The Cost Of Having A Baby

Earlier this year one of my road test clients told me that she was pregnant. When I asked when the baby was due she gave me the exact date. When I asked how she knew the exact date she told me that she was scheduled for a cesarean delivery. When I asked if she needed a cesarean because of health concerns she responded; “No, I'm scared of the pain plus that date is more convenient for me.”

This girl was single, 18 years old, unemployed and currently living with her grandmother. She lives in an area and has been brought up in a culture where a two parent family is the exception. Odds are great that she will have the baby, leave it with her grandmother while she attends a semester or two at the local community college, drop out, find a job in retail, have more babies and never get married.

Somehow she can afford a cell phone and plan to keep in contact with her friends, although some will stop calling when the baby comes because she can't club hop with them as before. She has a big screen TV to watch at grandma's, has not missed a meal, seems well dressed but is considered one of the urban poor by government standards.

I hear stories like hers everyday. The guys are always telling me how their girlfriends are pressuring them to get married. They tell me they earnestly want to step up and “be a man” because they fathered a child but can't quite see the benefits of giving up their freedom. The girls, well, they tell me about maybe going back to school, wanting to find a job, and how their life has changed. I hear nothing about marriage.

To be honest with you, I got mad after my client informed me that she was going to have birth by cesarean because vaginal birth would be painful and it fit in better with her schedule. I was thrilled that she did not plan to abort a human life. However, I know that because of the values in her community, the government system that would enable those values, the greed present from top to bottom that benefits from the situation, this woman would suffer far more long term than a few hours of labor and delivery pain.

If this woman and/or her family and/or her boyfriend knew they would have to come up with the money to pay for the delivery of a baby would she still have gotten pregnant? Obviously there are many variables to consider here but knowing that there would be a $12,000 bill for a cesarean delivery which one had to personally pay off would seem to have at least some effect on a couples sexual behavior. Please don't call me naïve. Remember the old adage, it's naïve to keep doing the same thing over and over, or to enable the same behavior over and over and expect different results.

I don't know who was going to pay the bill for this woman's cesarean but most likely it will be covered by Medicare or our state's Medicaid plans. In Michigan there are different birthing options available for women with different costs. Vaginal delivery at home using the services of a mid wife costs between two to three thousand dollars. This includes both prenatal and postnatal help. Vaginal birth at a birthing center costs about $4300. Vaginal birth at a hospital averages $8000 and cesarean deliveries at a hospital averages $12,000.

One of my daughters is a traveling labor and delivery nurse. Eighty percent of the deliveries at the hospital of her current assignment are by cesarean. This seems really odd because a vaginal birth is safer if there are no complications and better for future fertility. Cesarean delivery is an operation which always carries some risk and the risk increases if the woman has had a previous cesarean. They generally have longer recoveries and a greater risk of infections, blood clots and adhesion’s.

If this is the case then why do doctors schedule cesarean deliveries for healthy women? Although there can be valid reasons a lot of the time it comes down to the convenience for the provider and the amount that they will be reimbursed. The doctors at my daughter's hospital want to work during regular hours. C-sections provide that flexibility. The time needed to deliver a baby vaginally or cesarean is about the same but reimbursement for the provider is greater for a cesarean. If the reimbursement rate is set by Medicare or Medicaid statistics show that odds of having a cesarean go up 3.9 per cent for every $100 dollars over the vaginal birth reimbursement rate.

Something is not right here. My poor lady is in a poverty cycle that is perpetuated by the very benefits she receives and will no doubt vote for in the future. She will take advantage of a system that will take advantage of her and there will be no end in sight to rising costs and expanding services except that all this requires real money and the money will eventually stop flowing.

Our country is over 17 trillion dollars in debt, a lot of it to China, but we also have 90 trillion dollars worth of unfunded liabilities. Politicians refuse to take ANY steps to stop our country from the inevitable implosion because whoever suggests any real financial cutbacks will get pounded by those that want to stay in power. Friends, a decrease in the rate of expansion does not equal a decrease in debt. The refusal to fund promises now but rather leave them to the next elected officials will never decrease the amount of those promises.

Politicians who promise to give you everything you want without actually funding everyone of those promises should be lined up in a public square and shot, trillions of times. We the people should be told we have X amount of money to spend. Some must be used to pay off our debt. Some must be set aside to fund our promises. The rest should then allocated by making the hard decisions necessary.

We the people do not have the right, under the banner of fairness, to unfairly tax those who have more than us. The executive level of the government should not have the ability to raise money by printing more, devaluing and thus draining the savings accounts of we the people.  We are all in this together and the first thing we require from our government is honesty and responsibility, not massive growth and altruistic social change. 

I fear, because human nature is selfish, greedy and pleasure seeking.  The balance to that is not a society becoming increasingly devoid of Judea/Christian values.  Faith, morals and common sense financial decisions are being driven away from the public sector by a constant onslaught of mockery, threats, intimidation and character assassination.  There is a debt to pay for all of those attributes.  A society that remains in debt is going to collapse.  There will be chaos in the streets and the gift that was passed on to us by our founding fathers will be replaced by a despot who will change all that we hold dear.

Faith, hope and love means that we have a responsibility to help those around us.  Human nature wants us to abrogate those responsibilities to a third party.  There is merit in that what we can do together can be greater than what we can do alone.  But when the third party has a life of it's own, when we lose a voice in its  management and direction, when it becomes one of the biggest employers, when it can be used to silence our voice, when it demands an ever increasing share of our daily labors, when it spends more than it takes in, when it demands that we accept what God tells us to reject, then we need to rethink this whole deal and let our voices be heard.