In January 2018, I became pregnant with my first child. My husband and I were overjoyed, and I couldn’t wait to finally become the mom I was always meant to be. My daughter was due in September, which gave me plenty of time to prepare and get everything ready. The only thing that I was somewhat anxious about was giving birth in a country that wasn’t my own.
But I shouldn’t have been worried. My birthing experience was as near perfect as a mother could hope for.
I had been living in Italy for three years, after moving from New York City, where I was born. I spoke Italian somewhat fluently and was an Italian citizen, so the country didn’t feel completely foreign to me. But giving birth is such a personal, nerve-racking, and intimate moment, and I was panicked about the actual birthing experience—especially as an outsider. I was nervous that I would be so uncomfortable giving birth that I would forget how to speak Italian. I was nervous that I wouldn’t understand the Italian healthcare system should something unexpected come up. And as an American, I didn’t know what to expect when it came to giving birth in a hospital in Italy.
But I shouldn’t have been worried. My birthing experience was as near perfect as a mother could hope for. Besides the staff of the maternity ward being wonderful—from the nurses and doctors to the janitors—I learned that Italy truly has a mother’s best interest at heart.
Most importantly, giving birth in Italy is free. That’s right. The average cost of a hospital birth is $0. Whether you give birth vaginally or via C-section, you are not charged a dime. And if you give birth via C-section, like I did, you are required to stay at the hospital a minimum of five nights—again, at no cost.
The comparison with the average cost of a hospital birth in the United tates is stark.
I chose to upgrade to a private room at the hospital, for which I did have to pay out of pocket. But a private room for five evenings—which included two beds, so my husband was able to stay with me at all times, air conditioning, a private bathroom, and meals for both of us—cost…wait for it…858 euros, making the total cost just around $1,000. If I had chosen the default room, shared with several other women, my delivery truly wouldn’t have cost me anything.
The comparison with the average cost of a hospital birth in the United States is stark. According to Health Affairs, a study conducted by the University of Michigan in 2015 found that the average cost of a hospital birth in the United States for a new mother with health insurance is more than $4,500. If you dig deeper, the costs get higher depending on where you give birth and how. The average cost of vaginal delivery in the United States can run you $5,000–$11,000, as shown by data collected by Fair Health. And if you have a C-section? It can cost you $7,500–$14,500. These numbers may seem high, but they are even higher for those who are uninsured. According to research group Truven, a woman without insurance could pay $30,000 for an uncomplicated vaginal birth and up to $50,000 for a C-section.
In Italy, the cost and the actual hospital stay aren’t the only advantage; Italy also gives its citizens something referred to as the “Baby Bonus.” When I gave birth to my daughter, my husband and I received $8,000 from the Italian government over the course of 18 months. Since then, the Baby Bonus has changed: Families can receive up to $280 every month from the seventh month of pregnancy until the child turns 18. If your child is studying at a university, the bonus is extended until age 21. And for children with disabilities, the 21-year limit is extended for life. The Baby Bonus is issued regardless of the family’s income, but income does impact exactly how much money you will receive. Nonetheless, if you are pregnant, you will be given money, regardless of your economic status.
Even having a modest income in America is something not enough for a family to feel comfortable.
On the rare occasions that the United States does provide government-funded programs for pregnant women, there is too much red tape: You cannot apply for these programs unless your income is at or below 185% of the U.S. Poverty Income Guidelines (depending on your family size, annual income must be between $1,300 and $8,200) and you must meet other eligibility requirements too. Even so, much of the help the government offers is strict, such as vouchers that can be used only to purchase specific foods. Food stamp programs are also only offered to those with low or no income. It may seem harsh, but in some ways the American government is not trying very hard to help poor mothers or children born into poverty, at least not in the way that Italy and other countries do.
Italy is looking to help its citizens—regardless of their income. Starting a family is overwhelming, and the cost of having children is obviously expensive. Even having a modest income in America is sometimes not enough for a family to feel comfortable. In part due to Italy’s low birth rate, the Italian government is looking to give its citizens an incentive to have children but to also make it more manageable.
I’m hoping to have another child. But I must admit I would never consider giving birth in the United States. The United States does not put the needs of mothers first, and mothers lack the resources and respect that women deserve. I am so grateful to have given birth in a country that has my, and my daughter’s, best interests at heart.