We Need To Talk About How Much a Miscarriage Costs

Statistics show that about 10 to 15% of known pregnancies end in miscarriage: they’re not rare, yet we’ve always been reluctant to discuss them. As a result, many women who’ve endured them often keep their pain close to their hearts.

Over the past couple of years, many celebrities, doctors, and journalists have begun to share their experiences regarding miscarriage. As the emotional cost of miscarriage is coming to light, it opens the gate for a much-needed discussion on how our healthcare system deals with it.

It turns out the financial burden can be cruel, too – even with health insurance. The average cost of miscarriage in the United States is steep. Confused, in pain, and often grieving, many women often find themselves rushed into procedures or extra expenses.

What’s the average cost of miscarriage?

Miscarriage, or early pregnancy loss, happens when a baby dies inside the womb during the first 20 weeks of the pregnancy. In many cases, your body will recognize when this happens, and complete the miscarriage naturally. Other times, small fetal tissue or placenta fragments can remain inside the uterus, which can be very dangerous.

As with many other medical procedures, the total cost for a miscarriage will vary significantly from patient to patient.

The main three factors deciding the final price tag will be:

• Whether you have health insurance that covers the procedure
• How far along in the pregnancy are you at the time of miscarriage
• The method used to complete it.

Is miscarriage covered under medical insurance?

As simple as the question may sound, the issue of insurance coverage for reproductive health rarely allows quick answers.

For the most part, miscarriages are considered a necessary medical procedure, which means they are covered by insurance. However, the fine print may reveal some exclusions and caveats that can multiply your final medical bill unexpectedly.

The most common one? If one of your providers (such as your anesthetist) is out of network. Likewise, some extra exams (such as genetic testing) may be considered elective by the insurance company and may not be covered.

What are the methods of miscarriage completion?

Most miscarriages take place during the first trimester. At this stage, there are three different methods we can use.

At-home miscarriage

Also known as “expectant management,” this essentially means waiting for your body to expel the placenta and its contents by itself. After we confirm that the baby is no longer alive, we will send you home to let everything progress naturally. This may take between one and four weeks.

An at-home miscarriage is cheapest and least invasive option for pregnancies under 10 weeks. On the other hand, it can be the most psychologically taxing one. Waiting can be nerve-racking. Once the miscarriage effectively starts, you’ll deal with cramping, bleeding, and even unusually large blood clots for a few days.

If there are no complications, you will need to return to the gynecologist after the bleeding subsides. Then, you’ll get an extra ultrasound scan and a final checkup. The medical bills will depend on your insurance and co-pays, but they will certainly be a fraction compared to surgery.

Also, bear in mind that choosing “expectant management” at first doesn’t guarantee that you won’t need any further medical treatment. If the bleeding hasn’t begun after two weeks, you may need either medication or surgery.

Sometimes, while waiting at home, an incomplete miscarriage can produce an infection or septic miscarriage. If this happens, you will need emergency medical care, and you will need to add the extra costs of an emergency room visit to the miscarriage cost.

Pill-induced miscarriage

If expectant management feels too nerve-racking for you — or more than two weeks have passed without any bleeding — we can also use medication to help the uterus expel its contents. For this, we use a medication known as misoprostol (Cytotec®).

Depending on the stage of the pregnancy, this may be combined with mifepristone, which will lower your hormone levels and help the interior of the uterus shed faster. Combined, these medications are often known as the “abortion pill.”

After taking these medications, you can expect heavy cramping and bleeding to begin in under 24 hours. Once again, the cost will depend on your insurance company and plan. Without insurance, the full course of medication can cost approximately $750. With most state-sponsored insurance plans, such as Medicaid or Medi-Cal, the out-of-pocket cost can be as low as $40.

Afterward, you will also need to return to the doctor’s office for a final check-up.

Surgery

After confirming the baby is no longer alive, we can perform a surgery known as dilation and curettage or D&C. This procedure involves opening (or dilating) the cervix to remove the contents of the uterus.

So, how much is a miscarriage surgery? It depends. Of all procedures, this is usually the most expensive but fastest option; the procedure can be as short as 20 to 30 minutes. The cost of D&C without insurance can range from $2,000–9,000 – but even if you have insurance, four-figure deductibles are not rare, depending on your insurance coverage and the exact procedure specifics.

According to international guidelines, a competent OB/GYN can often perform a D&C at the doctor’s office with just local anesthesia. However, if you want general anesthesia (i.e., to be “put under”), you may also need to pay for additional blood tests, operating room rental, and an anesthesiologist.

Often, women who are 10 weeks along or less don’t necessarily need a D&C, especially if it’s their first miscarriage. However, D&Cs often promise “getting it over with,” which can be more manageable from a mental health perspective.

If your miscarriage is spotted after 10-12 weeks of pregnancy, then a D&C becomes a matter of safety: at this point, you’ll be much more likely to have an incomplete miscarriage. This can produce a life-threatening infection or septic miscarriage.

What about miscarriage testing?

The medical costs of a miscarriage are not limited to the procedure itself. If you’ve experienced fertility problems before, have undergone IVF, or have experienced repeated miscarriages, you may also want to know why the miscarriage happened.

Most of the time, miscarriages happen because of a genetic or chromosomal defect in the fetus, which keeps it from developing as expected. Sometimes, it may be useful to know the exact abnormality. In other cases, it can help grieving parents get a sense of closure.

Either way, your OB/GYN may recommend you have the fetal tissue tested. There are several commercial types of tests available nowadays, such as Anora™, Progenity™, or Igenomix™. These may cost anywhere between $100 and $2,000. Fortunately, new technology is rapidly lowering the cost of fetal tissue testing after a D&C.

What can you do if you start to miscarry?

Miscarriages are a stressful and painful experience – there’s no denying that. Upon hearing that their babies are “no more,” it’s natural to feel extreme grief, numbness, or detachment from the situation. Making a rational, money-based decision on the spot may be impossible.

So what can you do to safeguard your finances during a miscarriage?

1. Get informed beforehand

By reading this article, our hope is that you’ll already be better prepared to face a miscarriage if one happens. As we mentioned before, miscarriages are not rare, but for many expectant moms, just thinking about them may feel wrong.

Yet, they’re a statistically significant outcome of any pregnancy, especially if you already have other risk factors. You don’t need to dwell on it, but just by knowing the different methods available, you’ll likely be able to ask the right questions should the worst happen.

2. Know the early symptoms and red flags

Sometimes, we find out about a “missed miscarriage” in the office, during a routine checkup. Other times, you may begin to see the signs yourself and come to us to confirm them.

Some of these may include:

• • Cramping and severe pain in the lower abdomen (especially between the navel and the hip bone).
  • Pink or reddish discharge.
  • Passing blood clots.
  • Noticing your pregnancy symptoms disappearing abruptly (for example, your breasts suddenly stop feeling heavy).

Any of these symptoms should prompt you to call your gynecologist’s office and ask for an urgent appointment. In addition, any of the following symptoms mean that you need to go to the E.R. – even if you already saw a doctor and chose the “expectant management” route.

• • Severe drowsiness or weakness
  • Soaking through more than one pad in four hours
  • Foul-smelling vaginal discharge
  • Chills
  • Fever over 100° F

Any of these symptoms could point to a septic miscarriage, which is a medical emergency.

3. Ask for time to research and grieve

Often, there’s no need to make a decision right after we confirm a miscarriage. Provided you’ve been checked by a doctor, and they found no “red flags,” you can take the time to grieve first. If possible, go home, take the day off, and start to come to terms with the loss.

You can always explore your feelings about an at-home miscarriage – or start requesting a quote for a D&C – the morning after.

4. Give yourself time to heal

Right after a miscarriage, many people feel tempted to drown themselves in work or other obligations. Other times, the immediate reaction is to try for a new baby as soon as possible — or to pause the process for a time.

The grieving process will look different from person to person. Just remember two things: first, you have every right to grieve, even if you hadn’t publicly announced your pregnancy yet. Second, there’s help available out there. There are many support groups and therapists that specialize in this field.

Where do I get help for a miscarriage in Los Angeles?

Whether you are pregnant already or are planning to become pregnant, it’s important to enlist medical help throughout the process.

Dr. Thais Aliabadi and her team aim to be equal-time protectors and allies of their patients’ sexual and reproductive health. We aim to accompany women throughout every stage of their reproductive care, including the joyful and the stressful periods.

At our women’s health clinic, our focus is to help the patient decide what’s best for their own lifestyles. For this, we offer a full range of medical procedures – from routine pap smears to specialized hormonal tests – as well as a listening ear.

We invite you to establish care with Dr. Aliabadi. Please make an appointment online or call us at (844) 863-6700.

The gynecology practice of Dr. Thais Aliabadi is conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.