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First Decisions

Among the first major questions you and your partner will face after learning she’s pregnant are: Where are we going to have the baby? Who’s going to help us deliver it? How much is it all going to cost? To a certain extent, the answers will be dictated by your health insurer, but there are still a range of options to consider. As you weigh all your choices, give your partner at least 51 percent of the vote. After all, the ultimate decision really affects her more than it does you.

WHERE AND HOW

Hospitals

For most couples—especially first-time parents—the hospital is the most common place to give birth. It’s also, in many people’s view, the safest. In the unlikely event that complications arise, most hospitals have specialists on staff twenty-four hours a day and are equipped with all the necessary life-saving equipment and medications. And in those first hectic hours or days after the birth, the on-staff nurses monitor the baby and mother and help both new parents with the dozens of questions that are likely to come up. They also run interference for you and help fend off unwanted intrusions. If you have a choice among several hospitals in your area, be sure to take a tour of each one before making your decision.

Most of the time, you’ll end up going with the hospital where your partner’s doctor or midwife has privileges (or where your insurance plan says you can go). Some people do it the other way around: they select the hospital first and then find a practitioner who’s associated with that hospital.

Many hospitals now have birthing rooms (or entire birthing centers) that are carefully decorated to look less sterile and medical and more like a bedroom at home, although the effect is really more like a nice motel suite or a quaint bed-and-breakfast. The cozy decor is supposed to make you and your partner feel more comfortable. But with the wood furniture cleverly concealing sophisticated monitoring equipment, the cabinets full of sterile supplies, and nurses dropping by every hour or so to give your partner a pelvic exam, it’s going to be hard to forget where you are. Keep in mind that at some hospitals, birthing rooms are assigned on a first-come-first-served basis, so don’t count on getting one—unless you can convince your partner to go into labor before anyone else does that day. In other hospitals, all the labor rooms are also birthing rooms, so this won’t be an issue.

Hospitals, by their nature, are pretty busy places, and they have all sorts of rules and policies that may or may not make sense to you. Giving birth in a hospital generally involves less privacy for you and your partner, and more routine (and sometimes intrusive) procedures for her and the baby.

That said, if your partner is considered “high risk” (meaning she’s carrying twins or more, is over thirty-five, has had any complications during a previous delivery, had complications during this pregnancy, has any medical risk factors, or was told as much by her practitioner), a hospital birth will—and should—be your only choice.

Freestanding Birthing Centers

Of the 1–2 percent of births that take place outside a hospital, about 30 percent happen in private birthing centers. Usually staffed by certified nurse-midwives (CNMs), these facilities tend to offer a more personal approach to the birthing process. They look and feel a lot like home—nice wallpaper, hot tubs, and sometimes even a kitchen. They’re generally less rigid than hospitals and more willing to accommodate any special requests your partner or you might have. For example, there are fewer routine medical interventions, your partner may be allowed to eat during labor (a big no-no at most hospitals), and she’ll be able to wear her own clothes—none of those unflattering hospital gowns unless she really wants one. The staff will also try to make sure your partner and baby are never separated. One downside is that you and your newly expanded family may need to check out as soon as six to ten hours after the birth.

Private birthing centers are designed to deal with uncomplicated, low-risk pregnancies and births, so expect to be prescreened. And don’t worry: if something doesn’t go exactly as planned, birthing centers are always affiliated with a doctor and are usually either attached to a hospital or only a short ambulance ride away.

If you’re interested in exploring this option, start by getting a recommendation from your partner’s practitioner or friends and family. Or, contact the American Association of Birth Centers at www.birthcenters.org.

Home Birth

With all their high-tech efficiency and stark, impersonal, antiseptic conditions, hospitals are not for everyone. As a result, some couples (less than 1 percent) decide to have their baby at home. Home birth has been around forever (before 1920, that’s where most births happened) but has been out of favor in this country for a long time. It is, however, making something of a comeback as more and more people (most of whom aren’t even hippies) decide to give it a try.

My wife and I thought about a home birth for our second baby but ultimately decided against it. While I don’t consider myself particularly squeamish, I just couldn’t imagine how we’d avoid making a mess all over the bedroom carpet. What really clinched it for us, though, was that our first child had been an emergency Cesarean section. Fearing that we might run into problems again, we opted to be near the doctors.

If you’re thinking about a home birth, be prepared. Having a baby at home is quite a bit different from the way it’s made out to be in those old westerns. You’ll need to assume much more responsibility for the whole process than if you were using a hospital. It takes a lot of research and preparation. At the very least, you’re going to need a lot more than clean towels and boiling water.

Making the decision to give birth at home does not mean that your partner can skip getting prenatal care or that the two of you should plan on delivering your baby alone. You’ll still need to be in close contact with a medical professional to ensure that the pregnancy is progressing normally, and you should make sure to have someone present at the birth who has plenty of experience with childbirth (no, not your sister or your mother-in-law, unless they happen to be qualified). So if you’re planning on going this route, start working on selecting a midwife right now.

Statistically, it’s pretty unlikely that you’ll go this route. But in case you’re considering it, I want to take you through some of the reasons people commonly give for wanting to have their baby at home, and some situations that would make a home birth unnecessarily risky.

Natural vs. Medicated Birth

In recent years giving birth “naturally”—without drugs, pain medication, or any medical intervention—has become all the rage. But just because it’s popular doesn’t mean it’s for everybody. Labor and delivery are going to be a painful experience—for both of you, although in different ways—and many couples elect to take advantage of the advances medical science has made in relieving the pain and discomfort of childbirth. Whichever way you go, make sure the decision is your partner’s. Proponents of some childbirth methods (see pages 159–63) are almost religiously committed to the idea of a drug-free delivery, to the extent that they often make women who opt for any pain medication feel as though they’re failures. Besides making a lot of new parents feel bad about themselves when they should be celebrating the birth of their baby, that militant attitude is simply out of touch with reality. Nationwide, about half of women give birth using an epidural (which is the most common method of pain relief), and in some big-city hospitals that rate is north of 85 percent.

There are advantages and disadvantages to both medicated and unmedicated births, and we’ll talk about them when we get closer to your baby’s due date. But for now, the most important thing is to be flexible and not let your friends, relatives, or anyone else pressure you into doing something you don’t want to do.

You and your partner may be planning a natural childbirth, but conditions could develop that necessitate intervention or the use of medication (see pages 60–62). On the other hand, you may be planning a medicated delivery but could find yourself snowed in someplace far from your hospital and any pain medication, or the anesthesiologist may be at an emergency on the other side of town.

WHO’S GOING TO HELP?

At first glance, it may seem that your partner should be picking a medical practitioner alone—after all, she’s the one who’s going to be poked and prodded as the pregnancy develops. But considering that more than 90 percent of today’s expectant fathers are present during the delivery of their children, and that the vast majority of them have been involved in some significant way during the rest of the pregnancy, you’re probably going to be spending a lot of time with the practitioner as well. So if at all possible, you should feel comfortable with the final choice, too. Here are the main players.

Private Obstetrician

If your partner is over twenty, she’s probably been seeing a gynecologist for a few years. And since many gynecologists also do obstetrics, it should come as no surprise that most couples elect to have the woman’s regular obstetrician/gynecologist (OB/GYN) deliver the baby.

Private OB/GYNs are generally the most expensive way to go, but your insurance company will probably pick up a good part of the bill. Most private OBs, however, aren’t strictly private; they usually have a number of partners, which means that the doctor you see for your prenatal appointments might not be the one in attendance at the birth. So make sure that you’re aware of and comfortable with the backup arrangements—just in case your baby decides to show up on a day when your regular doctor isn’t on call. Labor and delivery are going to be stressful enough without having to deal with a doctor you’ve never met before.

Researcher Sandra Howell-White found that women who view childbirth as risky, or who want to have a say in managing their pain or the length of their labor, tend to opt for obstetricians.

WHY TO HAVE THE BABY AT HOME

• The surroundings are more familiar, comfortable, and private.

• You don’t like—or are afraid of—hospitals and doctors. Or you had a negative experience with a previous birth.

• You’ve already had one or more uncomplicated hospital births.

• You can surround yourselves with anyone you pick.

• The birth is more likely to go exactly as you want than it might anywhere else. And your partner will be treated less like a patient than she would be in a hospital.

• You can pay attention to the spiritual aspects of the delivery, an intimate matter that you might be discouraged from, or feel embarrassed about, in the hospital.

• Hospitals are full of sick people and it’s best to stay far away from them.

• It’s cheaper.

WHY NOT TO HAVE THE BABY AT HOME

• Your partner is over 35 or has been told by her doctor that she’s “high risk.”

• She’s carrying twins (or more) or you find out that the baby is breech (feet down instead of head down).

• She goes into labor prematurely.

• She developed preeclampsia, a condition that affects about 10 percent of pregnant women and that can have very serious complications if it’s not detected and treated early (see pages 61–62 for more on this).

• She has diabetes or a heart or kidney condition, has had hemorrhaging in a previous labor, has had a previous Cesarean section, or smokes cigarettes.

• No insurance coverage.

Family Physician (FP)

Although many FPs provide obstetrical care, not all do, so check with yours to see whether he or she does. If not, he or she will refer your partner to someone else for the pregnancy and birth. One of the big advantages of going with your family doctor is that after the birth, he or she often can see your partner and baby on the same visit. The time saved running around from doctor to doctor will be welcome.

Like most doctors, FPs are frequently in group practices, and there’s no guarantee that the doctor you know will be on call the day the baby comes. So, if you can, try to meet with the other doctors in the practice, as well as any OB/GYNs your family doctor might work with. (Most FPs can’t do C-sections or assisted deliveries, and will need OB/GYN backup. In addition, since malpractice insurance covering maternity care and childbirth is very expensive, many FPs will refer pregnant patients to an OB who already has that coverage. Make sure you’re comfortable with this person, since he or she may be doing the delivery if things get complicated.)

Midwife

Although midwives are not as common in the United States as they are in Europe and other parts of the world, they’re becoming increasingly popular. And you might want to consider bringing one into the process, even if your partner has a regular OB.

In Howell-White’s study, women who expect their partners to be actively involved in labor and delivery and who place a high value on getting information on the birth process are more likely to opt for a midwife. Interestingly, so are women who have no religious affiliation.

Certified nurse-midwives (CNMs) are licensed nurses who have taken a minimum of two or three years of additional training in obstetrics and passed special certification exams. They can deliver babies in hospitals, birthing centers, or at home. But because their training is usually in uncomplicated, low-risk births, CNMs have to work under a physician, just in case something comes up.

Some states have created a new designation, certified midwife (CM), which allows practitioners who aren’t nurses, but who go through the same training and take the same exams as CNMs, to work as midwives.

Many standard OB/GYN practices, recognizing that some of their patients might want to have a midwife in attendance at the birth, now have a CNM (or in some cases a CM) on staff. Officially, then, your partner is still under the care of a physician—whose services can be paid for by insurance—but she’ll still get the more personalized care she wants. Keep in mind, though, that because midwives aren’t MDs, they can’t perform surgery and they’re able to handle only low-risk cases.

If you’re considering using a CNM or a CM and need some help with your search, the American College of Nurse-Midwives (midwife.org) can put you in touch with one in your area and fill you in on any applicable regulations. If you’ve already found a midwife but want to be sure she’s properly certified, visit the American Midwifery Certification Board (www.amcbmidwife.org).

There are also plenty of midwives out there who are neither certified nor licensed. Lay midwives have a lot of experience working with pregnant women and may even have a lot of specialized training. But they’re not regulated and may not have passed any specific midwife exams, which means that in most cases they can work in home settings but not in hospitals or birthing centers.

Like CNMs or CMs, lay midwives must work with a physician, in case of an emergency. The Midwives Alliance of North America (MANA.org) can help you find out more about lay midwives and make contact with one near you.

Doula

Although it sounds like it should mean “a little duel,” doula is actually a Greek word that means “a woman caregiver of another woman.” Many doulas have had children of their own, and all of them go through an intensive training period in which they are taught how to give the laboring woman and her partner emotional and physical support throughout labor, and information about the delivery. Doulas have become increasingly popular over the years, and we’ll talk a lot more about them on pages 165–67. For now, though, as you’re just beginning the process, there’s one very important thing to think about.

Doulas are not medical professionals, they’re generally not regulated, and they may not be particularly welcome in hospitals. Here’s how childbirth educator Sarah McMoyler and I described, in our book The Best Birth, the sometimes combative relationships that can develop. “The problem is that some doulas have an agenda and see their role as protecting mom and baby from what they believe are unnecessary interventions. Sometimes they take that agenda a couple steps too far and start playing doctor, inserting their non-medical opinion into a science-based hospital arena. As you can imagine, this can create tension and confusion, and is, frankly, completely inappropriate.” Because this kind of attitude can interfere with the medical team’s ability to do its job, a number of OB/GYN practices and hospitals around the country have banned doulas from their delivery rooms. That said, several studies have shown that having a doula can reduce the length of labor. But before you plunk down a deposit, check with your OB.

What to Ask Your Prospective Practitioner

Besides a medical school degree, OB/GYNs may have little else in common. Each will have a slightly different philosophy and approach to pregnancy and birth. The same (except for the medical school part) can be said for midwives. So before making a final decision about who’s going to deliver your baby, you should get satisfactory answers to the following questions and any others you can think of. (If at all possible, make a separate appointment to do this. You’ll never be able to get everything in a fifteen-minute appointment. And no, there are no stupid questions—we’re talking about your partner and baby here.)

ESPECIALLY FOR OB/GYNS

• How do you feel about the father being there for prenatal exams and attending the delivery? Are you enthusiastic about it or just tolerant?

• Do you recommend any particular childbirth preparation method (Lamaze, Bradley, and so on)?

• At which hospital(s) do you deliver your babies?

• Are you board certified? Do you have any specialties or special training?

• How many partners do you have and how often are they on rotation?

• What percent of your patients’ babies do you deliver? What are your backup arrangements if you can’t be there?

• Where do you stand on the natural-vs.-medicated debate?

• What’s your philosophy about Cesareans, labor inductions, and episiotomies?

• What’s your C-section rate, and how do you make the decision to proceed with the surgery?

• Do you permit fathers to attend Cesarean sections? If so, where do they stand (up by the woman’s shoulders or down at the “business end”)?

• What is your definition of a “high-risk” pregnancy?

• What kind of monitoring do you recommend? Require?

• How do you feel about the mother lifting the baby out herself if she wishes?

• How do you feel about the father assisting at the birth?

• Do you routinely suction the baby or use forceps during delivery?

• Do you usually hand the naked baby straight to the mother?

• Do you allow the mother or father to cut the umbilical cord?

ESPECIALLY FOR MIDWIVES

• Are you licensed or certified? By which organization?

• How many babies have you delivered?

• Which physicians and hospitals are you associated with?

• How often does a physician get involved in the care of your patients?

• What is the role of the physician in your practice?

• What position do most of the women you work with adopt for the second stage of labor?

• How do you make the decision to transfer the patient to a hospital or the care of a physician? How often does that happen?

FOR BOTH OB/GYNS AND MIDWIVES

• Do you have an advice line we can call when we panic about something?

• What are your rates and payment plans?

• What insurance, if any, do you take?

• What percentage of your patients had natural, unmedicated births in the past year?

• What’s your definition of “high risk”?

• If labor starts when you’re not on call, will you come in anyway?

• What and who (besides you, Dad) is allowed in the delivery room (friends, relatives, doulas, cameras, webcams, etc.)?

• Are you willing to wait until the umbilical cord has stopped pulsating before you clamp it?

• What prenatal tests do you suggest getting? Which ones do you require?

• Which tests do you usually order for women like your partner (her age, race, medical history, and risk factors)?

• How many sonograms (ultrasounds) do you routinely recommend?

• Are women free to walk, move, and take a shower throughout the early stages of labor? Can the baby be put to the breast immediately after delivery?

• Are you willing to dim the lights when the baby is born?

• How much experience have you had with twins or more? (This is a very important question if you and/or your partner have a family history of multiple births or if you suspect that your partner is carrying more than one baby.)

BILLS

Having a baby isn’t cheap. Exactly how much you have to come up with will depend on how and where your baby is born, and which of the infinite combinations of deductible, coinsurance, copays, and out-of-pocket maximums you have. According to the Agency for Healthcare Research and Quality, a part of the U.S. Department of Health and Human Services, the average charge for a vaginal delivery is just under $9,000—nearly triple what it was in 1993. And the average charge for a Cesarean is almost $16,000—2.5 times higher than in 1993. Private insurance covered an average of 80 percent of prenatal care charges and 88 percent of delivery charges. But even if you have good insurance, that 12–20 percent can still add up in a hurry. Do keep in mind, though, that what the practitioner receives will almost always be quite a bit less than the sticker price.

In the sections that follow, you’ll get an idea of how the costs for a typical—and a not-so-typical—pregnancy and childbirth experience might break down. It’s a good idea to look over your insurance policy, find out how much it will be picking up, and start figuring out now how you’re going to pay for the rest of it. Oh, and all of this is in addition to anything you might have paid for fertility diagnosis and treatment. What we’re talking about here are just the costs that come up after your partner gets pregnant. Putting together a budget can be important even if you’re adopting. In many cases, adoptive parents are in close contact with the birth mother throughout her pregnancy and delivery. You and your partner might go with her to the doctor’s appointments, see the ultrasound, hear the baby’s heartbeat, and pick up the bills—most of which won’t be reimbursed by your insurance company—for everything. If you’re doing an international adoption, you won’t have to worry about covering the birth mother’s medical expenses, but you’ll probably need to budget in the cost of several overseas trips. In addition, you’ll need to take into account the many other adoption-related expenses you’re likely to incur, including agency fees, attorney’s fees, and the home study you’ll have to go through.

Pregnancy and Childbirth

Most doctors charge a flat fee for your partner’s care during the entire pregnancy. This generally covers monthly visits during the first two trimesters, biweekly visits for the next month or so, and then weekly visits until delivery. But don’t make the mistake of thinking that that’s all you’ll pay. Bills for blood and urine tests, ultrasounds, hospital fees, and other procedures will work their way into your mailbox at least once a month. Here’s what you can expect to pay (before your insurance pays its part) for having your baby:

OB/GYN

Expect to pay $2,500–6,500 for general prenatal care and a problem-free, vaginal delivery. Add a few thousand more for a C-section. Most doctors will meet with you to discuss their rates and the services they provide. For a list of important questions to ask, see pages 20–21. In addition, be sure to discuss which insurance plans, if any, they participate in (it might actually be easier to start with the doctors your insurance covers and choose from there). You should also ask whether they’ll bill your insurance company directly or will want you to make a deposit (most will want to collect about 25 percent of the anticipated bill up front); whether you can make your payments in installments; and whether they expect their fee to be paid in full before the delivery.

MIDWIFE

The average cost of a delivery by a midwife is $2,000–4,000, but it can vary greatly depending on where you live and whether you expect her to be with you throughout labor or just the part that’s right before the birth. If you’re delivering at home, you’ll also need to add the cost of the supplies the midwife thinks you’ll need for the birth (sterile pads, bandages, and so on).

Lab and Other Expenses

• Blood: Over the course of the pregnancy, you can expect to be billed anywhere from $200 to $1,500 for various blood tests.

• Ultrasound: At least $250 each. In an ordinary pregnancy, you’ll have between none and three.

Prenatal Testing

If you and/or your practitioner decide that you’re a candidate for amniocentesis or any other prenatal diagnostic test, you can expect to pay $1,000–1,500. In most cases genetic counseling is required beforehand, and that costs an additional $400–600. If you’re having any prenatal testing done just because you’d like to find out the sex of the baby or want reassurance of its well-being (and not because you’re in a high-risk group), your insurance company may not pay for it. But if your partner is thirty-five or older, they probably will pay for testing.

At the Hospital

• If you’re paying for it yourself, a problem-free vaginal delivery and a twenty-four-hour stay in a hospital will run anywhere from $4,500 to $9,000, depending on where you live. Add $5,000–7,000 for a Cesarean.

• If you’re planning to spend the night in the hospital with your partner, add about $250 per day.

• Anesthesiologists usually charge from $1,000 to $1,500, depending on what they do and the time spent doing it.

• Although a lot of people worry about preterm delivery, there’s also the issue of late delivery. If your baby decides to stay inside any more than seven to ten days past his due date, your partner may need to have labor induced. If that happens, add another $1,000–3,000.

• If your partner does deliver early (by more than a couple of weeks) and your baby needs to spend time in intensive care, the bills—most of which you will hopefully never see—can go into the hundreds of thousands.

If Your Partner Needs a Cesarean Section

If your partner ends up having a C-section (which happens more than 30 percent of the time—up from 21 percent in 1993), all bets are off. Even though it’s routinely done, it’s still considered major surgery, and is expensive. The operation, which your OB/GYN will perform, is not included in his or her flat fee, and you’ll have to pay for at least two other doctors to assist, plus a nurse, who must be in attendance to care for the baby. In addition, a C-section entails a longer recovery period in the hospital—usually four to five days—as well as extra nursing care, pain medication, bandages, and other supplies. If the baby is in good health, you can probably take him home while your partner stays in the hospital, but chances are you’ll want the baby to stay with your partner, especially if she is breastfeeding. The baby’s additional time in the nursery costs more too.

“Listen, are you absolutely sure you want to have kids?”

An Important (and Possibly Profitable) Word of Advice

Make sure that you and your partner check your birth-related bills very carefully. Hospitals can make mistakes—in fact, a study by credit giant Equifax found that nine out of ten hospital bills contain errors, and they’re rarely in your favor. After we’d recovered from the shock of the C-section bills for the birth of our first child (which started off at about $17,000), we asked a doctor friend to go over them with us. He found that we’d been charged for a variety of things that hadn’t happened and overcharged for a lot of the things that had. For example, we’d been billed $25 for a tube of ointment that the hospital’s own pharmacy was selling for $1.25. We (actually, mostly our insurance company) ended up paying closer to $15,000. And for the second pregnancy, our nitpicking review of the bills cut about 20 percent off the total.

Look for double billings, services you never received (say, a private room when you were actually in a shared one, or brand-name drugs when you really got generics), and any kind of suspicious jargon. A wonderful exposé done by ABC News found that people had been billed hundreds of dollars for a “disposable mucus recovery system” (a 79-cent box of tissues) and “thermal therapy” (ice cubes in a bag). Also keep an eye out for procedures that never happened. I’ve heard stories about new parents being billed for their baby’s circumcision. That would have been fine, except that they had a girl.

While some of these things may seem silly, they can really add up—especially if you’re footing a big portion of the bill. In the Equifax study, the average error was more than $1,300. And according to a joint study done by Harvard’s Medical and Law Schools, “[n]early half of all Americans who file for bankruptcy do so because of medical expenses.” About 10 percent of those are childbirth related.

Even if all the bills are being paid by your insurance, reviewing those bills can still be profitable. Although most insurance companies have their own internal auditors, all they’ll be able to catch are charges that are above the “usual and customary” and/or procedures that simply aren’t covered. They won’t know about most of the things mentioned above and will be ecstatic if your review ends up saving them money. In fact, some insurers are so thrilled that they’ll actually give you a percentage (sometimes as much as half) of the money they save. Naturally, though, you’ll have to ask for your reward. So, read your policy carefully and, if you still have questions, talk to your agent or one of the company’s underwriters.

And while you’re reading your insurance policy, here are a few other things to look out for:

• How long before the birth does the insurer need to be notified about the pregnancy and estimated due date? Not complying with the carrier’s instructions could mean a reduction in the amount they’ll pay for pregnancy and birth-related expenses.

• When can the baby be added to the policy? Until the baby is born, all pregnancy- and birth-related expenses will be charged to your partner.

After the birth, however, your partner and the new baby get separate bills (all baby-related expenses, such as medication, pediatrician’s exams, diapers, blankets, and various other hospital charges, will be charged to the baby). Some carriers require you to add the baby to your (or your partner’s) policy as far in advance as thirty days before the birth; most give you until thirty days after. Again, failing to follow the insurer’s instructions could result in a reduction of coverage.

LOW-COST ALTERNATIVES

Obstetrical Clinics

If you live in a city where there is a large teaching hospital, your partner may be able to get prenatal care at its obstetrical clinic. If so, you’ll spend a lot less than you would for a private physician. The one drawback is that your baby will probably be delivered by an inexperienced—yet closely supervised—doctor or a medical student. This isn’t to say that you won’t be getting top-quality care. Clinics are often equipped with state-of-the-art facilities, and the young professionals who staff them are being taught all the latest methods by some of the best teachers in the country.

Your Rights to Free and Subsidized Medical Care

If worse comes to worst, hospital emergency rooms are required by federal law to give your partner an initial assessment—and any required emergency care—even if you can’t afford to pay. But that’s no substitute for the kind of ongoing prenatal care that will ensure a healthy pregnancy, healthy baby, and healthy mom.

So if you’re uninsured or underinsured—according to the American Pregnancy Association (americanpregnancy.org/), that’s the case for 13 percent of pregnant women—or just need some help paying for that prenatal care your partner needs, your first step should be to find out what Medicaid benefits she’s eligible for. (If you’re in this category, don’t feel bad. Nearly half of all births in the U.S. are financed by Medicaid.) Since benefits vary by state, you should also make contact with your state’s health department as well. You’ll be able to get most of your questions answered at the Medicaid website (medicaid.gov).