*Expenses don’t end at childbirth, one husband laments
*’What I expected would be ₦180,000 exceeded ₦1 million’
*Experts warn rising charges are driving unsafe births, maternal deaths
For many expectant mothers in Nigeria, childbirth is no longer just a medical journey, it has become a financial ordeal. Soaring hospital bills, hidden charges and difficult decisions force families to choose between delivering safely in the hospital or turning to risky alternatives, including home births. Across both public and private health facilities, the cost of antenatal care, normal delivery and Caesarean Section (CS) has climbed sharply. In this special report, mothers, families and healthcare experts speak on the rising cost of bringing a child into the world and what it means for maternal health in Nigeria.
By Chioma Obinna
For Adeola Laolu, a new nursing mother, the pain of labour was only part of the experience. The greater burden was the cost of giving birth. While she recovered on her hospital bed, her husband, Akin, spent most of the day moving from one payment point to another, buying drugs, settling bills and even donating blood. What the couple believed would be an affordable delivery at a government hospital quickly became a financial nightmare.
“People go to general hospitals because they believe the services are cheaper, but that is no longer the case,” Adeola told Vanguard. Her voice betrayed both exhaustion and frustration as she recalled how the hospital bill kept rising without warning.”First it was ₦55,000. Later it became ₦65,000. After that, we kept buying drugs. It was not little money.”
For Akin, the experience was just as traumatic. What began as a joyful journey to welcome their baby soon turned into an endless cycle of payments, prescriptions and uncertainty. “Every time you think you are done paying, they bring another list,” he said.
Sometimes it was drugs. At other times, laboratory tests, gloves, disinfectants or baby supplies. According to Akin, even after donating blood, they were asked to buy additional consumables.”You just keep spending because you don’t have a choice. Your wife is in labour, your baby is coming, and you cannot start arguing.”
But for Adeola, the bills were only part of the problem. “People go to the general hospital because they expect the cost of childbirth to be lower, but things have changed. General hospitals are now for people who have money. They ask you to buy things you don’t even need, they’ll tell you to buy many drugs, and in the end, you won’t even use them.”
She said families whose relatives require a Caesarean Section at the Gbagada General Hospital, Lagos, should be prepared to spend a large sum of money. “If you don’t have between ₦700,000 and ₦800,000, don’t even bother going. If you don’t have that kind of money, don’t bother. They are also fond of asking you to buy excessive drugs,” she added. Others, unlucky and with nastier experiences put the cost at over ₦1,000,000.
What exactly are we paying for?
What hurt the couple most, however, was the sharp contrast between the amount they paid and the conditions they found themselves in. According to them, the ward was overcrowded, with mothers sharing limited space. There were no baby cots, broken windows allowed mosquitoes into the ward at night, while buckets had been placed beneath leaking sections of the roof to collect rainwater.
“You look around and ask yourself, what exactly are we paying for? This is a general hospital, yet the ward is leaking, they can’t even maintain it. There are no baby cots and mosquitoes are everywhere – even where newborn babies are kept. You can’t sleep properly at night. If you are paying so much money, you should at least get value for it,” he said.
Further, Adeola said recovery after childbirth came with physical pain and emotional disappointment. According to her, proper nutrition, which should aid healing, was almost non-existent.”You need good food after giving birth. You need protein. But what they brought was not enough. They served mothers food as if they were feeding a seven-year-old, even a four-year-old won’t be satisfied with that meal, yet you are paying for the food and the service; it isn’t free.”
Despite her complaints, she commended the quality of medical care.”They have very good doctors; they attend to patients promptly, especially during emergencies. You will see many doctors working together to save lives, they are professional in that aspect.” Some good news, that is!
When affordable care becomes unaffordable
She, however, called for improvements in the hospital environment and the quality of meals served to patients. For women like her, public hospitals, once regarded as the safest and most affordable option, are becoming increasingly difficult to afford.
“General Hospital is no longer what it used to be. By the time you get there, what you budgeted for is no longer what you end up paying. They keep sending you from one place to another for different tests, and sometimes they even ask you to repeat them,” she remarked.
Their story represents just one in many.
High costs, higher risks
Akinde said the cost of a caesarean section varies considerably from one state to another and also depends on the type of hospital. He recalled that Ondo State operated a free CS policy during the administration of former Governor Olusegun Mimiko, although he could not confirm whether the programme is still in place.
According to him, many public hospitals across the South-West currently charge between ₦150,000 and ₦200,000 for a CS, while private hospitals charge significantly higher fees.
“In private hospitals, especially the high-end facilities in Lagos, a caesarean section may cost as much as ₦3 million, while medium and lower-tier private hospitals may charge between ₦1.5 million and ₦2 million.
“The difference is understandable because private hospitals receive no government subvention. They pay staff salaries from internally generated revenue, provide their own electricity, security and water supply, and also contend with multiple taxes and levies imposed by different government agencies.”
Akinde said the high cost of emergency obstetric care remains one of the major drivers of Nigeria’s persistently high maternal mortality rate, as many women delay seeking medical attention until complications become life-threatening.
“Many patients only come to the hospital after trying every other alternative and when the situation has become critical. They present at the eleventh hour because they simply do not have the money to access care earlier.”
He urged governments at all levels to move beyond policy pronouncements by ensuring maternal health programmes are properly implemented and regularly monitored.
“It is not enough to issue circulars from the ministry. The government must monitor these policies consistently and evaluate whether they are achieving the intended objectives.”
Akinde also advocated wider health insurance coverage to guarantee free or heavily subsidised maternity care for low-income families.
“Health insurance should provide free or subsidised maternity services, particularly for low-income earners, and the government must ensure that this is effectively implemented. For years, professional bodies such as SOGON and the Nigerian Medical Association, NMA, have advocated free CS services. It appears policymakers are yet to fully appreciate that one of the best investments any government can make is investing in the health of its people.”
The implication, he warned, is grave. “More and more deliveries will now take place outside health facilities.” That, he said, will almost certainly lead to an increase in maternal and neonatal illness and deaths.
A ₦180,000 bill that became ₦1 million
But Adeola’s experience is not isolated. For a Lagos father, Jonathan Adeyemi, what began as a projected ₦180,000 bill for a CS at Ayinke House, within the Lagos State University Teaching Hospital, LASUTH, eventually spiralled into a debt of over ₦1 million.
When Shade, his wife, was admitted in January 2025, his expectation was that everything was planned adequately. But shortly after the baby was delivered on February 7, doctors informed him that the newborn had developed complications and would require prolonged intensive care.
Everything changed from that moment – fresh bills arrived daily. There were charges for the incubator, specialised nursing care, laboratory investigations and an endless stream of prescriptions. “When I paid ₦180,000, I genuinely believed it was the major expense we would face to safely welcome our baby. I had no idea it was only the beginning of a much longer and far more expensive journey.
“The special care unit came with daily charges for the incubator, specialised nursing care, laboratory investigations, treatment, water, soap, toiletries and other items in quantities far beyond what my baby actually needed. I would wake up every morning, queue to make payments, carry samples to the laboratory, then rush to the pharmacy,” he lamented.
The days passed and bills kept rising, but there were more challenges in store. “What made everything even more difficult was that the hospital was understaffed. Beyond the financial pressure, I found myself taking on responsibilities I never expected. I spent hours standing in line to make payments and collect laboratory results. I was repeatedly carrying blood samples for tests, sometimes several times a day, including full blood counts, electrolyte tests, infection screenings and other investigations needed for my baby’s treatment.”
The hidden price of neonatal care
The baby’s jaundice meant repeated tests and ongoing treatment. Every investigation attracted a separate bill. Every medication had to be sourced. At times, Adeyemi admitted, the emotional strain became almost unbearable.
“You are watching your baby fight to survive, while at the same time thinking about where the next money will come from.The expenses did not stop there, the hospital frequently ran out of essential supplies, I was regularly directed to outside pharmacies to buy medications, intravenous fluids, cannulas, feeding tubes and other consumables before treatment could continue. Family members and friends stepped in to help, without them, I don’t know how we would have managed.”
His wife, still recovering from surgery, could do little but watch. While she remained on her hospital bed, he spent his days moving from one hospital building to another, shuttling between laboratories, pharmacies and payment points to ensure both mother and baby received the care they needed.
“Each day brought another payment, another prescription or another test. She kept asking about the baby, she cried and worried while I was moving around trying to settle bills.” The emotional strain of worrying about his newborn’s survival was overwhelming, but the unexpected financial burden only made an already traumatic experience even harder for the family.
Each day brought another bill, by the time mother and baby were discharged, the family’s savings had been exhausted, they had amassed accumulated debts.”What I expected would cost ₦180,000 exceeded ₦1 million,” Jonathan said.
What should have been one of the happiest moments of their lives became a financial setback they are still struggling to recover from.
Families counting the cost
Another mother, Mrs Chinenye Aduba, who delivered at the Federal Medical Centre, Ebute Metta, said she spent a total of ₦160,000 to have her baby.
A mother from Iyana-School shared a similar experience. She said she paid ₦38,000 for a normal delivery at Alimosho General Hospital, Igando, when she had her first child, while a CS at the facility costs between ₦130,000 and ₦200,000. However, when she had her second child at a private maternity hospital, the difference was striking. A normal delivery cost ₦120,000, while a CS was ₦350,000.
Choosing home over hospital
For many women, the rising cost of delivery has become the reason they stay away from hospitals. One of them is Esther Ossai, a nursing mother who gave birth at home just a few days ago with the help of a traditional birth attendant (TBA) in the Ikotun area of Lagos. She told Vanguard she spent ₦35,000 on the delivery after abandoning plans to give birth in a government hospital.
According to her, she had registered for antenatal care at one of the state general hospitals, but realised she could not afford to deliver there. During antenatal visits, doctors informed her that her baby was not properly positioned and that she would require a CS to save both her life and that of the baby.
“I was told to deposit ₦300,000 for the delivery. My husband is a tricycle operator and couldn’t afford it. We had no choice but to look for another option. My neighbour, where I sell pure water and soft drinks at Ikotun Bus Stop, directed us to a traditional birth attendant who helped me deliver the baby.”
Esther survived, so did her child. But many women are not as fortunate, a reality reflected in the persistently high maternal mortality rates recorded in Lagos and nationwide. Across Lagos, stories like hers are becoming increasingly common.
Experts sound the alarm
For a past president of the Society of Gynaecology and Obstetrics of Nigeria (SOGON), Dr Joseph Akinde, the rising cost of maternal healthcare is pushing more women away from hospitals and into unsafe childbirth practices.
Speaking with Vanguard, he warned that the trend could reverse the modest gains made in improving access to skilled birth attendance.
“Currently, only 37 per cent of deliveries in Nigeria are attended by skilled birth attendants. If more families become unable to afford hospital fees, that percentage will fall even further.”
According to him, the rising cost of antenatal care, normal delivery and CS has become a major barrier to accessing skilled maternity services at a time when the cost of living continues to rise across the country.
“We are all witnesses to the increasing cost of living in recent months, and this has made it difficult for many families to afford even the minimum charges for antenatal care and delivery services. The implication is that more women will deliver outside health facilities, increasing the risk of maternal and newborn illnesses and deaths.”
What it costs to give birth in Lagos
Vanguard findings show that the cost of childbirth varies widely depending on the health facility, its location, the type of delivery and whether complications arise. At the Lagos Island Maternity Hospital, a normal delivery costs about ₦100,000, while a CS ranges from ₦150,000 to ₦300,000 or more. At public hospitals in Lagos, normal delivery costs are estimated at about ₦150,000, while a CS range from ₦180,000 to over ₦350,000.
The hidden charges
Those figures, however, rarely tell the full story. They often exclude the hidden costs of medications, laboratory investigations, blood transfusions, scans, neonatal care and specialised nursing services. Vanguard found that this is where the real financial burden begins.
In many public hospitals, a CS advertised on hospital notice boards or websites at between ₦100,000 and ₦200,000 can eventually cost two or even three times as much after additional investigations, medications and prolonged hospital admission are added. The cost rises even further when newborns develop complications. For babies who require oxygen therapy, incubator support or intensive neonatal care, daily expenses mount rapidly, placing enormous pressure on families.
Public vs private
Private hospitals are even more expensive. At some highbrow facilities in Lekki and Ikoyi, a normal delivery can cost as much as ₦800,000, while a CS may exceed ₦2 million. Delivery costs also run into hundreds of thousands at hospitals on the mainland. In some top-tier private hospitals, a CS can cost up to ₦3 million.
Medium and lower-tier private hospitals typically charge between ₦1.5 million and ₦2 million. For many middle and low-income families, such costs are simply beyond reach. The wide variation in charges also highlights a much deeper divide within Nigeria’s healthcare system.
WHO and LVASA-SRS report
According to the latest joint estimates released in 2025 by the World Health Organization and partner UN agencies:
Maternal mortality ratio: About 993 maternal deaths per 100,000 live births (2023 estimate)
Estimated maternal deaths: Around 75,000 women died from pregnancy or childbirth-related causes in Nigeria in 2023, accounting for nearly one in three maternal deaths globally
For Lagos: about 430 maternal deaths per 100,000 live births from a 2024 statewide population survey using the indirect sisterhood method.
A newer Lagos State Verbal and Social Autopsy Sample Registration System (LVASA-SRS) report released in 2025 estimated 833 maternal deaths per 100,000 live births over its 12-month study period.
The report also found wide variation across local governments, with Somolu recording about 154 per 100,000, while Badagry recorded about 4,210 per 100,000.
Can health insurance close the gap?
Also speaking with Vanguard, the immediate past President of the Medical Women’s Association of Nigeria (MWAN), Lagos State chapter, Dr Funmi Ige, said affordability remains one of the biggest barriers to quality maternal healthcare. “Cheapness is relative. What is affordable to one person may be expensive to another,” she said.
Echoing Akinde’s concerns, Ige noted that the rising cost of childbirth has become a significant obstacle to accessing skilled maternal care, particularly in the current economic climate. According to her, what one family considers affordable may be completely beyond the reach of another.
“The issue of whether delivery costs are cheap or expensive is subjective because it depends on a person’s purchasing power. However, it is a fact that not everybody can afford the cost of delivery in health facilities across Lagos and Nigeria.”
She said delivery costs in most public hospitals across Lagos range from ₦150,000 to ₦250,000, while private hospitals generally charge from ₦300,000 upwards, with some high-end facilities charging close to ₦1 million or even more, depending on the location and level of care required.
Explaining the disparity, Ige said public hospitals benefit from government support, unlike private facilities, which bear the full cost of providing healthcare services. “In public hospitals, government provides infrastructure and pays the salaries of health workers. This reduces operational costs and ultimately lowers what patients pay. In maternal healthcare, we talk about three important factors: availability, accessibility and affordability. Services may be available and accessible, but if a woman cannot afford them, she may delay seeking care or resort to unsafe alternatives.”
Ige acknowledged that Lagos State has provisions for free emergency care in public hospitals during the first 24 hours, but said financial barriers continue to contribute to poor maternal outcomes.
“In Lagos State, emergency services during the first 24 hours in public hospitals are free. The priority is to save the woman’s life before payment issues are addressed. No woman should be denied emergency treatment because she cannot immediately pay.”
To make maternal healthcare more affordable, she advocated wider enrolment in health insurance schemes, particularly through the Lagos State Health Management Agency (LASHMA).
“Women should embrace health insurance instead of relying on out-of-pocket payments. In Lagos, LASHMA provides an opportunity for families to prepare ahead for emergencies. When enrolled, a pregnant woman can access skilled maternal care without having to produce cash at the point of need.”
Pregnancy and responsibility
She also urged pregnant women to register early for antenatal care instead of waiting until complications develop.
“Pregnancy is a nine-month journey, and families should use that period to plan financially, attend antenatal clinics regularly and prepare for delivery. Antenatal care helps detect complications early and reduces the risk of emergencies.
“I also encourage all women of reproductive age to enrol in health insurance schemes. We must move away from depending solely on out-of-pocket payments because, in an emergency, there may be no money available. Health insurance is like preparing for the rainy day before it comes.”
Ige further called on governments to improve road infrastructure and transportation, noting that physical access to healthcare remains a major challenge for many women.
“Healthcare facilities may be available, but if roads are poor or transportation is unaffordable, women will still struggle to reach them in time. Improving road networks and reducing transportation costs are critical to improving maternal health outcomes.”
A matter of justice
Also weighing in, Chairman of the Public Health Sustainable Advocacy Initiative, Barrister Ayo Adebusayo, argued that the crisis goes beyond economics. For him, affordable maternal healthcare is fundamentally a matter of justice. “No woman should lose her life or her baby simply because she cannot afford to give birth safely,” he said.
Adebusayo attributed the rising cost of childbirth to a combination of inflation, soaring energy costs, the increasing price of imported medical supplies and chronic underfunding of the public health sector.
“More than 70 per cent of healthcare spending in Nigeria is still out of pocket. That is one of the highest burdens anywhere. When governments fail to protect mothers, families are left to carry the burden alone.”
To reverse the trend, he called for increased public investment in maternal healthcare, expanded health insurance coverage and greater local production of essential medicines and medical supplies to reduce dependence on costly imports.
The price of doing nothing
For generations, childbirth has been described as one of life’s greatest moments. But for a growing number of Lagos families, it is becoming something else entirely, a financial test that begins before labour and often continues long after mother and child leave the hospital.
As inflation pushes healthcare costs beyond the reach of ordinary Nigerians, more women are delaying hospital care, turning to unskilled birth attendants or abandoning skilled delivery altogether. Health experts warn that unless urgent steps are taken to make maternal care affordable, the consequences will be measured not only in debt, but in the lives of mothers and newborns lost.
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Child Birth Delivery in Ajeromi-Ifelodun:
General hospital CS: ₦243,000
Normal delivery : ₦103,000
Private Hospital
Normal delivery: ₦90,000 – ₦250,000
CS, 1 baby: ₦250,000 – ₦600,000
Twins or more: ₦600,000 – ₦1,000,000+
Another Private Hospital in Ajeromi-Ifelodun
Normal Delivery: ₦60,000 – ₦90,000
CS: ₦300,000 upwards
Private Hopital in Festac Town
CS: ₦600,000 upwards.
If it is twins or more: ₦1,000,000+, around ₦1.2 million.
