The Real Cost of Motherhood with Elaine Welteroth
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80% of the maternal deaths in this country are preventable. There is a solution, a data-backed solution, and all it needs is us to invest in it. Of course we need laws to change. We need the systems to change. We need insurance to change how they incentivize physicians to care for pregnant people. There's a lot about the model of birth care in this country that needs to shift. We don't have time for those systems to change because mothers need this support. Families need this support right now.

What's up, rich friends? Welcome back to another episode of Net Worth and Chill with me, your host, Vivian Tu, aka Your Rich BFF and your favorite Wall Street girly. And I fear I am officially at that age, that age when my friends are starting to have children on purpose.

Honestly, I joke, but in all seriousness, I recently just navigated my own fertility journey. I did a round of embryo freezing and a good number of my closest friends are now family planning. They're painting baby rooms and buying cribs and getting strollers. And that's terrifying because...

Not only am I just starting to get comfortable with the idea of being the cool aunt, as it turns out, having a kid isn't as easy as they make it out to be in the movies. Not only is preparing for a baby's arrival super extensive and time intensive and kind of scary, but it's also physically very dangerous to give birth. And I didn't even know that.

Not only are you in a cold, sterile hospital room about to do the most vulnerable thing a human being can do, but you also get the privilege of spending thousands of dollars to do so. Not great.

But that's why our special guest today is trying to change just that. She's an author, a journalist, a television host, creative entrepreneur, and a mom of two. At just 29, she became the youngest person to be the editor-in-chief of Teen Vogue, and she's the founder of Birth Fund, an organization dedicated to reducing the maternal mortality gap. Everyone, please welcome Elaine Walteroth. That was an amazing intro. Good one, right? Thank you. I'm very honored, yes. Yes.

I am so excited for us to chat today. But before we get into it, I have a fun little icebreaker. Let's do it. What is your first funny, proud mom, but like, oh shit, I didn't realize that having kids was going to be so expensive moment. Support for Net Worth and Chill comes from Amazon Pharmacy. The last thing you want to do when you're sick is go pick up your prescription at the pharmacy because then you're standing in a long line with a whole bunch of other sick people.

And everyone is sick of being sick, especially around other people who are sick. Amazon Pharmacy will deliver right to you fast. So you can get meds without congregating amongst the contagious. Healthcare just got less painful. Amazon Pharmacy. Learn more at health.amazon.com. Oh my goodness. I would probably say it's not like a funny or fun or even unexpected answer, but school.

I'm like... School. At like preschool, it's as much as I paid for college tuition. And it's... For them to play with blocks? For them to play with blocks. I'm like, wait, really? Really? I mean, but it is what it is. And I think that's just another reason why you want to make sure that you're having babies at a time in your life where you're...

really prepared. Yeah. And you can have more choices. But the answer is school. It's hella expensive, even preschool. Yeah. Okay. And you mentioned this, like,

being financially ready to have kids, was there like a number you felt like you needed to hit to be like, I can have kids? Or was there a point or a feeling that you came to? No, no, no, no, no. I laughed when you, I giggled when you said like your friends are having babies on purpose. And I was like, not all of them. Not all of them are on purpose. Neither of mine were on purpose actually. Really? Like every part of my life I feel like is so intentional. And this is the one part that's

arguably the most important that we didn't plan at all. And it wasn't even on our five-year plan. But when it happened, you just surrender. But it did come with a bit of an identity crisis because I was like, wait, wait, wait, wait. This wasn't part of the deal. I had such a full plate. And I was like, how do you make more room for a human in your life, in terms of what we're talking about today, your bank account and all of the expenses that come with it? But

There wasn't necessarily – I don't think anybody gets to a place where they're just like, my life is totally ready for a baby because you just don't know how to plan for the unexpected. Like having a baby is – there's so many things that you cannot plan for, even if you plan for the baby. And so I just feel incredibly grateful though that –

I waited as long as I did. Like, I am the mom that I am because I had the baby at the time in my life that I did. And I...

You know, young people who are like in their 20s who have this unrealistic ideal in their mind that you should be having babies by 25 or before 30. Like, girl, no. Wait. Find the right partner. The people you're dating at 25 most likely are not the people that you really will want to be partnering with for life around 20.

the most important job of all, which is parenting. So I think I am a big, big proponent of waiting as long as possible to have babies. To be sure. To be, not even about being sure, even if you're totally sure at 25, I think it's about making sure you have A, the right partner to do this job with. That's your co-founder, okay? Yeah.

And what kind of business are you trying to build with them? What kind of environment and culture are you trying to create for that child? Like every decision now becomes like a two-way decision. So who do you want across the table from you making those important choices for your kid? And then also financial readiness. Like I feel like I was not –

And I'm so glad, like the day before, I wouldn't have been as ready. You know what I mean? Yeah. I feel like I was at a place in my life, I think I was 34 or 35. I was married. I had a house. For the first time, we had just bought our first home together. I felt for the first time in my life, like really financially secure.

I guess if that's a word. Secure. Secure. I had started investing. I felt like I could really just breathe for the first time. Yeah. And then I got knocked out. Yeah.

So talk to me about that. Like, what was that first pregnancy like? Like early motherhood? Was it sunshine and rainbows? Not at all, sister. I feel like they need to rebrand pregnancy and to give you the real. I was not expecting it to be as hard as it was. And I know it's not this way for everyone. Yeah. But I had a challenging pregnancy in a number of ways. It was a lot harder than I thought to find –

a care provider to go on this journey with. Like that was the part I had given zero thought to. Talk to me about that. Well, I think we have this idea that you just find a doctor and

you know, they are with you throughout your pregnancy and then they're there, you know, delivering your baby and you guys are BFFs and everything's all good. And then, you know, you go home with your baby and like right off into the sunset. For me, it wasn't like that at all. And the more women I speak to, the more I find that

We are all facing a set of real challenges around the maternal health system, which is not dissimilar from the medical system at large. And there are...

so many challenges, especially for women of color, to find a care provider that makes you feel seen, heard, and safe. And that's coming from someone who truly did not expect to feel that way. Like, I'm like, I'm a journalist. I'm a friendly person. I like

I'm a people person. How hard could it be to find a doctor in this new city? I had just moved to LA during COVID, and so I didn't have a doctor. I'm generally healthy, and so I was like, I better find a doctor now. And I went on what I call, it felt like I was dating doctors.

You were speed dating doctors. I was speed dating doctors. I was trying to find the right fit. And every single time I left feeling smaller and smaller and smaller. And I had just so many like unexpectedly awful experiences of just not being listened to. My questions weren't honored. And it was the most overwhelmed and vulnerable I've ever felt in my life. What exact conversations were you having that you were like,

My concerns are not being listened to. Well, I have said this before, but one anecdote I can share is that I had a doctor stand up in the middle of our conversation and say, you have exceeded my two to three question max per visit.

Yuck. So incredibly rude. But particularly when we're talking about questions that could be life or death for me and my child, for you to rush a woman like that in her most vulnerable state was so incredibly hurtful and scary because I felt like I had nowhere to turn. I went through eight different doctors and I'm like, when does it feel... And by the way,

I mean, I can give you so many examples of just conversations that would make your jaw drop. Like I had a doctor take six vials of blood on accident and then not admit it to my face, but she thought I had left. And so I heard them arguing in the hallway being like, I thought you said this panel. No, she already did that. I mean, it was like...

That kind of thing, there was another thing that happened where I asked a doctor, which I encourage every pregnant woman, whether you give birth in the hospital or at home is your choice. But if you are choosing to give birth in the hospital, there are very important questions you need to ask to figure out what the mindset is of your doctor to help keep you safe. You have to go in advocating for yourself from day one. So...

First things first, if they're not listening to your questions and cutting you off, that's not the right care provider for you. One of the questions that I asked was, what's your intervention rate? Because what we know is that we are living in – first of all, we're living in a maternal health crisis. Yeah. Most people don't think about that. Maybe they don't know that. Yeah.

But especially as a person of color, black women are three to four times more likely to die during and after childbirth. So in this climate, you deserve to have your questions answered. If Serena Williams can almost die giving birth, one of the richest black women on the planet.

it can happen to you. And that's very scary. 100%. 100%. What does that say for the rest of us? Right. Because I have to imagine she's getting the creme de la creme care, private room, everything. What about the rest of us? Exactly. And by the way, we are both very privileged as well. Of course. We have insurance. We speak English as our first language. We know what questions to ask. And even still, the way that I was treated helped me understand why women are dying at the rates that they are. And I decided to make a difference.

decision at the end of that dating spree. I was like, this is not my vibe. This is not serving me. And so I was redirected to midwifery, which is a holistic form of birth care that is truly ancient and the default birth care model in every other high income nation across the world. Really? And believe it or not-

The United States has much worse outcomes than every other, 10 times deadlier outcomes than every other high income country across the world. Did you hear what I just said? When we think of the US, we think like we have access to the best technology. We have the best.

I think now we know. I think we now know a little bit better than that. But the point is I found midwifery care on a personal level to be life-changing and

Yeah.

Going back, the thing that I was going to say is the question that I think every pregnant person should ask their doctor when they're dating them, because you are dating them, right? And you need to make sure it's the right fit, is what is your intervention rate? And that will tell you a lot about their philosophy because here's the difference between midwives and doctors. Doctors, OBs...

are trained surgeons. Midwives are birth workers that are experts, medically trained experts at delivering or as they say, catching your baby and caring for the mother holistically. So if you need a surgery, the hospital is the right place to be. And there are people who need C-sections and scheduled C-sections. They know this in advance.

But if you are someone who's having a fairly healthy normal pregnancy, you can consider midwifery care and a home birth or an out-of-hospital birth. So that's just something to know. But so many of these maternal deaths are the result of unnecessary medical intervention. So that's why it's important to ask because when you – that first intervention is

can lead to a spiral of interventions that can often lead to unnecessary emergencies and sometimes death. And so when I asked this question, I had a reason for asking it. And the answer that I got was my doctor laughed in my face and said, I don't know what you think this is. Everybody needs something.

And you can't just walk up into a hospital, pop a squat, and have a baby. But, like, isn't that how all the cavewomen and then literally everybody after them did it until kind of recently? Right? So I said, okay. In my mind, that was my final doctor's visit before I decided this system does not serve me. Yeah. And I'm going to find alternative paths to better care outside of the system. And I decided to have a home birth at 37 weeks because I was –

That scared and that conditioned to think that midwifery was somehow unsafe and dangerous.

There's a reason we all think that, by the way. There's like been generations of propaganda campaigns that have – Money behind marketing. Yes, that have incentivized us to think that there's only one good, safe, healthy way of giving birth and it's in the hospital. But I now know better and at 37 weeks, I made the decision to deliver my baby –

At home, I popped a squat and I pushed that baby out like women have been doing since the beginning of time. And it was a nine pound baby. A bowling ball. The most ginormous baby of all time. And truly to the save. All the things I've done in my career, like that is my proudest achievement. I am like, put that on the tombstone. She pushed out a nine pound baby unmedicated at home. But it was such an empowering experience to go from feeling so disempowered to

by these doctors and this medical system that just isn't set up to incentivize proper care. It's really incentivized for profit over patient care. And then to make a different decision for myself and for my family that was right for us. And I had the most beautiful, sacred, safe experience.

And honestly, joyful birth and a birth that I didn't even know was possible based on what we've all what we've always seen presented to us like this. You know, it's always seemed like this, like the screaming agony filled thing. I was literally meditating in my shower for hours silently and never cried, never made a sound, never screamed. It was it was a deeply emotional.

like spiritual experience and I I just share that story because I wish I had heard that kind of because that's what we see in the movies we don't see that in the movies and there's reasons for that I mean I think the more that we fear something the more we give up our power yeah the more we are likely to be taken advantage of and easier to be taken advantage of we give up our authority um and I

having a home birth and birthing with a midwife is the exact opposite experience. It's about giving you your power back. It's about removing the fear. It's about connecting with your body and trusting it to do what it was meant to do. And I know that to some people might sound like woo-woo, but it's actually proven to have better outcomes all across the world. And not only that, but we're not just talking about keeping moms alive. We're talking about

trying to prevent birth trauma, which by the way, 50% of mothers in this country walk around with birth trauma that we don't talk about. What is that? Birth, it's exactly what it sounds like. It's trauma related to a bad or a negative birth experience. And it impacts how our postpartum goes. It has a lot to do with why postpartum depression is so high in this country. And

There are long-term psychological and physical consequences. So we can't take this lightly when we live in the richest country in the world. We can do better and we should be by these families, especially at a moment where we're stripping women of their reproductive rights and forcing them into motherhood before they're ready. So all of that is why I started Birth Fund. Can we talk a little bit about why birth?

You started Birth Fund. Like, what is Birth Fund? Give us the elevator pitch. Like, why is this important to you? Well, based on my experience of being pregnant in this country and seeing up close just how broken this maternal health care system is, but also seeing as a journalist, seeing as a mother and also as a journalist, understanding birth

that midwifery is a solution to the maternal mortality crisis. It's not the only solution. But as I was navigating this journey, I put my journalist hat on and I dug into the research. And what I found is that 80% of the maternal deaths in this country are preventable.

That's horrible. 80% are preventable and 80% could be averted with midwifery care. So for me, that was an aha moment where I was like, wait, why have I only ever heard about the maternal mortality crisis through the lens of the problem? Like it always stops at the scary statistic and then you're just left with the fear. But I had a lot of hope around this idea that like there is a solution, a data-backed solution

And all it needs is us to invest in it. Like we can do that without this. Of course, we need laws to change. We need the systems to change. We need insurance to change how they incentivize physicians to care for pregnant people. There's a lot about like the model of birth care in this country that needs to change.

to shift. Yeah. But we don't have time for those systems to change because mothers need this support. Families need, need the support right now. And so I felt compelled to, to,

invest my own resources into this kind of this solution, this model of care that I know is proven to have better outcomes. And that is incredibly empowering as well. So I started really small. I decided for my birthday that year that I was just going to do an Instagram fundraiser and invite my community to join me.

in trying to raise money to cover the cost of at least one family's care right here in LA. To get a midwife. To get a midwife. Yeah. Within 16 hours, we raised $16,000 and we were able to cover the cost of not one, but two families to have access to midwifery care. And from that point, it was kind of like my moment of ignition. I thought like,

I can scale this. I know some people I can call who will join me in creating a funding circle. And I have a lot of corporate partners that I've worked with throughout my career that I can bring, you know,

invite to bring into this movement. And one of the first calls that I made was Serena Williams, who, as you said, shared her story about almost dying during childbirth, even though she is, you know, one of the strongest women in the world, most powerful and one of the wealthiest. Ostensibly very healthy, ostensibly, you know, getting the best possible care. Like,

And knows her body. Yeah, exactly. And even she wasn't listened to. When she said something is wrong, I know my body. Right. And so she was one of the first people I called. I asked her to get on board and she said, yes, absolutely. And she said, call my husband. She said, he needs to get involved in this. And I was like, absolutely, because we need men involved in this conversation because no one is more impacted. Yeah.

by this issue than the men that are going home without their partners who didn't make it through childbirth and left to raise their families on their own. It's devastating. But even beyond that, like birth fund is really about...

families coming together to help fund other families' births. And we're here to cover the cost of midwifery care because it is a data-backed solution with better birth outcomes. Can I ask you a quick question? We know that giving birth in a hospital with an OB can sometimes run people thousands of dollars. Sometimes it's free, depending on your insurance, but you never know these days.

What is the average cost of a midwife for one family?

So...

It's hard to give an average because the range is so wide. Got you. It really depends on where you live, your midwife, their birth... They set their own prices, but we...

say $10,000 at Birth Fund is what we apply towards everybody's birth. Like each family gets $10,000. We also offer partial grants. Some families don't need the full grant, but in different, it can range between like, in some places it's as low as like $2,500 or

Between that and like 4,000 and other cities like L.A., it's really expensive. Yeah, major metros, it's always. It's on the higher side, yeah. Birth Fund is a coalition of families, individuals, and corporate partners who have come together to invest their own resources to ensure that families have access to this life-saving,

saving model of care, of birth care. And so basically we cover the cost of midwifery care for families all across the country because I believe and I think we can all agree that quality birth care should not be seen as a luxury in this country. It should be a right that everyone has access to. And for people who have made the decision for themselves that a hospital birth is

isn't safe for them or it isn't the right fit for them, money shouldn't be the thing that stands in the way of them feeling safe and dignified and for them to have access to compassionate care. And so that's what we're here to do is to remove that financial barrier for families because unfortunately, while we know and all the statistics tell us that midwifery care is safe

and it is life-saving. It's also not covered by insurance in America, which is why it is so cost prohibitive for so many families. And it's why we're stepping up.

That's a longer story. That is a longer – we don't have time for that on today's podcast, but there are many reasons. It comes down to insurance. And really, that is an entire industry that needs to be disrupted. Maybe you can talk me through just what was the advertising campaign or what changed so that people thought –

you know, having a midwife instead of a doctor was so dangerous. Yeah. So legally midwifery was outlawed shortly after the advent of obstrenetics, which is like modern- OBs. OBs. And-

And again, this is not to vilify OBs. This is not an anti-doctor movement. I believe deeply in Western medicine, but I also believe that, you know, there's room for different kinds of birth care, right? So I just want to make that really clear. Yeah. Like doctors...

So OBs, midwives, and doulas should all be a part of an integrated birth care model that serves women and their babies in the highest form, right? So I just want to say that. But basically, in order for like OBs to come in and become the –

default option for families to give birth, they vilified midwifery care. And there was a decades-long propaganda campaign, smear campaign, that had really

Yeah.

those stereotypes and that stigma last is, was lasting. And it has effects that are like really rooted still in our culture today. And I even say like, I I'll be honest, I didn't feel safe having a baby with a midwife. I still, even with all the things that I had learned and,

I watched this incredible documentary, which literally everybody needs to watch. You need to watch it. Your mind is going to be blown. It's called The Business of Being Born. And it breaks down in much better terms what I'm talking about right now, the kind of historical timeline that leads to where we are and how we got here in terms of how deadly our birth outcome rates are and birth trauma as well. But

When we, even with all of this knowledge, I was like, but for my first baby, I think I still will have a baby just to be safe. And it's like, just to be safe, I should have a baby with a midwife because they give more time per visit to get to know me, to actually answer my questions. Like the difference is huge.

Pretty incredible. 15 minutes is max what you'll get in a hospital visit, whereas midwives is up to an hour or more. And it's, by the way, at your bedside at home. And as you become more and more pregnant, you'll realize like this is not a luxury. This is something that you actually medically need at some stages of your pregnancy. Many people do. Anyway, I'll stop there. The bottom line is that there is a reason that we are conditioned to think there is only one

to give birth safely in this country. And what I would just challenge any person to do is to take time to unpack what you think about birth and why you think that and open your mind to other alternative pathways to safe, quality, compassionate births.

birth care. I love that so much. And I know we are coming up on time. So I do want to think and chat a little bit about a new headline that has come out of the White House. Oh, God. You're already making a face. So yeah. Oh, God. Another headline. Yeah. The White House has said that they want people to have more babies and that if you actually have six or more kids, they'll give you a medal.

I would love your take on this. And, you know, what's your POV on people having more kids?

Oh, my goodness. The best way to encourage women to have more babies is to give them structural support. Right. Which we lack severely in this country. And when you can't afford to have a baby, one baby, how you how you expect women to have six? If you can't afford child care for one, how you expect them to have six? Like we this is the most.

archaic and nonsensical notion. I mean, there are many at this moment swirling in our culture, but this is, it's truly insulting. It's as if there's no concept of what women are going through as it is with the children that they have now on top of the idea that our rights are being stripped. So even like

Even mothers who choose this path are struggling to afford it, to take care of themselves. Like this is we have a structural problem in this country around around parenthood and motherhood for those who choose it. Yeah. And then now we have a rising number of people who are being forced into parenting and and motherhood specifically before they're ready to.

And then there's no resources. And then there's no resources for them. So we could talk about this a lot longer, but net-net, as you can see, like not for it, not for it at all. What is your take on it? As somebody who doesn't yet have kids, but it sounds like you are preparing for that stage of your life. Yeah. Well, I just think it's, one, a little frustrating when we are not going to

put forth protections against our environment, against our climate. So will our children really have a great world to inherit? One. Two, our entire episode today, there are severely lacking maternal protections. There's no federally mandated parental leave. There's no support for child care costs, which are one of the highest expenses after shelter and transportation. And, you know,

I then have this child. This is my pride and joy, my baby. And I send them to school and you can't even promise me my kid's going to be safe at school. If I see one more headline of one parent devastated that their child's life has been taken senselessly, violently, I mean, it doesn't feel very pro-life. It feels very pro-birth.

Drop the mic. Yeah. Drop the mic. That's exactly right. I couldn't agree more. And even as somebody who ended up as a mother, even though I wasn't planning for it, I feel those things deeply. They keep me up at night. Yeah. And I don't have the answers, but what I know is a stipend for having more children is not the answer. And a $5,000 stipend. How rude, by the way. Do you know what it costs to raise a child at 18? Roughly $310,000.

And that's like baseline. Your kid does not go to travel soccer. That's like baseline just survival needs. Right. So what's your number? Like if you if if there is somebody listening who's like, what's the number that I should have in my bank account or across all of my investments, like where it's like a safe number to have a baby? What would you say?

There's no such thing. Every single parent will find that they are under-saved and under-invested for their child, almost every single one. In particular, I encourage parents to look at fixed, so the one-time costs, but more so the variable costs, the ones that are going to continue to happen time and time again, the reoccurring costs. And

Ultimately, you can make an estimate of what that needs to be added to your current budget to make you feel comfortable. But listen, when I went to school, private school education was a quarter of a million dollars. By the time my kid goes, it'll be about a million bucks. And so is there really any preparing? No. You got to really, really want to make it work. And I wish there were so many more supports for the moms and the families and the kids to

that we are hopefully bringing into the society. And it's quite a bummer to feel like people don't want to not have families. People want to be able to have families and still put food on the table. And that sucks. But I'm really glad that you and Birth Fund are certainly doing a lot to provide the resources and options

to so many families so that they can make these smart decisions for themselves. Well, thank you. And also it is a bit grim because, right, like the government should be doing what we're doing. And I hope one day that we go out, there's no need for a birth fund because this is the kind of support that you get in other countries. Like it's just a given. And the fact that we have to raise money

to help people cover the cost of birth care is in some ways really sad. GoFundMe is not insurance, by the way. Right. So we're all clear. Yeah. But at the same time, it is changing lives. It's saving lives. The families that we...

support are some of them have had terribly traumatic birth experiences in hospitals and are so terrified to go back that if it wasn't for birth fund, they would have given birth at home on their own with no care.

supervision with no midwife, with no care provider. And the thought of that is pretty unthinkable in the richest country in the world in 2025. And so there is a need for this support. And we have raised $3 million in under a year to help stand in the gap for these families. And

We're not going to stop anytime soon, but we are partnering with folks who are working on changing legislation, who are working on the systemic shifts that need to take place. But in the meantime, my motto is it's on us to save us. And I think that is a perfect place for us to wrap. I absolutely love that.

Elaine, thank you so much for being here. Tell us where we can find you, where we can find Birth Fund. You can follow us at Birth Fund on all social platforms. And you can check out our website at thebirthfund.com if you'd like to donate.

And you can follow me at Elaine Welteroth on Instagram. Thank you so much for being here. Thank you for having me.

Got a burning financial question that you want covered in a future episode? Write to us via podcast at yourrichbff.com. Follow Net Worth and Chill Pod on Instagram to stay up to date on all podcast related news. And you can follow me at yourrichbff for even more financial know-how. See you next week.

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