  3. I didn’t have health insurance for either of my pregnancies and it was always a pain. Not only trying to get care, but then being looked down upon from some medical staff for it. I’m lucky to live in a state that offers great state insurance for uninsured pregnant women, even paying in full for my midwife which many of my friends with insurance through their jobs were not able to get. However that coverage ended as soon as the pregnancy ended, leaving me to cover after-care completely on my own. Caring for mothers after birth is just as important as before birth.

  4. Black thirteen insists on attempting to comment despite being rightfully banned. Apparently he thinks that pregnancy is a choice and therefore women should pay out of pocket for it. For this logic to work we’d have to ignore the high prices the medical establishment charges for basic services. A normal delivery can cost at least 10,000 dollars. This isn’t something the average person could pay up front. Further, insurance companies try to avoid paying for contraception as well. The U.S government is doing its damndest to eliminate abortion as a choice as well. In a culture that allegedly values life, why is it that pregnancy related services are cost prohibitive? Shouldn’t prenatal care cost the least if they’re so insistent on women giving birth?

    I just wonder if this logic applies to any other necessary medical services. If you need emergency care, should you have to pay for it yourself if you in any way contributed to your situation? Wore new shoes and tripped? Gotta pay for that shit. Had untreated high cholesterol? Hope you have enough for bypass surgery in your savings account.

    But again, this is from the same person who thinks that Viagra is a medication that ought to be covered by insurance–because clearly this is a pressing medical condition that is in no way influenced by the patient’s choice to seek treatment and everyone should pay for that. If you have any desire not to have children–or to have them, well that’s your business and you should pay. Men have erections to maintain you know, and it isn’t cheap.

  5. Well put, Ophelia.

    Maggie’s post actually discusses this a bit:
    “Pregnancy isn’t exactly an elective thing, like cosmetic surgery. And it isn’t exactly something you get, like an illness. It’s something between the two. It can be planned, it can be accidental, but for most of the women in the world, it’s a possibility. The fact that there aren’t completely effective ways to postpone pregnancy (the pill isn’t perfect, ladies) means there is no excuse for an insurance company telling you when they’ll let you get pregnant. When treated properly, pregnancy can be a lot less trouble than an illness. It’s for a limited time, it’s common, and the doctors who work with it are highly specialized. These should be reasons it’s fully covered instead of reasons it’s not.”

    Also, remember that while becoming pregnant is sometimes a choice, complications that might arise during pregnancy never are:
    “Even the policies that cover maternity benefits have a tendency to limit their payouts to only a limited number of doctor visits or a limited amount of benefits… Even a mother in a normal pregnancy and delivery with no complications could pay nearly $8,000 under certain individual policies providing maternity coverage. A c-section under the same plan goes up to nearly $10,000. A pregnancy with complications takes you over $20,000. Of course, none of these would apply to me if I got pregnant tomorrow, I’d be paying every penny myself.”

  6. When I got pregnant with my son, his dad and I weren’t married at the time. He couldn’t add me to his insurance plan because we weren’t married, so I had no health insurance thru either him or my job. I made too much to qualify for public assistance so that was out as well. When we did get married, he still couldn’t get me covered because it was now a “pre-existing condition” and not coverable. When our son arrived, the insurance magnanimously offered to cover 400.00 of his nursery care after the fact. We told them to take a long walk off a short pier.

  7. I agree completely with the mixed messages from insurance companies. No birth control, no abortion, no pregnancy. (Maybe they’re monks?)

    I think this is the kind of issue that could really get the right moving towards some of the health care changes people on the left are pushing. We all just make too many assumptions about what’s covered. Leaving it to the states only goes so far, as we saw earlier this year with Bush vetoing the children’s health care bill which helped to fund the state programs.

  8. I recently switched jobs and have insurance through my office for the first time. Our plans here do not cover any “pre-existing” conditions that happens within the first 12 months that you are on the plan. Even if a previously undiagnosed issue occurs 6 months down the line I’m out of luck because it did not wait a full year.

    Which leaves me wondering why the hell I am paying the insurance if i can’t use 3/4 of the benefits for a year? I wouldn’t pay for anything else for a year without seeing some benefit or product return

  9. No, they’re waiting for the rapture. No point in bringing new people into the world for them to be brought back to heaven, lol.

  10. Thanks for the timely post. I work as an independent contractor so I am responsible for securing my own health insurance. I cannot buy insurance in my state that will cover maternity care. I think one insurance plan will cover pregnancy complications, as another poster commented on this thread, but none will cover prenatal care and delivery. What is offered through some insurance companies (and it costs them nothing because it’s not really a plan and they just refer to these outside companies) is a pregnancy discount service and these are ripe for scams, as seen in several states offering these “services”. They will often tell pregnant women to go for services and that they will work with the doctors/hospitals at the end very end to negotiate a smaller lump sum. Problem is, women pay a fee for this “discount” up front and may never realize an actual discount. Also, some of these discount companies masquerade as insurance companies, misleading women into thinking they are covered when they are not.

  11. So where are the right to life fundies on this? Oh that’s right, they really don’t give a fig about the fetus after all, it’s just about controlling women’s bodies.

    Seriously, wouldn’t you think the right to life aholes would be all over this? But their not.

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