The present study used data from several sources to 1) present information on mothers and births in a single state (Delaware); 2) present cost data to estimate health-related birth real costs; and 3) use the data to estimate the costs and impact on mothers, health care providers, and taxpayers. In addition, this study explicitly examined costs of births through the lens of unplanned/unintended teen and young adult births. Concomitantly, the medical cost of these pregnancies for most of these young mothers who had not wanted to be pregnant at the time, was paid for through the state’s Medicaid program. The percentage of Medicaid funded births was much higher for young mothers than for older mothers. Ultimately, it was estimated that young teen (age 17 and under) births cost about $4.0 million each year, older teens (18-20) births $14.0 million, and young adults (21-24) over $26 million. The State funded almost 75 percent of the health care costs of young teen pregnancy prenatal care, deliveries, and newborn care, through Medicaid. And over 75 percent of these Medicaid costs are for births that were unintended at the time. The cost of unintended teen and young adult births funded through Medicaid in Delaware was approximately $25 million annually.