As devastating as miscarriages are emotionally, they often are accompanied with a price tag if medical attention is required. A miscarriage is not something any woman, or couple, can prepare for emotionally or physically…unbeknownst to us, it wasn’t something we were prepared for financially either!
We were recently pregnant for the second time and consumed with the gamut of emotions from fear to elation after receiving the positive test (okay fine, tests...plural...I didn't believe it at first!). Early in the first trimester I started experiencing bleeding and intense cramping on one side. It was a Saturday morning and I knew I would not be able to get in to see my midwife until Monday morning, so I called the on-call line at my OBGYN office. The nurse was very compassionate and talked me through the scenarios to watch for that would alert me to a higher level of care: heavier bleeding/soaking through a menstrual pad in under an hour, clotting larger than a golf ball, or symptoms of an ectopic pregnancy such as severe pain in the abdominal area, dizziness or faintness. I was instructed to take Tylenol and lie on my left side with a heating pad applied to the painful area. An hour later the pain was intensified to what reminded me of an early labor and still only on one side which was alarming, the bleeding was much heavier and I was passing numerous clots larger than a golf ball in size, so we made the call to go in…then started the adventure we weren't ready to go on.
Our very sweet and supportive neighbors took over care of our 19 month old (thank you, y’all are the best) and my husband and I headed to urgent care as instructed by the on call nurse. Upon arrival, I explained to the woman at the desk that I was under the impression that my body was going through an early miscarriage. The urgent care nurse explained that they did not have the diagnostic imaging required to handle this and that my only option on a Saturday morning was to head to the emergency department…so onward we went.
We checked in to the emergency department and a subjective report was taken by the ER nurse, I declined the desire for any additional pain medications and an IV was stared for hydration…$8631 billed for the IV and saline. A blood draw was performed to complete a complete blood count/CBC ($365.25), immunology to confirm my blood type and RH type ($446) and a chemistry panel to confirm the pregnancy ($2359.50)…$3170.75 billed for bloodwork. The doctor came in a confirmed that we were, in fact, pregnant, but she was unsure if the pregnancy was still viable, if we were in the throws of having a miscarriage or if the pregnancy was ectopic secondary to the unilateral pain I was experiencing. She recommended an ultrasound to confirm and we were taken for a transvaginal ultrasound to figure out what was going on…$2915.25 billed for an ultrasound. Following the ultrasound and two hours of waiting the physician returned and let us know that the results were inconclusive and she was unable to confidently say whether or not we were going through a miscarriage, if the pregnancy would continue or if it was ectopic…thank you, that will be $716. It was further recommended that I get a RhoGam injection and follow up with my midwife on Monday to repeat testing. I declined the injection and stated that I would have that done at the office on Monday, knowing it would be billed out at a significantly reduced rate from my midwife. The ER physician returned 45 minutes later and let us know that she spoke to the hospital's on-call OBGYN and they recommended the injection immediately (for absolutely no good clinical reason) and because I was done arguing and feeling emotionally drained I agreed…$1516.50 billed for the injection. Somewhere along the way a peripheral vascular lab was performed and billed…$1108.25.
In total, $17,771.35 billed to insurance.
All of this to tell us absolutely nothing we didn’t know going in, but it did provide us a baseline HcG level for our follow up (via bloodwork)…which could have been completed at urgent care for a lesser price tag. Do I regret going in to the emergency room? On one hand, yes…on the other hand, no. I had no idea what was happening with my body and if the unilateral pain was a sign of an ectopic pregnancy and I did not want to wait the 48 hours to find out.
We followed up with our midwife on Monday morning and due to exponentially falling HcG levels and no evidence of a viable pregnancy with a second transvaginal ultrasound our miscarriage was confirmed. Suddenly losing a pregnancy is traumatic and my husband and I were both feeling emotionally shaken by the miscarriage, but with support from our friends and family we were able to start the healing process.
What we were not prepared for were the bills that rolled in a month later, not just because they billed over $17000, but more so it was an additional thing to have to deal with as we were moving forward in our process of grief. Fortunately, we do carry insurance, so after contractual adjustments we were responsible for just over $2600…but what if we didn’t carry insurance?! Our story is far from uncommon as up to 25% of all clinically recognized pregnancies will end in miscarriage, most occurring during the first 13 weeks of pregnancy.
I wanted to share my story to bring awareness to a growing healthcare issue we face in our country. The fact that women and families have to pay for miscarriages wasn’t something that crossed my mind before we found ourselves in the situation. And while I knew a trip to the emergency department would come with a cost, what was actually billed to insurance certainly blindsided me.
To health + wellness for your pelvis,
Kelly