What It Really Costs To Lose A Pregnancy In America

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.

Here's the bill with that shocking total for my day in the emergency room.

If you have a story to share, send an email to costofcare@refinery29.com with a picture of your bill, cropped or redacted however you feel comfortable, and tell us a bit about what happened.

What state do you live in? What kind of medical care did you need, and what kind of facility did you go to, hospital, clinic, or otherwise? How much did it cost, with or without insurance? If you had to travel out of state, that all counts! Share your #CostOfCare story, and let’s keep this conversation going.
My miscarriage cost nearly $1,000 out of pocket, since I have excellent health insurance.

"My miscarriage cost nearly $1,000 out of pocket, since I have a deductible but excellent health insurance.

"I first had to have a doctor's visit to confirm the pregnancy loss. This cost $450 to see a midwife and have an ultrasound. I am lucky because my practice gave me the option of an in-office D&C with local anesthesia. The practice I used to go to only performs D&C's at the hospital which costs way more. My out of pocket costs for the D&C itself were $556."

It turns out, the genetic testing is not covered by insurance.

"I had my third miscarriage in April. I knew something was wrong the minute I saw the ultrasound (at nine weeks), and the doctor confirmed that it was not a viable pregnancy. My options were to either schedule a D&C or go home and wait to bleed.

"After a week of waiting (and continued morning sickness), the doctor recommended I have a D&C, since the placenta was continuing to grow and it didn't look like my body was going to naturally abort the contents of my uterus anytime soon. He also recommended genetic testing since it was my third miscarriage even though I am young and have had a healthy baby already (17 months old now).

"I live in New Jersey, and have premium insurance. I was floored by the bills I am still paying. It turns out the genetic testing is not covered by insurance. So far the total out of pocket cost has come out to $7,666.41. Here's how it breaks down:

"Hospital: $574.55
Anesthesiologist: $331.90
Hospital Pathology: $9.96
External Lab: $6,750"

I was responsible for $2,000 out of $10,000.

"I experienced a miscarriage last year. It was my first pregnancy, and I was 28 and healthy. We have been together now for over 10 years, so when we got pregnant, we were ecstatic! At 11 weeks, we were able to do genetic testing that allowed us to know the sex of our baby, along with some abnormalities, if there were any.

"At 12.5 weeks, we found out we were having a boy. A baby boy. I always wanted to have a son first. My fiancé wanted a boy too! We definitely wanted healthy. But a baby boy! How could we be so lucky??

"At the end of the 13-week mark, which happened to be right before New Year's, the doctor tried to hear the heartbeat with the Doppler. He couldn't find it. With the ultrasound tech being gone for the holiday, he pulled out the old machine that uses a wand on the belly. This was my first time seeing an ultrasound in person. The doctor specifically started, "here's the head, the sac, and you see this little flutter... I'm 80% sure that's the heartbeat, but I'm not an ultrasound tech." I swear on my life, that's what he said.

"We googled and read that it was normal to have a hard time finding the heartbeat around 13 weeks. It's all about positions, etc., so we stopped worrying and decided to enjoy our New Year.

"On Jan. 2, we attended a family holiday party, where we announced our pregnancy. We discussed baby names. This was also the day that I started having a little bleeding, which google said could happen; a cousin mentioned she bled through her entire last pregnancy. I called my doctor who said if I started bleeding super heavily, go to the ER.

"That night, I lost my son. I knew I did the moment I started passing clots.

"The ultrasound the next day confirmed. I was absolutely traumatized and heartbroken when the doctor told me, and gave me two options: have a D&C or try to pass the sac on my own, at home. He did warn me that passing it on my own could be painful. I was numb. I decided to try to pass it on my own.

"After two days of just bleeding, I had to get a D&C, so I could go back to work, and two months later, I received a bill in the mail. I was responsible for $2,000 of the $10,000 total. Twist the knife deeper in the wound, America."

Altogether, my two miscarriages cost $28,848.

"My first miscarriage occurred on January 23, 2017, exactly one week after my husband and I had seen our baby's strong and healthy heartbeat for the first time. It was our first pregnancy. We had gone in for my nine-week visit and stared up at the screen, as the ultrasound tech announced, "I'm sorry, but there's no heartbeat." I told my husband that I could not go home and let nature run its course. We scheduled a D&C for the next morning.

"Fast forward six months, and three rounds of Clomid, I'm nine weeks pregnant again and alone at a conference halfway across the country when I start spotting. I call my OB who recommends that I find an in-network hospital and ask for a sonogram. I Uber my way to the closest ER and undergo an abdominal and transvaginal ultrasound, pelvic exam, and a handful of blood tests.

"Three hours later, the doctor confirms my worst fears. I had miscarried again. My OB had warned me against getting on a plane if there was a chance that I was actively miscarrying, so I requested a D&C. I was admitted to the hospital 1,237 miles from home, and a D&C was scheduled for the next morning.

"By the claims that have been process so far, this out-of-town treatment cost $23,264. Altogether, my two miscarriages cost $28,848. I was responsible for a $1,000 deductible and $4,000 in coinsurance."

"It's just so incredibly unfair."

"I live in Minnesota and work for the state so luckily I have great insurance. I had a "missed abortion" miscarriage and had a D&C at the hospital; the total for care came to $5,728.90, of which I owed $210. The care I received was amazing and I know I'm very lucky to have access to affordable quality care. My heart really goes out to women and families who don't...it's just so incredibly unfair."