When most people think about the adoption process, the expenses for the birth mother (parent) are rarely considered. These expenses include pregnancy-related medical and living expenses. In some cases, expenses can extend beyond birth to postpartum recovery.

Almost all U.S. states have laws governing the fees and expenses adoptive parents are expected to pay when arranging a private-placement or independent domestic adoption. There are also provisions that limit birth parent expenses. These limits are usually vague (“reasonable and customary”), which leaves it to the court to decide what is reasonable in each family’s case.

Each family is different but, if you’re considering adoption, you should estimate birth parent expenses and budget accordingly.

What Are Birth Parent Expenses?

A birth parent’s expenses can include doctor’s visits, the cost of giving birth, housing, utility and grocery bills, counseling, travel costs, and legal fees. A birth parent’s expenses vary widely based on their living situation, the pregnancy, and whether they are insured.

If the birth parent enters into an agreement with prospective adoptive parents (whether in a private adoption or through an agency) before giving birth, the agreement usually outlines what expenses are to be paid by the adoptive parents. If, however, the birth parent has already given birth and then decides to place the child for adoption, they may not be entitled to reimbursement for the cost of pregnancy and childbirth unless expressly agreed upon.

When working with an agency, birth parent expenses are usually included in agency fees and paid directly to them by the agency. These payments are reviewed by a court during the adoption approval process to ensure compliance with state laws that stipulate what birth parents can be reimbursed for and how much.

While only seven states explicitly prohibit the payment of certain expenses, the majority limit reimbursement to only those expenses expressly permitted by law or deemed reasonable by a court. Ineligible expenses often include education, vehicles, vacations, and permanent housing, which qualify as compensation rather than reimbursement. It is illegal in every state to pay a birth parent to adopt their child.

Some states even go so far as to stipulate how long before or after birth adoptive parents can pay certain expenses. In Iowa, adoptive parents cannot pay the birth parent’s living expenses more than 30 days after she gives birth. New York limits the payment of living expenses to a 90-day window—60 days prior to birth and 30 days after.

Eligible expenses vary widely from state to state. “In New Jersey, birth parent expenses are heavily regulated; this is not the case in other states,” explains Christina Letizia, the Executive Director of A Loving Choice Adoption Associates. “I have seen out-of-state adoptions cost in excess of $60,000. New Jersey residents are not permitted to utilize the services of paid facilitators or consultants.”

What Birth Parent Expenses May Include

Pregnancy-Related Medical Expenses

Medical expenses include labor and delivery expenses, prenatal and postnatal doctor’s visits, prenatal vitamins, specialist services for pre-existing conditions, ultrasounds, and additional care during the recovery period. When using an agency, these expenses may be included in the agency fees. If not, the adoptive parents may have to pay them directly according to the reasonable needs of the birth parent.

If the birth parent is insured, insurance should cover a lot of these medical costs, in which case adoptive parents would only be responsible for copays and coinsurance for doctor visits and prescriptions.

Travel & Transportation

Travel to and from doctor’s appointments, court appearances, or to the hospital to give birth may be reimbursed by the adoptive parents. Adoptive parents may be asked to pay for taxi or bus fares, gas, or even plane tickets if it is an out-of-state adoption. Although most courts won’t approve the purchase of a vehicle, adoptive parents can pay for a reasonable car service when used for appointments and necessities. If the birth parent has dependent children or needs a companion to accompany her, their transportation costs may be charged to the adoptive parents as well.

Pregnancy Clothes

Some birth parents may not ask to be reimbursed for pregnancy wear, but they are allowed to ask for it and courts may approve a reasonable amount, which varies from case to case.

Counseling

Adoption can take a physical, emotional, and mental toll on a birth parent. Therefore, access to counseling during pregnancy and after adoption placement is standard, but the amount adoptive parents can pay for counseling is different in each state.

Agencies may include these services in their fee or adoptive parents may set aside money to pay for these services if necessary. A Loving Choice Adoption Associates fee schedule, provided to Investopedia directly, states that counseling for any party to an adoption is billed at $150 per hour.

Housing

If a birth parent cannot pay rent or does not have adequate housing during the pregnancy or adoption process, then adoptive parents may be asked to help. Housing expenses can include utilities (such as electricity, water, and gas), groceries, and phone and internet bills. An adoption agency can help adoptive parents ascertain what costs are reasonable to expect.

Legal Fees

Adoptive parents are responsible for birth parents’ legal fees on top of their own, including home study and guardian ad litem fees. According to the Child Welfare Information Gateway, court documentation fees range from $500-$2,000. And adoptive parents working with an agency, whose fees often include some legal expenses, can expect to spend up to $4,500 on attorneys. Families adopting independently will pay even more in legal fees, ranging from $7,000-$15,000 by the Gladney Center for Adoption’s estimate.

Does Health Insurance Cover Birth Parent Expenses?

Under the Affordable Care Act, health insurance plans must cover pregnancy and childbirth costs, including prenatal and postnatal care. If the birth parent is insured, then most adoptive parents will only cover the cost of premiums, deductibles, copays, and coinsurance. Though, the cost of healthcare in the U.S. being what it is, that can add up. According to the Peterson-Kaiser Family Foundation Health System Tracker, insured women who give birth pay almost $3,000 more on healthcare than their peers who don’t give birth.

If the birth parent does not have insurance, they could enroll in Medicaid as long as they meet state eligibility requirements. If the adoptive parent is ineligible, the adoptive parents may need to pay for them to enroll in a private plan. Because pregnancy is not a qualifying life event that makes one eligible for a Special Enrollment Period, adoptive parents may need to buy short-term insurance to cover the birth parent until they can enroll in a marketplace plan during open enrollment. After adoption placement, the insurance of the adoptive parents will cover the baby as a dependent under their policy.

Can Adoptive Parents Be Reimbursed if the Adoption Falls Through?

Whether adoptive parents can be reimbursed for their payments when an adoption falls through depends on the state in which the adoption is taking place. Only Idaho and Puerto Rico require that a birth parent return payments made to them by adoptive parents if they decide not to go through with the adoption. In Montana, North Carolina, and Vermont, the adoptive parent can stop additional payments when the adoption falls through unless there was a prior written agreement to make payments regardless of the adoption outcome.

In the unfortunate event of a birth parent taking payments from multiple adoptive families, lying about being pregnant, or accepting payments with no intention of completing the adoption, adoptive parents may be entitled to reimbursement for their expenses. Adoptive parents should talk to their lawyer or adoption agency about what expenses they may be able to recover if the adoption falls through.

The Bottom Line

Adoption is a costly process for everyone involved. Some birth parents do not require financial support for health expenses, but many do. Legal fees, travel expenses, and even lost wages are all expenses that can be passed along to adoptive parents if state laws allow it and courts deem it reasonable. Many agencies and adoption facilitators work to ensure that the birth parent does not incur any expenses in the process, but each state has specific limits on individual costs that can be claimed by a birth parent and the timing of when these fees should be paid.