Monday, October 10, 2011

How Much It Cost To Give Birth: The Anatomy of Our Hospital Bill


How much does it cost to give birth at Makati Medical Center? There is no straightforward way to answer this question because it depends on the particular birthing situation of each individual, but I will attempt to try to give a detailed description of what my bill looked like to help other pregnant women out there who are looking for info. My total bill was 7-pages long, with a summary on the first page, and a detailed list of all the things I paid for. If I were to simplify the components of the bill, I'd say they could be divided into the following categories: 1) Delivery Room Charges; 2) Room & Board; 3) Nursery; 4) Pharmacy, Central Supplies and Lab Tests; and 5) Professional Fees.

Signing paperwork in the birthing room.    
Delivery Room Charges constitute a huge part of the hospital bill.
1) Delivery Room Charges: This includes the use of the birthing room, the cost of using equipment, and all the materials and supplies used.  For 2 hours, the birthing room costs P3,465, with an additional P462 for every succeeding hour.  I used the delivery room for 2 hours preparation and 2 hours recovery, and 4 hours for labor, for a total of 8 hours (which means I paid P2,772 on top of the P3,465). Every companion you bring in also has a charge of P578/person.  I know of people who were in labor for much longer, and brought in more companions - so the cost of using the birthing room depends on how cooperative your cervix is :-D In addition, if you decide to use an epidural, you pay for the anesthesia (I paid P2,800); Then there's the use of equipment, such as the fetal monitor (P950), Infusion Pump (P808), Suction and Warmer (P800), and a host of other things like Criticare (P4,000), OB-Pack (P2,385), Espocan (P2,055), Supplies (P3,950), Sterile Instruments Pouch (P1,557), and for a Spontaneous Vaginal Delivery there's a fee of (P3,750). The rest of the bill listed small items like booties, gowns, thermometers, gloves etc. My total delivery room charges reached P30,000. I imagine it would cost more for a C-section. I got the biggest and nicest birthing room, so maybe there are cheaper options.

2) Room & Board: There's a range of options for private rooms, from the Small Private Room in the old wing (P3,220), to the newly renovated rooms (P4,700 or P5,200 depending on amenities). Cheaper than the small private would be the ward and semi-private options, but if you want privacy, the small private room is the most affordable option.  Those who want better rooms can opt for the large private rooms, or suites. A 3-day stay in a small private room can cost 9,660 - 15,600 depending on the room you choose. Some women choose to stay only 2 days, but with babies waiting for their newborn screening test to be administered 48 hours after birth, a 3-day stay is recommended, especially if mothers want to breast feed round-the-clock.  My room and board bill was at P9,660.  

Nursery Room & Board (P1,500/day). If your baby needs to be in the ICU it will cost more (P4,900/day).

3) Nursery Fees: Room and Board for the baby costs P1,500/day, and a typical stay is 3 days or P4,500. Other Nursery-related expenses include: the nursery service fee (P2,500), transport incubator (P500), and since we had our baby boy circumcised, we paid extra for the use of the circumcision room (P1,000), and use of radiant warmer to help heal his circ faster (P1,000). There were other items in the bill, such as the vaccination (P250 for the BCG), use of a BP Monitor (P240). The total costs reached around P10,000.  Note: If your baby has an infection, or is suspected to have one, a stay in the Neonatal ICU may be in order, in which case the costs would be different. The daily rate in the NICU is P4,900/day, and if your baby has sepsis, a 7-day stay to run a full course of antibiotics is the usual protocol - this may mean an additional P35,000 to your total bill, on room and board alone, not including the cost of tests and meds.

4) Pharmacy, Central Supplies and Lab Tests: Pharmacy. For my 3-day stay I had to use a number of medicines, from the oxytocin used to speed up labor, to the pain killers and antibiotics which were given to me round the clock by the nurses.  In addition to the medicine I needed, there was the stuff for the baby such as Terramycin eye ointment (P750), Sterile water, Lactacyd baby bath wash etc. The total bill from the pharmacy: P6,245. Then there was the bill from Central Supplies: Everything I used, from cotton balls to the "tabo" (dipper), bed pads and alcohol, to latex gloves, as well as the things baby needed - which is part of a newborn starter kit (P1,941)...all these are sourced from central supplies and in my case, added up to a total of nearly P4,000.   And finally, baby's Lab Tests: We had a lab fee for blood typing (P529), Hearing Test to check baby's hearing (P550), Newborn screening test for some dangerous diseases (600),    All three combined (Pharmacy, Central Supplies and Lab Tests) cost around P12,000.

My total hospital bill for Delivery, Room and Board, Nursery Fees, and Pharmacy/Central Supplies/Tests reached nearly P65,000 pesos, excluding professional fees.

5) Professional Fees: In my case, I had to pay 4 professional fees, namely: First, my OB's fees for delivering my baby; Second, my Anesthesiologist's fees for the epidural; Third, my Pediatrician's fees; and finally, my OB's fees for my baby's circumcision. The combined total of all my professional fees cost more than the hospital bill I outlined above. Without getting into detail, I suspect that the professional fees I paid were rather on the high side, but I knew this beforehand since this is my second baby to be delivered by the same team - I was just very happy with my OB and Anesthesiologist because my experience with them was textbook perfect, with absolutely no complications, and I am also super happy with my pediatrician.  It is hard to benchmark prof fees because it will depend on the specifics of your situation and your baby's. One way to find out the range of fees charged by your doctor is to ask from someone who's worked with them before, or, ask the secretary who schedules their appointments and ultimately prepares their receipts.

I understand that Makati Med has birthing packages that pegs both Normal and C-section deliveries within a particular price range, these are published in an info sheet available at the Admissions office in the ground floor. Not all doctors in Makati Med do these packages. If you're keen on delivering in Makati Med and would want to keep within budget, look for a Makati Med practitioner that does the package. The room for the package is semi-private.  If however, you are keen on working with a particular doctor, and that doctor you choose does not do the hospital birthing package, be prepared to pay more. (If you need a ball park figure just so you know how to plan and prepare, I figure that setting aside P150,000 should be sufficient for a normal delivery, this would leave you with enough elbow room for a few extras - like circumcision if you're having a boy - or a safety fund for in case your baby has an infection and would need to stay longer in the hospital).   

So how much would it cost to give birth in Makati Med these days? After my very long, and detailed sharing of my experience, I'd still say: it depends. It depends on how fast your labor is, and whether you'd deliver normally or via C-section, and how expensive your Professional fees are, what kind of room you get, and whether your baby will require more expenses (either for an infection, or for an extra procedure like circumcision).

Related Posts:

On Our Baby's Circumcision: A Mother's Point Of View
http://nikki-mama.blogspot.com/2011/09/on-our-babys-circumcision-mothers-point.html

46 comments:

  1. Thanks for this very detailed post on birthing cost, Nikki. I think this gives all soon-to-be moms a clearer picture of what to expect on their bill come D day, even if they are not planning to give birth at Makati Med.

    Thanks again! :)

    - Angela

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  2. Hi Angela,
    You're welcome, I hope it helps! I tried looking for info before I gave birth and it was difficult to get answers, now I understand why! Even for my 2nd delivery, I was still guessing how much it would all cost even if I had just given birth to my first child 2 years back, I was trying to guess if inflation had an impact, and if the professional fees would increase by much. Good luck to you! May you have a wonderful birthing experience :-D

    Nikki

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    1. mam nikki tanong ko lang po, may alam po ba kayong hospital na mura lang ipa incubator yung baby, nanganak na po kasi yung kapatid ko 6 months palang buhay po ang bata, ang bayad sa hospital eh 15k per day,

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  3. my gad, that's seriously expensive! pwede bang ikain ko na lang ang perang yan? haha!

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  4. That's so true Jona! When my son got sick a week later, and I called different hospitals to find out their daily rates for Neonatal ICU - I realized how expensive Makati Med is in comparison! Pero my brain kasi works this way - it retains the positive memories - I remember the good experience. I wrote this account to give other prospective mothers a real picture of what's to come.

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  5. Hi! Thanks for the detailed account, really very helpful. I haven't seen any article/blog breaking down the costs like you did. I'm due any time now and planning to deliver in MMC. My OB advised me to expect to spend about the same amount, and your account really gave me a clear idea where all that money will go :)

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  6. Thanks Jenny, for your encouraging comment. I was hesitant to share this info and I sometimes regret posting it given the kind of upbringing I had - in our family we were raised not to talk about money in public - but I figured when I was looking for info when I was pregnant, I wanted more details! Thanks again and good luck with your forthcoming birthing day! God Bless you fellow mommy! :-D

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  7. Hi NIkki, Thanks for this very detailed info and your experienced in giving birth at MMC..Its very helpful since I'm due in 3 to 4 weeks time now.. I'm searching how other mommies experienced in giving birth at MMC.. so that I know what to expect..and whats the procedure and process at MMC..

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    1. You're welcome. I did this detailed account precisely because I was looking for this kind of info on-line when I was about to give birth myself. Surprisingly, even if it was my 2nd time to give birth at MMC, I forgot a lot of the details from my 1st delivery (things like how much what cost exactly). May you have a smooth and lovely delivery soon! Cheers from one mom to another! -Nikki

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  8. Thanks for going to the trouble of posting this article about MMC. I created a link to your site from my blog about "Medical Care in the Philippines", featuring MMC and some other Philippine medical centers. http://timotraveling.blogspot.com/2012/06/medical-care-in-philippines-doctors-and.html

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    1. Thanks for dropping by! I checked your site, and I saw how you were comparing the different hospitals. I have a blog post on bringing our baby to 3 hospitals for jaundice and sepsis (see my "medical adventures" blog posts). I saw the difference first hand, on the quality of care and facilities at Makati Medical City, St. Luke's, and Medical City because we had our baby confined in all three hospitals. Thanks so much for sharing info, I am sure many people find it helpful. More power to you!

      N

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  9. I really appreciate this extremely informative post on the cost of giving birth at MMC. It was a great breakdown especially for first time mothers to know what to expect and with what they end up including on the bill. I totally forgot that they MMC charges for every single item they use to touch you even as superfluous like a cotton ball!

    Upon research and doing up a lot of reading on the benefits of not bathing a newborn, I wonder if they would cut the cost of products to bathe the baby with, if I opt out of it. Any idea?

    Again, thanks a bunch for this!

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    1. Hi! I think it would be best to mention your preferences to your OB when you write up your birth plan. If I remember correctly, you have 2 options: room-in or nursery and it's "touch move" - that is, if you choose to room-in you can't request midway to transfer your baby to the nursery. The hospital has to follow certain protocols. If you want full control of what will be done to your baby once you deliver, perhaps the room-in option is for you (I am not the best person to give advice on this because I opted to send my babies to the nursery for both of my pregnancies). If you room-in, I can already see a number of costs that would be stricken off your bill: the nursery charges, the baby kit, use of equipment etc.

      If you choose to entrust your baby to the nursery, I doubt they'd let you "opt out" of bathing your newborn. I think they will most likely follow standard protocols and administer services uniformly. All I can say is, the guys at the nursery are amazing! They move fast and expertly and they are gentle both to babies and moms!

      Whatever way you choose to go, I am sure it will turn out well, you're in MMC after all :-D

      I hope this helps!
      Enjoy!

      Nikki

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  10. nice blog, very informative and in detail. My sister is due next month so upon reading this it gave me an idea how much she needed to prepare @_@. Like you've said, it's all worth-it knowing its a good team and you're comfortable with them. I am due as well but on November, though i'm checking in a hospital in Las Pinas this helped me to get an overview of the much anticipated expenses.. ^^

    more power nikki!

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    1. Thanks for leaving a comment here! I can relate with you :-D I remember when I was pregnant, I wanted to get an idea of what to expect and I was reading blogs of other mothers as well. It's cool that you and your sister are giving birth a month apart - your kids will be batch mates! Sounds like it's going to be fun for you and your kids :-D Take care!
      Nikki

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  11. Hello nikki, im due on june 2013 and my ob is at mmc and im also planning to give birth there. I askd my ob during our 2nd appointment about the costs and packages.but she said that she will just discuss it with us later on when "malapit nako manganak" so your blog is really helpful. By the way, may i know the name of your ob, if you don't mind. :) im also looking into trying a different doctor just to have a point of comparison.thanks much!

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    1. Hi, my OB's name is Dr. Teresa Henson, I describe her and my other doctors (anesthesiologist and pediatrician) in a related post entitled "Enjoyable Delivery at Makati Medical Center" (click on the link provided above). She was also the same doctor who did our son's circumcision, in case you're having a boy and considering your options (see related post on Circumcision, also with a link provided above). Good luck!!! It's really hard for doctors to give a concrete figure on their fees, and it's hard for us to get the info we need no? Remember, this was in 2011, and you're giving birth 2 years after I did...so there may be changes in prices and procedures. When my daughter was born in 2009, it was different from my son's birthing in 2011 - different operating rooms and equipment used, even if I worked with the same team! Inquire with the admissions office which doctors do the maternity package, if you're interested in having a clearly define budget. I know of a friend who did that, and it went well, and they were billed the amount they were told initially, so that took the guesswork out of their preparations. Take care!

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    2. Thank you for your help nikki! :)

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  12. Hi, Would you think for a Pedia to have a 40k PF fine? Just want to have your 2 cents on this. I totally have no idea about the range but the reason I asked is that the Pedia has double the PF than our OB and anaesthesiologist combined. Our daughter by the way stayed for almost 23 days in NICU. Appreciate if you can share your thoughts on this.

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  13. Hi there!

    Our baby boy was confined in the NICU for an infection two weeks after he was born. We rushed him to St. Luke's (Global City) and transfered him to Medical City midway. He was in the NICU in both hospitals. Fortunately, my husband's sister is a pediatrician, and the doctors who treated our son were her friends, so our professional fees were very low, so I do not have a factual basis for gauging the cost of your pedia's PF. (here's the link to the post I wrote before).
    http://nikki-mama.blogspot.com/2011/09/our-baby-in-hospital-for-jaundice-and.html

    That said, I still wish to share my opinion on this. I do believe the PF is linked to the rates of the room, and the NICU is a higher category for sure. The length of stay, 23 days in the NICU, may be the major factor in the cost of PF. We transfered our child from NICU to a regular room, because of the different protocols involved. The regular rates of pediatricians for births with no complications is at no less than 5k but nor more than 12k at a good hospital (based on experience and info from friends - but that was 2 years ago, can be higher now). Imagine, that fee is for 3-days work of checking on the baby at the nursery. So imagine if it is 23 days of monitoring, sure the nurses are there to care for the baby, but the ultimate accountability and decision-making responsibility rests on the pediatrician, that means being abreast regularly on the status of your child. So I think, in your case, the cost may be justified. Again, I'm no expert! I'll ask my sis-in-law and get back to you...she'd know better.

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    1. Well, thanks again mam. No need to ask your sis-in-law now. I guess I was just surprised yesterday to hear the amount and basically compared it to the PFs of other doctors that attended but I'm ok now as we have already paid the bill. He he he. Appreciate your response though.

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  14. Hi. That was really informative and detailed. I'm sure that it will help a lot to those who want to have more input/idea about giving birth nowadays. Good Job!

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  15. Hi Nikki! I really appreciate your blog as I am due in 4-6 weeks. I will also give birth in MMC and I am contemplating if I should get the birthing room or not. Giving birth nowadays is very expensive, though I also want to make sure my experience (as a first time mom) would not be traumatic.

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  16. Oh my gosh, and this is 2011 pa? :) We had baby Charley early December 2014 - even her prenatal check-ups are expensive, but we love Makati Med because it's very convenient and the services are really superb! My OB is Dra. Marinette Sto.Domingo, and she is love! <3 http://charleysmommy.blogspot.com/

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