The United States is the most expensive country to give birth in

It’s a time when parents should be thinking about baby names and nursery decor, but for many American parents an impending birth means an impending bill and stress over money.

Indeed, the United States is the most expensive country to give birth in, and the ‘fee-for-service’ payment system may be why.

According to the International Federation of Health Plans, the average cost of a vaginal delivery in the United States is about $10,808. More recent data from health care technology firm Castlight Health suggests that number may be a bit lower, at $8,775, and nonprofit organization FAIR Health says it’s actually higher, with the average cost for a vaginal delivery coming in at $12,290.

The variations reflect different methodologies, but all the data sets reveal one thing: Americans pay way more to give birth than parents in other nations. In countries like Sweden (where the maximum daily cost for a hospital stay is about $11 USD) or Canada (where most costs are covered by provincial health plans), parents don’t have to wonder how much they’ll pay to bring a baby home from the hospital.

Prices aren’t just high—they also vary wildly. As noted in a study published in the journal Health Affairs, the cost of a hospital stay related to a low-risk delivery can range from $1,189 to $11,986 (that’s just for facility fees and does not including the cost of an OB or a midwife).

For most families, it’s the post-delivery hospital stay that adds up. Data from Truven Health Analytics shows facility fees are a significant portion of the cost of giving birth, far outstripping fees for maternity care providers, pharmacy, radiology and imaging, laboratory, and anesthesiology services.

And once you add in everything, the total of a family’s bill depends a lot on where they live. A vaginal delivery that costs $6,075 in Kansas City would be billed at $15,420 in Sacramento.

According to the authors of the study in Health Affairs, the variation birth-related hospital costs suggest there may be opportunities to reduce bills by “increasing the coordination of care, and emphasizing value of care through new payment and delivery systems reforms.”

Some health sector experts agree, changes need to take place to standardize and reduce the cost of giving birth in America.

“The price variances seen in both routine and cesarean deliveries reflect the larger systemic problems in our nation’s healthcare system,” says Kristin Torres Mowat, senior vice president of Plan Development and Data Operations at Castlight Health.

American parents want to know how much a birth will cost them, but, as new father Johnny Harris wrote for Vox, finding out the cost of having a baby before you have one is very challenging. “It’s significantly easier to find out how much it costs to park at a hospital than how much it will cost to get treatment,” Harris wrote.

The out-of-pocket costs a family pays after a birth are not only dependent on the location of the hospital, but also on their insurance. Negotiated rates, deductibles and health plan coverage varies, but regardless of your plan and state, if you’re in America you’re paying more than you would anywhere else in the world.

Add to that the struggle for paid parental leave, the high cost for childcare, and lost income for parents who do stay home for a few years and it seems like the price tag on birth in America is just the beginning.

Parenthood may be pricey (we don’t even want to think about how much college is going to cost), but it always feels worth it when we bring home that new baby.