Paying for a home birth
If you do not have insurance or your insurance will not cover our services, a cash discount is available. Many clients have reported that the cash fee is comparable to what their copays have been for a hospital birth with insurance. Payment plans and discounts are available because we understand that paying out of pocket for midwifery services can be a big expense.
Here is more information about what you are paying for.
In addition to spending an average of 1 hour at each prenatal appointment, the midwife spends a fair amount of time in her car driving to the office locations and home visits. The midwife might spend anywhere from 3 hours to 2 days at a birth and is on-call for her client throughout care. Phone calls, individual research, and responding to e-mails adds to the investment of time.
When you call your midwife, she answers the phone- not a receptionist. Your appointments are designed to offer individualized care for you and your circumstances.
Most midwives choose to limit the number of clients she takes to be sure that she is able to give her best to her clients and her family. When she puts your due date on her calendar, she commits to being on-call for you: this includes arranging backup care for the possibility of two clients in labor at once or while on vacation. Scheduling a vacation requires turning away clients due within a month of the vacation or having a back-up midwife lined up.
The rule of thumb is that a self-employed professional's income is only half of what they earn, after deductions for vacation and sick time, self-employment taxes, health insurance, and business expenses. Communication and travel expenses can be very high for a midwife, which means many midwives spend quite a bit more than half of her income on expenses. I drive an average of 25,000- 30,000 work-related miles per year: this means increased frequency of gasoline fill-ups, maintenance, wear-and-tear, and new tires. There are also routine professional expenses and equipment that needs to be maintained or replaced periodically.
TRAINING AND EXPERIENCE
It’s important to pursue continuing education, and continuing education units (CEUs) are required to renew certification every three years. Neonatal Resuscitation and Basic Life Support (CPR) must be renewed every two years. As with scheduling a vacation, in order to attend conferences and training opportunities, a midwife has to limit the number of clients she can accept due around the time she will be unavailable or hire a back-up midwife. Conferences can be expensive and often require out-of-state travel. Online midwifery schools cost $285 or more per credit hour.
Being on-call requires a certain level of personal sacrifice from a midwife and her family. This includes a willingness to be awakened in the middle of the night to go attend a labor and missing the occasional family event or holiday. Shopping trips and dinner plans mean that a midwife must plan ahead in the event that she is called to a birth before it is over. Additionally, midwives who are also mothers must have childcare or transportion lined up for her children and a dependable vehicle gassed up and ready to go at a moment’s notice.
We believe that two sets of hands are better than one, so a birth assistant is on-call for every birth.
When you put it like that, you may be thinking, “Why would anyone want to do this job?“. Because we love what we do, and we are honored to attend this important moment in your life!
Michelle Ingram, CPM, CDEM