What It Really Costs To Lose A Pregnancy In America

Photographed by Eylul Aslan.
When I had a miscarriage last month, there was a lot to be scared and sad about.
I had spent two years trying to conceive. Two years of confusion and false starts, of tests, of acupuncture and herbs, of brave smiles, and tears, and trying to talk myself out of my deepest desires. I had turned to IVF. I felt like a warrior woman shooting myself up with hormones each day for months: 74 shots, two big Sharps containers full. Proud of my own strength.
And I got pregnant on my birthday! Everyone told me that was lucky, and I wanted to believe it was. I felt good, the baby was growing; we saw the heartbeat and cried with joy three separate times. At the last visit, I even saw the baby moving around on the screen (a dancer, the ultrasound tech joked). Finally, a sense of excitement, possibility, and love was growing, too.
Then, on June 12th — my 12th pregnant Monday — I stood up to leave a meeting and felt a rush of blood. By the time I got to the bathroom, my pants were soaked and I was in a full panic. My doctor told me I had to go to the ER. At midnight, I learned that my baby’s heart was no longer beating, and I had a choice: medication or an abortion procedure to remove the remains of my child. I didn’t want to make a choice in that moment, didn’t want to say goodbye. But I had to.
This experience was incredibly traumatic for me — both physically and emotionally — but I kept thinking how lucky I was to be able to receive care without fearing for the bill that would come. To have loved ones around me. To have health insurance.
A month later, as I'm coming out of the darkness and beginning to envision how my life will continue to unfurl ahead of me, the hospital bill arrived.
The grand total: $40,374.06. That’s how much it cost me to rush to the hospital — in a taxi, not an ambulance — bleeding profusely just shy of my second trimester, and stay there for 20 hours total.
While at the emergency room, I had an ultrasound to confirm this was what they not-at-all euphemistically refer to as “fetal demise.” I had one dose of misoprostol and then another, in an attempt to expel the remains from my body. When neither did the trick, and I was still bleeding, my doctor and I opted to move forward with a D&C. The procedure took 30 minutes.
Up to 25% of pregnancies are said to end in miscarriage; of those, as many as 50% may require a D&C. While not all of these take place in the emergency room, roughly 500,000 women a year find themselves in the ER with bleeding related to pregnancy loss. In other words, while it felt shocking and devastating to me, my experience was not all that unique. This $40K bill is the result of some pretty routine stuff.
It felt important, almost like a sign, that my hospital bill arrived on the same night that Senate was voting on whether or not to unravel the healthcare system as we know it. Because at the bottom of my bill, which you’ll see in the photo, is the balance that I owe: $150. The procedures I underwent while losing my pregnancy rang up to over $40,000, and thanks to my insurance, I will pay $150, which, by the way, isn’t nothing.
For the majority of Americans, with a median salary around $55,000 a year, this type of health care could bankrupt a family without insurance — and it can be tough to afford even with it.
The Senate has begun to debate repealing and replacing Obamacare, but Tuesday night voted down the broad repeal (the one that would’ve left some 22 million Americans without insurance). Next, the so-called "Skinny Repeal" was struck down. This may feel like a victory for now, but Republican lawmakers have shown themselves to be committed to undoing the Affordable Care Act, and we can't be sure what's coming next. And the harsher truth is, even with insurance, certain aspects of women’s health are excruciatingly expensive. Many abortion procedures that are “elective” — meaning you chose it, even if you made that choice after receiving a grave medical diagnosis — aren’t covered by insurance at all.
That’s why I’m telling my story now, and I hope you will, too.
I believe that sharing our stories can create change. That we can turn our pain into purpose. With more stories like this, we can continue to draw attention to this important issue — to help lawmakers see the real impact of their choices.
Have you experienced a pregnancy loss, an abortion, or any other concern due to that pre-existing condition called womanhood which ended up costing a crazy amount of money? Tell us about it. (Also, my heart goes out to you.)
Piera Gelardi is the executive creative director and cofounder of Refinery29; keep reading to see her hospital bill, and more stories submitted by readers like you.