When Amy Klobuchar gave birth a quarter century ago, her baby, who couldn’t swallow, was rushed to intensive care.
Though her daughter was being tested and fitted with a feeding tube, Klobuchar, now a U.S. senator from Minnesota, was sent home. Klobuchar’s insurance required new mothers to be discharged within 24 hours of birth. Despite her daughter’s precarious health, Klobuchar’s time was up. The future Democratic presidential candidate checked into a nearby motel and wore a rut—still in her hospital gown—between her room and the hospital so she could pump breast milk for her newborn.
Her experience eventually moved Klobuchar into politics. In fact, during this brutal election season, voters have a chance to vote for candidates whose political activism is fueled partly by their lived experiences as women, and how we support (or don’t) pregnancy and childbirth in this country could sorely use their attention.
Another Democratic presidential candidate, Elizabeth Warren, a U.S. senator from Massachusetts, says she has a plan to decrease maternal mortality among African Americans, which, according to the Centers for Disease Control and Prevention, is three times higher than the rate for white women. According to the same report, 700 women die from pregnancy-related complications each year. In fact, the United States is the only developed nation in the world where maternal deaths are steadily rising.
This is not to say a male candidate is incapable of addressing these issues. Still, if we’ve reached a point where our maternal mortality rate is more than double that of Canada, Sweden and Germany, there’s already been ample missed opportunity to step up. In December 2018, the Trump administration approved $60 million over five years meant to help states prevent maternal deaths. A big part of that funding is going to data collection, which is far from uniform from state to state. We don’t yet have the data with which to write good policy.
And while candidates are on the topic, it would be great if someone would look at the out-of-pocket costs of childbirth. The average cost of having a baby runs between $5,000 and $11,000, depending on where you live, whether the birth includes complications or surgery is necessary. A study from last year said the average cost for childbirth is $10,808.
Here again, American women are outliers. They can expect to pay more to have a baby than women spend anywhere else in the world, according to a University of Michigan study released last month. Obamacare (the Affordable Care Act) requires maternity coverage, but plans can charge copays and deductibles—and they do. According to the Michigan study, the average out-of-pocket cost for all births—vaginal or C-section—was $4,569 in 2015, the last year for which the figures are available. The percentage of women who had out-of-pocket expenses for childbirth climbed from 93.7% in 2008 to 98.2% in 2015.
The study found that out-of-pocket spending was higher for lower-income working women from 2008 to 2013, but that difference disappeared as higher-income working women started paying extra as more Americans started being covered by high-deductible insurance plans.
Policies that led to experiences such as Klobuchar’s drive-through delivery started in the ’80s, in part because mothers requested them. (For what it’s worth, when I had my son 35 years ago, I was home by the afternoon after his early morning delivery.)
By the time Klobuchar gave birth, insurance companies were calling the shots, and deliveries—regardless of the health of the child—meant a trip home before 24 hours had passed.
Today, Klobuchar’s daughter, Abigail Bessler, is a healthy young woman who works for the New York City Council. You could say all’s well that ends well, and while that may be true for this family, childbirth is the main reason women go to the hospital, and costs for those common, everyday visits are increasing, especially for women with employer-provided insurance policies.
We face an abysmal rate of maternal mortality, and we’re charging too much for childbirth. My queendom for a candidate who takes this seriously, before the election and beyond.
Susan Campbell teaches at the University of New Haven. She is the author of several books, including, most recently, “Frog Hollow: Stories From an American Neighborhood.” She can be reached at email@example.com.
Correction: An earlier version incorrectly reported where Sen. Amy Klobuchar is from. She is from Minnesota, not Michigan.