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The economic downturn has prompted people to scale back in a lot of ways.

There has been speculation that baby-making might just be one of them.

No one wants to think having a baby boils down to money, but for families worried about finances and the future, it’s a consideration.

As Zeiss and Tracy Thessen planned for their first child, the economy was continuing in a nosedive. Their financial situation was not the best it could be, Tracy said in August, a few weeks before she was due to give birth.

“We are both in our mid-30s. Because of the age, and the economy and our financial situation, we decided this is going to be our only one,” she said. “And we are OK with that.”

Expenses for a new baby, including hospital co-pays, diapers, formula, doctor visits, etc., can eat up 25 percent of a young family’s income for a year, said Mary Anne Graf, vice president for women’s and children’s services at Bon Secours Richmond Health System.

“When you look at the research on the economy, it’s pretty clear who will get nailed is young families,” Graf said. “When you look at who is most vulnerable, when you really drill it down, it’s people making less than $48,000 a year. The average young family income is around $50,000 to $55,000 a year with two of them working.”

. . .

The U.S. birth rate has been sliding for years. It was 24.1 live births per 1,000 population, in 1950, 15.9 in 1980, spiked to 16.7 in 1990 but by 2000 was back down to 14.4.

“Historically if you look at trends, there have been two big dips” in the birth rate in modern times, said Jeffrey Hass, an associate professor of sociology at the University of Richmond. One was around the time of the Great Depression; another was in the 1970s, when feminism and birth control gave women more control of reproduction choices but there was also the oil crisis and high inflation.

The birth rate was down to 13.9 in 2002, but the trend had been going in the other direction in recent years. It had been holding steady for some time at around 14.1 to 14.3 live births per 1,000 population but dropped last year to 13.9. The 2 percent drop in 2008 stands out because it’s the largest year-to-year change in some time.

“It’s been about a year since we have officially been in a crisis,” Hass said. “When do people start feeling the crunch? There is no exact date. Plus it takes nine months to gestate and have a birth, so there is all kind of lag going on here.”

. . .

Preparing for the change in lifestyle and added costs of having a baby, the Thessens, who live in Midlothian, started tracking expenses closer. They realized savings, for example, by consolidating all their insurance policies with the same company. They attended a “budgeting for baby” seminar at St. Francis Medical Center, where they picked up tips on saving for college, buying diapers online and shopping at consignment stores.

“We were fortunate to have all the support from our friends and families,” said Tracy Thessen, an art teacher in Henrico County. “I have friends and relatives who just had babies in the last few years. We wouldn’t know what to do if we hadn’t had that. It’s just so expensive.”

A baby shower took care of most of their needs. One friend loaned them a bassinet. Another loaned her a top-of-the line breast pump that Thessen said she wouldn’t have purchased because of the cost.

“If you are going back to work, you really need a good, efficient one. I would have rented out a hospital-grade one for about $30 a month,” she said.

Thessen said she looked closely at what her insurance plan would cover of the hospital birth costs.

“Teachers get pretty good benefits,” she said. “I made sure I understood how it’s going to work. They have payment plans available for you.”

. . .

One online survey tried to gauge women’s intentions in real time. The June-July survey commissioned by The Guttmacher Institute, an organization that advocates for women’s right to birth control and safe abortion, asked women about childbearing plans. Of the 947 women ages 18-34 whose responses were tallied, 44 percent said they wanted to delay childbearing or have fewer children.

Reality, however, often conflicts with intentions.

“People get pregnant because they get pregnant,” said Kim Mosny, a licensed certified professional midwife.

“We have more ‘oops’ babies in our culture than we have planned babies. I think plenty of women are having babies. They figure it out. . . . Really, a mommy’s breast, a warm blanket, a dry diaper and a car seat are really all that children need for almost a year.”

Mosny, who charges about $3,500 for a home birth, said most of her clients seek out her services because they want to have more control over their birth experience. But for some, affordability is a factor.

“People who don’t have insurance or who have only catastrophic insurance often will look for financially alternative ways to have their baby,” Mosny said.

Virginia Health Information data show that the average hospital charge in the state for a vaginal delivery is $6,023. People with health insurance typically pay just a fraction of that out of pocket.

. . .

The current recession started around December 2007, according to the National Bureau of Economic Research. Graf, who also runs a health-care market-research firm, said she has been hearing from her consulting clients since the spring of 2008 that births are down.

“For young people, the recession started in 2007,” said Graf. “By [last] fall, everybody I talked to was feeling it in births being down,” At the same time, she said, data were also showing that vasectomies and abortions were up.

“Nationally, you are looking at between a 5 [percent] and 10 percent decrease in births due to the recession,” Graf estimates. Definitive national data is probably two years or more away.

Graf said market research completed for Bon Secours tried to get a picture of what’s happening locally. A phone survey in March of 275 families with a child under 5 or who were expecting at the time asked them how they were doing.

“I think the most surprising thing for me was despite a slightly more-affluent group, 87 percent had changed how the family spent money, 77 percent had changed how their family shopped for groceries and 40 percent acknowledged strained relationships with their spouse and partners,” said Graf. “Another 30 percent said the economy had hurt their sex life.”

Another finding: 16 percent were making fewer doctors visits, and about four of the 20 pregnant women in the survey indicated that they had cut back on prenatal visits.

Graf said the hospital has implemented some programs, such as payment plans, sliding-scale of fees and the budgeting for baby classes, to help young families. The hospital is also working with doctors to make sure women have access to prenatal care. Young women, Graf said, are not always cognizant of the fact that delaying pregnancy has consequences.

“The longer they put that off, the more trouble they have. Infertility brings its own risk of complications,” Graf said.

. . .

Laura and Chris Hamm had planned to have a second child. It just happened sooner than they had planned.

Laura Hamm said she had fertility treatments to conceive the first time.

“Luckily, I got pregnant on my own” the second time, she said. Their second child arrived in March, and they have a 3-year-old.

“The only issue we had, we didn’t have health insurance when I got pregnant” the second time, she said. “The health insurance through my husband’s job is about $2,000 a month.”

Hamm’s first birth was a cesarean in a hospital. The second was at home with Mosny as her midwife.

Hamm said she wasn’t doing it to save money, but it did save them “a ton of money.”

Hamm said she and her husband would like to have another baby, but now that they have two, there is no rush.

“My husband and I would like to wait another two to three years to see where we are then.”

. . .

Jeffrey Hass, an associate professor of sociology at the University of Richmond, said theories trying to gauge the impact of the downturn on childbearing patterns go both ways.

“One hypothesis is that the crisis might lead to an increase in the birth rate. When women get laid off, they might decide I might as well have a kid, I have nothing else to do,” Hass said.

On the other hand, women worried about job security may delay getting pregnant for fear they won’t have a job to come back to if they take maternity leave.

“Ask me in two to three years,” said Hass. “That is really when we will start to see if there is a true effect or not.”

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October 17th, 2009 | Category: insurance coverage | Comments Off
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