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Josephine Anderson, who posted a video on her Instagram @fosterthevalley, outlined the costs of her uncomplicated vaginal birth, and TBH, it was shocking.

The financial breakdown of her experience (with Cigna for insurance):

• Routine office visits (including 2 ultrasounds): $1,266
• Labs: $3,440.81
• NIPT genetic testing: $15,319.36
• Anatomy scan: $1,270
• RhoGam: $360
• Hospital for mom: $23,722.10
• Hospital for baby: $7,402.80
• OBGYN for delivery: $5,000
• Epidural: $5,720
• Breastfeeding support: $2,589.78
• Pediatrician: $209

Josephine’s video warranted thousands of comments, most of which were appalled by the costs of her experience:

“This needs to be shared in SexEd classes,” one commenter wrote.

“The US medical system is BROKEN,” another said.

“And people are still confused why more women are choosing to remain child free… we literally can’t afford it,” another user commented.

Brit + Co spoke with Wendy Colson RN, IBCLC and CEO/Founder of BOOBIE Superfoods to gauge if Josephine’s costs were typical for the care she received. Colson has significant insight into how insurance works not only from an employer’s perspective, but from personal experience as a patient with breast cancer.

“The $4,788.98 net amount she mentions is realistic given that her deductible was $3,000. If she had chosen a plan with a $1,000 deductible – which is a common ceiling for good coverage – the same scenario would have cost her around $2,789,” Colson said. “The video highlights the importance of understanding what you're getting with an insurance plan, especially when you anticipate major life events like childbirth.”

Colson primarily attributes unanticipated costs for medical care (like in Josephine’s case) to patients that choose their insurance plans with, well, no real plan.

“Many [people] opt for the [plan] with the lowest paycheck deductions without fully evaluating the benefits,” Colson said.

There’s often a tradeoff between paying less per paycheck and receiving your desired benefits: for example, if you elect to contribute less money towards your insurance per paycheck, you may end up paying more out of pocket for things like doctor’s office visits and prescriptions.

“Making an informed choice is key to saving money in the long run,” Colson continued. “In short, it's crucial to consider both the immediate costs (like paycheck deductions) and the potential future costs (like deductibles and copays) when choosing an insurance plan.”

Another major cost Josephine mentions in her video was 12 weeks of unpaid maternity leave, which cost her a total of $18,000 (in lost income).

Per the passing of the Family and Medical Leave Act (FMLA) in 1993, moms have a legal right to up to 12 weeks of unpaid maternity leave. The U.S. Department of Labor notes that the act was designed to help employees balance their work and family responsibilities, accommodate the legitimate interests of employers, and promote equal employment opportunity for men and women.

It all sounds great until you realize the time off is indeed unpaid, which doesn't really aid in the amount of money parents end up owing after all is said and done in the pregnancy and childbirth processes.

Only 13 states plus the District of Columbia offer paid maternity leave. When you compare the United States’ laws to that of other industrialized nations, they don’t exactly measure up.

Colson says Sweden’s maternity leave policy is “one of the most generous,” offering 390 days of paid parental leave (shared between parents) and 80% of wages covered for a significant portion of the leave. In Germany, mothers are entitled to 14 weeks of maternity leave plus a tax-free, income-based allowance straight from their insurance provider.

Though it’s likely that US laws will never be that generous in terms of paid maternity leave, there are a few things you can do to make the blow of medical costs hurt a little less, says Colson.

“My advice is to be your own advocate,” she says. “If you’re planning to have a baby, start by understanding what your state provides in terms of paid leave to avoid surprises after delivery.”

To keep the cost of having your baby (if you’re planning to have one) transparent and free of surprises, Colson recommends:

• Asking your physician’s office for a detailed breakdown of insurance billing codes, including:
  • Office visits
  • Lab work
  • Epidural (and the anesthesiologist’s separate fee)
  • Hospital admissions
  • Specialist consultations during admission
  • Optional procedures like circumcision, if desired
• Email the insurance billing codes to your insurance provider, who can help calculate your out-of-pocket costs and deductible

“Having a baby is priceless,” Colson says. “By planning ahead – understanding your insurance options, healthcare costs, and available benefits – you can ensure peace of mind and focus on what truly matters: your growing family.”