Planning for a baby can be the most exciting period of a woman’s life, but it can be frightening at the same time especially for first time mothers. While you’re family planning, it’s a good idea to do some financial planning as well, to ensure you’re not left with unexpected bills before, during and after your bundle of joy arrives.
Rising Cost of Delivery in Shanghai
How much does it cost to deliver a baby in Shanghai? For expats living in Shanghai, there is the choice of local or international hospitals. For international hospitals, the total cost, including prenatal care and delivery, can start anywhere from 75,000RMB. The consultation fee per visit of a pediatrician or an obstetrician starts from 700RMB and 1000RMB respectively.
Ruth, an American, delivered her first baby at a local hospital, The International Peace Maternity, in 2004 and the total cost then was 17,000RMB. By 2006, she paid 22,000RMB for her second baby. In 2011, the total cost of delivering a baby, assuming everything goes smoothly, at the same hospital, has risen to at least 30,000RMB. That is an increase of 76% over a period of six years.
With these figures in mind, many aspiring parents choose to invest in pregnancy insurance to assist with the booming costs. But it’s important to know what to look for and what questions to ask before signing on the dotted line.
What is Pregnancy Insurance?
Maternity insurance and international health insurance go hand in hand. The former is an add-on option, which usually pays for pre- and postnatal care and treatment, delivery cost, complications of pregnancy and delivery and routine newborn care.
Expatmedicare conducted a focus group survey of expat women in March 2011, to find out how much women know about pregnancy insurance. The survey revealed some surprising results. Many women were simply unaware of some of the fine print traps they should look for before choosing insurance.
Five Things to Look Out For When Buying Pregnancy Insurance
1. Waiting Period
70% of those surveyed did not know that different insurers have different definitions of the term ‘waiting period’. 40% did not know that there is a waiting period before receiving coverage for maternity.
The waiting period is the time you must wait before making any claim for that particular treatment. For maternity, it’s usually 8 to 12 months after you take out the policy. However, if maternity insurance is offered as an employees’ benefit, some insurers may waive the waiting period.
But they’re not all the same. Be careful to ask insurers to define their waiting period. Some insurers will only pay claims if conception happens 12 months after the policy is in place.
2. Congenital Conditions
Congenital conditions are abnormalities, deformities, diseases, illnesses or injuries present at birth, whether diagnosed or not. Being covered for these rated in the top three most important concerns for expat women, yet 60% were not aware that this can be covered.
The cost of care for babies born with congenital conditions is high. The neonatal intensive care unit (NICU) at the Fudan Children’s Hospital costs 10,000RMB per night compared with Shanghai United Hospital which costs 30,000RMB per night. And some babies might need care for weeks or months.
Once again, read the fine print. Some insurers do not cover congenital conditions at all, while some provide total coverage. Others still cover up to a certain amount within a limited time (eg US$150,000 for the first 90 days of the newborn’s life or US$ 10,000 for up to 30 days of hospital stay).
3. New Born Care
Once the baby is delivered, examinations are carried out to ensure that the baby is in good health. 50% of the expat women interviewed didn’t know about this coverage.
Some insurers automatically include this, for up to 7 days following birth, under the mother’s maternity insurance. Some specify clearly that they do not cover any routine physical examination, normal hearing tests, inoculations, vaccinations and preventive medicines. Others specify what they cover and some go one step further and specify the duration of cover or number of visits.
4. Complications of Pregnancy and Childbirth
Being covered for complications during pregnancy and delivery was nominated as the top priority for expat women surveyed and yet 30% of women were unaware that this coverage even exists.
“Complications in pregnancy” is defined as conditions that arise during the prenatal stages of pregnancy and some insurers will pay out using the outpatient benefits. “Complications in delivery” is defined as conditions that arise during childbirth and some insurers will pay out using the inpatient benefits.
Once again, insurers deal with this in different ways. Some put a monetary limit to each pregnancy, while others cover the expense in full. For medically necessary caesarean section, some insurers define it as complications in delivery and it is paid out from inpatient benefits. For other insurers, all costs related to maternity, whether pre- or postnatal, delivery and complications, are simply classified under maternity benefits, and covered by the one piggy bank.
5 – Delivery Cost
Surprisingly, 20% of expat women surveyed did not know that delivery was covered under Pregnancy insurance. Most insurers will cover hospital charges, obstetricians’ and midwives’ fees and postnatal care for the mother immediately following normal childbirth (e.g. stitches)
Most insurers do not cover:
- Voluntary caesarean section
- Medically necessary caesarean section due to any previous non-emergency caesarean section undertaken
- Premature or multiple births following assisted conception (eg IVF)
- Waiting period – Usually between 8 to 12 months. Check how insurers define their waiting period.
- Congenital disease – Make sure it is at least partially covered to ensure that your newborn receives the best medical care should the need arise.
- Complications of pregnancy or childbirth – Ensure you know which benefit is used to pay for complications of pregnancy or childbirth.
- Delivery cost – Check for exceptions (eg. voluntary caesarean section)
- Age limit – Most insurers set an age limit for maternity insurance. Most will not insure women over 44.
Postnatal Support in Shanghai
For those planning to breastfeed, join a breastfeeding support group prior to delivery and learn about successful lactation. According to certified lactation consultant and La Leche League (www.llli.org) volunteer leader Melanie Ham, “Support groups teach normal infant behaviors and feeding patterns, while connecting new moms with a network of others who share tips, tricks, and strategies for integrating breastfeeding into daily life.” There is also a Chinese La Leche League group (www.muruhui.org).
New mothers need encouragement, education, and time to develop confidence and enjoy a positive breastfeeding experience. “A lactation consultant is a healthcare worker who liaises with the mother’s doctor and the pediatrician to create a plan to help the family achieve their breastfeeding goals. Many hospitals inadvertently sabotage breast- feeding through prolonged separation of mother and baby, improper positioning, and prematurely introducing formula. Attending a sup- port group or hiring a lactation consultant such as Lunabelle Lactation (www.lunabellelactation.com) can help families avoid these challenges,” explains Ham.
New mothers who experience postpartum depression can access resources and support through Shanghai Doula, Lifeline Shanghai (www.lifeline-shanghai.com) and the Community Center Shanghai.
What is a yuèsao?
A yùes o is a nanny who cares for both mother and baby in
the first months after birth. Most yùes o live-in, maintaining the same schedule as the baby and providing round-the-clock care. Duties of a yuès o may include breastfeeding assistance, changing and bathing the baby, administering night feeds, checking the mother’s postnatal progress, and preparing special foods and soups to nourish the mother and promote milk supply.