Sept. 10--Expectant parents wanting the best for their babies typically focus on the best strollers, cribs and cost-effective diapers.
But they might want to consider where best to have their baby. That place may not be Pennsylvania, with its low number of pediatricians, obstetrician-gynecologists and parental-support groups, and the lack of a "baby-friendly environment."
Pennsylvania actually ranked next to last, ahead of only Mississippi, based on health care costs and available services and resources for babies and parents, according to WalletHub.com's 2015 rankings of the best and worst states in which to have a baby.
The consumer finance website that helps people make financial decisions posted its rankings Wednesday based on budget, health care and baby-friendly environmental factors involved in having and raising babies.
Pennsylvania ranked 50th but wasn't dead last because the District of Columbia was included, pushing Mississippi to 51st, with West Virginia at 49 and Ohio at 22. Top-ranked Vermont was followed by North Dakota, Oregon, Hawaii, Minnesota and Kentucky.
"Our website is geared to the consumer, and we use data-driven studies to help people make the best financial decisions possible, and having a baby definitely is one of them -- and it gets more expensive year after year," said Jill Gonzalez, a WalletHub analyst who worked on the metrics used to make the rankings.
The website said America has the highest birthing costs in the world, with the average cost of a conventional delivery about $10,000, with $5,238 more for a cesarean section and $2,824 more if there are any complications.
Pennsylvania ranked dead last in the "baby-friendly environment" category with the nation's lowest number of support groups and programs per capita. It also ranked 48th in the number of pediatricians, with only three per 100,000 residents compared with Vermont's 35, Ms. Gonzalez said. The state also was 45th in the number of obstetrician-gynecologists per capita.
One reason few pediatricians may be practicing medicine in Pennsylvania, she said, is its third-lowest average annual wage of $140,000, which does help lower pediatric-care costs. Pediatricians in Montana on average make $240,000, with the District of Columbia lowest at $90,000. The national average is $181,000.
"Pennsylvania has nine training sites for pediatricians or pediatric residency programs, but most are in Pittsburgh and Philadelphia with a few in smaller cities including Allentown," said Suzanne Yunghans, executive director of the Pennsylvania Chapter of the American Academy of Pediatrics, with 2,200 members. Most pediatricians set up practice in cities while those training here often leave to practice elsewhere. Many family physicians statewide also treat children.
But other factors made Pennsylvania sink rather than float in the rankings.
Budget rankings included high delivery charges, annual infant care costs, the cost of living, wages of nurses and health insurance premiums. Overall, Pennsylvania ranked 37th in the budget category.
The health care category included the infant death rate, the maternal mortality ratio per 100,000 live births, birth weight and rate of premature babies, with the number of midwives, ob-gyns, pediatricians, maternity practices in infant nutrition and care and fertility clinics measured per capita. In the health care category, Pennsylvania ranked 36th. Its best ranking was 18th in the number of fertility clinics.
But it was the "baby-friendly environment" category in which Pennsylvania came in last because of being ranked 48th in air pollution, 40th in the number of Superfund contamination sites and its bottom rank for support groups for mothers.
"I was surprised that Pennsylvania ranked 50th [overall], but it's hard from the surface of the article to really understand why," Ms. Yunghans said. Most counties in the state do not have health departments, with only six existing in the entire state, several being city health departments. Many hospitals statewide have been eliminating baby-delivery services, she said, with Philadelphia's number falling from 20 to six in recent years.
Ms. Gonzalez said the rankings also may reflect how well states adopted Affordable Care Act policies or had to deviate from current practices to meet the new law. She was unaware of how it affected Pennsylvania.
It's well-established that having a baby is expensive.
"And depending on where you raise that bundle of joy, you might need a deeper pocketbook than other expectant parents," based on location, the website stated, adding that "couples need to take a careful look at their life circumstances as well as their finances before starting a family."
David Templeton: dtempleton@post-gazette.com or 412-263-1578.
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