For future moms who are thinking about having a baby, you usually ponder the excitement of pregnancy and the joy of holding your newborn in your arms. The price tag of actually bringing your child into the world is an afterthought. But when you sit down with a calculator and start adding up the expense of pregnancy, giving birth, and what you need to survive the first few weeks with a newborn, the dollar signs appear. From the price of diapers to the going rate for a cesarean section, here’s the bottom line for moms-to-be who want to learn more about the cost of having a baby, as well as where to save, and where to spend wisely. The Price of Pregnancy Although it’s easy to get excited about the countless number of baby supplies you can buy during the course of your pregnancy, your focus here should be not so much on spending but on your health, and your baby’s. “Early and continuous prenatal care is essential both before and throughout your pregnancy to help ensure a healthy delivery, and healthy baby,” says Jeanne Conry, MD, an obstetrician with Kaiser Permanente in Sacramento, Calif. This is where health insurance comes into play for the first time during your pregnancy -- if you have it, these visits and any diagnostic tests like ultrasounds will likely be covered and are generally considered preventive care. If not, be ready to pay out of pocket. One of the most important elements of prenatal care is a prenatal vitamin, which contains at least 600 mcg of folic acid and aids in preventing some birth defects, like neural tube defects. This is one cost that should be incurred even before you get pregnant; because about half of all pregnancies are surprises, women of childbearing age should be on a multivitamin that contains folic acid, Conry says. Ranging in price from $10 to $20 in the US for an over-the-counter option, or the cost of a co-pay if covered by your insurance company and prescribed by your doctor, this could be one of the most important pregnancy investments you make. Other pregnancy-related costs are maternity clothes, which can range from free if you hit up your mom-friends for hand-me-downs, to middle-of-the-road department store finds, to designer duds that cost hundreds of dollars. If you’re looking to save, this is one way to pinch pennies by borrowing and consignment shopping. Preparing for baby Shopping for a newborn baby can be overwhelming, especially for first-time moms who aren’t sure what is necessary, and what’s just nice to have. Even more intimidating than the endless aisles of baby supplies is the chance of going overboard on baby luxuries that you’ll never use, but cost a fortune. “There are thousands of baby products on the market for new moms to consider, but frankly speaking, most are nice-to-haves,” says Lori Hill, a certified doula with the Doulas of North America in Williamsburg, Va. You need to focus on what you and your baby can’t go without first from a cost perspective, she says, and then figure out how much you have left over to spend on accessories. The fundamentals can be simple: a car seat, a crib, diapers and wipes, a changing table, a few baby clothes to get you started, and a baby monitor. A thrifty mom can make these buys for about $400 by shopping bargains, but don’t sacrifice safety to save a buck, especially on the car seat and crib. The American Academy of Pediatrics recommends avoiding older, used car seats to ensure maximum protection for your child and using cribs certified by the Juvenile Products Manufacturers Association (JPMA). Diapers and wipes are other essentials that you need to purchase during pregnancy in preparation for baby’s arrival. The good news is these both offer opportunities to save by either buying in bulk or by using cloth diapers. Wipes can also be substituted for washcloths, saving you a lot for a box of almost 400, which typically lasts a few weeks for one child. Baby clothes are like maternity clothes -- you can spend hundreds or even thousands outfitting your little one, or ask around for gently worn hand-me-downs that will get you started. Since baby grows out of her outfits so fast, this might be a way to save. Another important cost when you are getting ready for baby’s arrival is childbirth education, says Hill. Ranging in different prices, these classes can help a new mom with the trials of pregnancy and childbirth, and surviving the first few weeks with a newborn. “Education, preferably in the form of childbirth, infant care, and breastfeeding classes, really is an important part of preparing for delivery and bringing baby home,” Hill says. The hospital expense Where the cost of having a baby can really add up is at the hospital. With the average charge of an uncomplicated cesarean section more than doubling from 1993-2007, and the cost of an uncomplicated vaginal delivery almost tripling during that same time period, first-time moms really need to make sure they are well-prepared financially for this part of pregnancy -- especially if you don’t have health insurance. “Looking at a sample of nine states, researchers found that 17% to 41% of childbearing women lacked insurance before coming pregnant," says Carol Sakala, director of programs at Childbirth Connection, a national nonprofit organization that works on behalf of mothers and babies to improve the quality of maternity care in the U.S. “While 13% to 35% of the pregnant women qualified for Medicaid coverage, many either didn’t qualify or didn’t apply, finding private insurance or paying out of pocket," Sakala says. For these women, the costs of childbirth can be a significant financial pitfall. Data gathered from 2008 by the US Agency for Healthcare Research and Quality shows that the charge for an uncomplicated cesarean section is approximately $15,000, while an uncomplicated vaginal birth runs about $9,000. The underinsured run a risk here as well. Women who have individual policies often find that maternity care coverage is completely excluded, versus Medicaid or group private insurance plans that cover almost all pregnancy-related healthcare costs, Sakala says. This means that coverage is only available with a large surcharge, or that only a portion of maternity care services are covered. “It’s important to be aware that these numbers reflect the amount a hospital will charge for these services, rather than the actual cost,” says Anne Elixhauser, PhD, senior research scientist at the Agency for Healthcare Research and Quality. “The actual amount of what it costs the hospital to perform the service is about 30% of what’s charged.” For an uninsured woman or someone facing out-of-pocket costs, this is an important negotiating tool. “Ask and negotiate with a hospital to pay a discounted rate,” Sakala says. “Since what is being charged is significantly higher that the actual cost, you have some room to potentially save.” The bottom line When it all adds up, bringing your firstborn into the world can either break the bank if you don’t have health insurance, or run the cost of a few important supplies if you do. Here’s a cheat sheet of some of the approximate costs -- or ranges, depending on your insurance situation -- you’ll face when you decide to its time to have a baby: • Prenatal care: $0-$2,000 • Prenatal vitamin: $15/30-day supply • Maternity clothes: Free, if shared • Crib: $100 • Wipes: $10/box of 400 • Diapers: $40/box of 250 • Monitor: $15 • Changing table and pad: $100 • Baby clothes: Free, if shared • Car seat: $100 • Childbirth classes: $50-$200/class • Hospital costs: $0-$15,000