Image by Fred Jala via Flickr (CC BY 2.0)

The U.S. is the most expensive country in the world in which to give birth and a country that makes it incredibly difficult, if not impossible, for an insured pregnant woman to secure medical insurance. Molly Osberg, writing for Splinter, picks apart the catch-22s, loopholes, and flat-out denials that plunge pregnant women into debt — and somehow get them to blame themselves for not being more fiscally-minded during active labor.

When I started speaking to women about their uninsured pregnancies, I was surprised at how many placed the blame for their bills on themselves. If only, she had been a “better consumer,” one told me, more attuned to a cost-benefit analysis between Medicaid and the private marketplace, more comfortable crunching potential numbers and filling out forms. Another said she wished she’d had the presence of mind, in the middle of a difficult and painful labor that lasted more than 24 hours, to refuse the help doctors were offering.

“Emotionally,” she told me with sober hindsight, the lack of control “really affected my capacity to manage the moment.”

Of course, even when you think you’re insured, or that Medicaid will cover things, communications breakdowns or processing issues might thwart you:

A full year and three months after she gave birth, Rief received an invoice for $8,996 for her delivery. When she called Blue Cross Blue Shield, they told her she’d been denied for the low-income program, and too much time had passed for her to appeal. She still doesn’t understand what happened, even after spending months on the phone. She called the hospital so often she says they started to recognize her. A few months later, they stopped working with her and sent her debt to collections. Rief is still paying off the bill.

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