Cities Journal

Giving Birth Will Cost You A Lot In These U.S. Cities


There is a number that illustrates how much a country is growing the natural way, i.e. the number of births and deaths. This number is called the rate of natural increase and it is calculated by subtracting the number of deaths per 1,000 people from the number of births per 1,000.

For example, in the African country of Niger, 51.08 people are born to every 1,000 people and 14.47 people die to every 1,000 people over the course of the year. Their crude natural increase is therefore 36.61.

Some parts of the world have a very high natural increase and the vast majority of these countries is in Africa. On the other end of the spectrum, you have a number of European countries and Japan where the natural increase is negative. In essence, these countries are dying out.

As you can imagine, this is not good for a country, as it leads to an increasingly old population where the economy suffers due to the imbalance between the working population and the retirees.

The United States of America is in the bottom part of the list with the natural increase of 4.36. It is not a particularly bad number but it is not the greatest either. Compared to just 10 years ago, we suffered a great drop in the rate of natural increase and this is a trend that has been going on for decades. For example, in the early 1960s, our rate of natural increase was around 15.00. You can find more about this here (

The reason why we are banging on about this today is that there are innumerable things that govern how many children people will have and that this drop in the rate of natural increase needs to be slowed down and probably reversed at one point.

One of the factors that contribute to how many children people will have is the way companies and employers handle pregnant employees and the expenses they (the companies) incur when one of their employees has a baby. In short, the price of having a baby has a massive effect on how many babies people will have.

Because of this and because they are a hardworking bunch, the folks at Castlight Health investigated the prices of the routine vaginal delivery and the cesarean delivery in the country’s 30 largest cities. Now, you might think this was an exercise in futility and there was no way the difference could be in any way significant.

Well, you couldn’t be more wrong.


As an illustration, the routine vaginal delivery in Sacramento, California, costs, on average, $15,420 while in Kansas City, Missouri, it costs only $6,075. It is more than two and a half times as expensive to give birth in Sacramento as it is in Kansas City! This is insanity.

The most expensive American cities for a routine vaginal delivery are the aforementioned Sacramento, then San Francisco, CA; Minneapolis, MN; Philadelphia, PA; Portland, OR; Indianapolis, IN; Miami, FL; New York, NY; Seattle, WA; and Boston, MA.

 San Francisco featured the highest price reported at $28,541. It should also be pointed out that the costs of delivery vary greatly within individual cities as well. For example, in Los Angeles, you can be charged anywhere between $4,223 and $27,326 for a routine vaginal delivery.

When it comes to the cesarean delivery, the most expensive cities were Sacramento, CA; San, Francisco, CA; Portland, OR; Minneapolis, MN; San Diego, CA; Denver, CO; Seattle, WA; Los Angeles, CA; Philadelphia, PA; and New York, NY. This time, it was Pittsburgh, Pennsylvania, where they saw the lowest average price at $6,891.

Los Angeles was the place where the highest price was reported at $42,530 and also the place with the widest range of prices starting from $6,232 and going up to the aforementioned $42,530.

You can find the whole list here.

CBS News talked to Dr. Paul Jarris, senior vice president and deputy medical officer at March of Dimes, and he told them that such fluctuations in the prices are nothing surprising and that they have absolutely nothing to do with the quality of the hospital, clinic or the service you get.

He said, “It really reflects the market power of the hospital and their ability to charge higher prices if they’re in a less competitive market.”

As the U.S. gets older and as we get closer to being one of the countries that are dying out, we just hope this will change in the near future.


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