What’s the real cost of delivery?

Babies are quite a costly affair and nowhere does this manifest itself better than when paying the maternity fees at the hospital after delivery. You may have heard ‘of a person being detained in hospital because of non- payment of hospital dues and wondered, ‘Didn’t this woman know she was pregnant all along so as to plan for delivery? Why go to a hospital you cannot afford?’

Pregnancy is usually manageable, if one does not have complications, but delivery is unpredictable. Depending on the mode of your baby’s birth and where it occurs, a delivery gone wrong is enough to warrant a loan from a bank or a Sacco.

Sandra Mulluka paid for a pregnancy package at a Nairobi hospital. Her budget was Kshs 15,000/-
(about UShs. 375,000/- or TShs. 195,000/-). Her baby was delivered by vacuum extraction, observed in an incubator for a day and she stayed an extra two days in hospital.  What were the implications? ‘Just how much should you put aside for your delivery?’ asks Sandra, as she narrates her own experience.

When I was expecting my first baby, I did all the groundwork concerning where to deliver. I also did my arithmetic taking all possible costs into account. In my estimation my plan and budget were workable. The hospital in mind charged Kshs. 15,000 for a normal delivery, which was what I was going for. This fee was inclusive of a three-day stay.

I checked myself into the hospital on a Sunday evening and delivered the following morning at around 9.00 a.m. During my prenatal clinics I was seeing a private gynaecologist, therefore the hospital had advised me that it would only be prudent for the same doctor to be present at delivery because he knew my history; I saw nothing wrong with that.

My delivery was what can be called a ‘modified normal delivery’. I delivered through vacuum extraction. Because of the mode of .delivery, the paediatrician advised that the baby be kept in an incubator for observation. He was also medicated with antibiotics which were administered intravenously (by drip).

It was while under observation that the baby was diagnosed with jaundice. Treatment was through phototherapy (use of blue fluorescent light) for three days. On the other hand I was also under strict monitoring because after delivery my blood pressure dropped and I kept having blackouts. I was on antibiotics, some very strong painkillers and glucose drips.

As treatment goes on, I am counting days and I feel I have not really overstayed that much, as I expected to be discharged within five days-two days in excess of my original plan.

As I predicted, I am discharged on day six. I am ready to leave and so I go to collect my bill. To say that I was in shock when the bill was presented to me is an understatement. That could not have been my bill!

To break it down: Normal maternity delivery package: 15,000; doctor’s fee: 31,000; additional stay in hospital 2,000 per day for 2 days: 4,000; paediatrician fees: 11,000; incubator charges: 2,000
per day for 4 days: 8,000. Other costs included drugs. Vacuum extractor. syringes. gloves, etc. In a nutshell, I was looking at a bill of close to Kshs. 100,000! I was glad I had a normal delivery, but not after this bill. That’s what I call a very abnormal delivery!

Initially, the doctor was to charge me Kshs. 20,000 which he kindly agreed to discount to Kshs. 18,000. He had further agreed that I pay him in instalments, after delivery, when I explained to him my unfavourable financial status.

However after the delivery we had to re-negotiate everything. There were additional costs related to the visits he made as a private obstetrician/gynaecologist, something I had not taken into account. As I was not a prenatal patient at the hospital (I was attending his private clinic), the gynaecologist came with a private paediatrician because I did not qualify to use one from the hospital. This had not been explained to me, even though I understood why a paediatrician was necessary.

The paediatrician charged Kshs. 7,000 for delivery and Kshs. 1,500 per visit, and given my baby’s condition, you can imagine the number of visits she had to make in total. Fortunately, the paediatrician was very understanding and agreed to reduce her fees. However, all doctors’ fees were included in the hospital bill; therefore I could not be discharged from the hospital without paying the whole lot!

I had not anticipated that my baby would be ill on delivery so the incubator fee, drug costs or even extra hospital lodging charges were all out of my hands.

You can imagine my anxiety as the nurses waited on me to clear… I was silently wondering from where I would get the cash to meet the difference! Luckily, my mother, my in-laws and friends came to my aid. As the doctor put it candidly when I tried talking to him to reduce his fees further, ‘My dear, you have been pregnant for nine months. Don’t you think this is something you should have prepared for? Don’t behave as if this is an emergency.’ Well, it sounded harsh, but he was correct!

Once bitten, twice shy. I learnt my lesson, albeit the hard way, and would advise pregnant women and their spouses to ask as many questions as possible to eliminate any grey areas that may end up being your downfall when you should be celebrating.
Don’t just take anyone’s word, do your own homework and provide for contingencies. Also talk about costs to people who have gone through the delivery experience. Because money issues are sensitive and some people do not want to appear to be out of pocket, they may shy away from consulting with colleagues!

Iron out any issues that pertain to cost beforehand with your doctor or the hospital to avoid shocks.

PG 6 MAY 07/46-47