Official government figures show that the birth rate in South Africa has been steadily decreasing over the past few years.
The arrival of a newborn may be a joyous moment. However, the financial implications of raising a child can often be a daunting prospect.
In South Africa, the cost of bringing up a baby has been steadily rising. Now would-be-mothers may be shunning giving birth where it is safest, but expensive.
Official government figures show that the birth rate in South Africa has been steadily decreasing over the past few years, averaging 1.5 percent per year. In 2023, the birth rate was 18.994 births per 1000 people, a 1.73 percent decline from 2022.
The data does not explain whether the drop is due to voluntary delay of child bearing, or whether the cost of giving birth and rearing the baby is putting off some. However, interviews with new mums paint a discouraging picture.
The cost of giving birth and raising a child can surpass R1.6 million ($89,442) over the first 18 years, putting a considerable strain on middle-income households as this is approximately R90,000 ($5,000) a year. This is according to a leading financial service company in SA, Discovery, who also added that a child is likely to cost a parent R256 ($14) a day or R7,785 ($435) a month.
Kirtanya Maharaj, a new mother from Durban, sheds light on the financial challenges of having a baby. Mrs Maharaj points out that the expenses begin before the baby is even born, with regular check-ups, ultrasounds, and blood tests, all of which can be quite costly.
“Our medical expenses for private GP (general physician) visits alone reached R3,500 ($195), while antenatal classes and pregnancy essentials cost an additional R2,300,” she revealed.
The cost of childbirth is higher, especially when opting for private facilities. Expenses for a natural birth with an epidural and a three-day stay in a private hospital could amount to approximately R45,000 ($2,500).
Mamello Msibi from the Vaal, south of Johannesburg shares a similar experience.
“Having a baby is not cheap. just for antenatal care and scans, my husband and I spent over R13,000 ($726). And that doesn't even include the delivery costs, which averaged around R32,500 ($1,800) for both natural and C-sections in private practices.
“We went to Midvaal Private Hospital. Government hospitals are free but the service is poor, you wait in long queues as the rate of newborn babies is high in South Africa so we wanted the best care for our baby, hence we opted for a private practice.”
The financial burden doesn't end after the birth. Mrs Maharaj outlines the costs of essential baby items.
“We spent R14,000 ($780) on a Black Friday deal for a pram, cot, and other essentials, while items like a bottle steriliser and electric breast pump cost an additional R3,500 ($195).”
Additional monthly costs include R1,200 ($66) for diapers, R500 ($27) for formula and breastfeeding supplies, and R890 ($49) for baby clinic appointments and vaccinations.
Mrs Msibi echoes this sentiment, saying that her monthly costs for diapers, baby care products, and midwife visits amount to almost R2,200 ($122).
Despite having medical aid, out-of-pocket expenses can still be significant. Mrs Mbisi noted that while vaccines are free at public clinics, private services can cost around R2000 ($111) upfront, followed by additional monthly charges.
For parents without medical aid, the health medical insurance, these costs can quickly become overwhelming, making public health options a vital consideration. The decision of whether both parents should work or if one should stay home to care for the child is another crucial factor with financial implications.
“A live-out nanny costs around R6,000 ($334) per month, a significant increase compared to pre-baby household help,” added Mrs Maharaj.
Parents must consider the financial sacrifice of a single income versus the costs of professional childcare. Financial planning doesn't stop when the baby arrives. Creating a will, life insurance, and an education fund are essential steps for securing the child's future.
Given the escalating cost of education, Discovery's budgeting experts recommend that expecting couples start planning early.
Mrs Maharaj offers practical tips to help them prepare financially. “Have a baby shower registry and plan a nappy party for dad. These gifts can save you thousands in the first few months. Also, keep receipts! Returns and exchanges are common with baby items.”
Planning and budging are very important as Mrs Maharaj advises: “Ensure you have a happy and financially stable home before taking this step. The financial and emotional challenges of raising a child are significant, but with good planning, it’s manageable.”
There are currently 8.94 million South Africans covered by registered medical aid schemes, according to the 2023 annual report from the Council of Medical Schemes (CMS). This leaves around 51 million people who rely on public healthcare facilities.
According to the South African Department of Health’s Maternal, Perinatal, and Neonatal Health Policy, public hospitals provide prenatal, birth, and postnatal care at minimal or no cost, making these essential services accessible to the majority of the population.
For pregnant women, regular antenatal visits, which include check-ups, blood tests, ultrasounds, and screenings, are typically free or require only a small fee, particularly for low-income individuals.
While basic services are generally covered, certain specialised tests or advanced scans may incur minor charges ranging between R50 ($2.79) to R200 ($11.15), depending on the type of test and the hospital. Even then, some of these may be free of charge.
When it comes to giving birth, the cost remains low in public hospitals. A normal birth canal delivery is usually free, with patients sometimes only paying a nominal administration fee of between R30 ($1.67) and R100 ($5.58).
Even more resource-intensive procedures, like Caesarean sections, are heavily subsidised and come at minimal or no cost to the patient. Postnatal care is similarly accessible. After childbirth, both the mother and baby receive essential follow-up care, which includes check-ups, immunisation, and counselling.
These services are largely free at public hospitals and clinics, ensuring that even after birth, ongoing health support is available to all. Routine postnatal visits are usually free, with any potential charges being minimal.
While medical services are mostly free, patients might still bear the cost of transport and other related expenses like maternity supplies.
Public healthcare in South Africa is designed to ensure that maternal care is affordable and accessible, aiming to provide comprehensive support from pregnancy through to postnatal care for all, regardless of financial status.
