How Much is a Midwife?

How much is a midwife?  How can I pay for my natural birth?  Good questions!  In fact, these are probably the most common questions I hear from new moms considering an ‘out of hospital’ (OOH) birth plan.  

Welcome back Mama!  This is part 2 of a 5 part series which will demystify your birth options and understand the benefits of natural birth.  As we shared in the Introduction, our topics include:

1. What are the advantages of a natural birth?  How does it differ from a typical hospital birth?
2. How much does a natural birth cost?  Does insurance cover it?  How can I pay for it?
3. Does a natural birth hurt more than a hospital birth?  How can I manage without pain medication?
4. How does a midwife compare to a doula compare to an OB / GYN?  Who should I have on my natural birth support team?  
5. What is the single most important thing I can do to prepare for a natural birth, regardless of the care setting I choose?

By the end of Part 5 you will have your personal answer to the most important question:

Each Part of this site will cover a specific topic on the way to answering that question.

I hope that you were able to complete Part 1, which focused on understanding the differences between an in-hospital vs. out-of-hospital birth experience, and the advantages of natural birth.  If not, consider going back to it right now before continuing with Part 2.

BACK TO PART 1

If you do have remaining questions about Part 1, please don’t hesitate to reach out using the ASK ME button below.  As I shared before, I am a real person, I am here for you, and I WILL respond.  No strings attached.

Once we are all caught up, let’s talk about …

How Much is a Midwife?
The Average Cost of a Natural Birth

Let’s begin our discussion on how much is a midwife, with a couple of comparisons:

According to the Kaiser Family Foundation (KFF), the average cost of birth in a hospital in the United States in 2021 was $18,865.

For hospital births resulting in cesarean section rather than vaginal delivery (approximately 32% of all births according to March of Dimes Peristats), the national average including hospital fees rises to $26,280.

Of course, for many of us an insurance provider plays a key role in our medical bills, particularly the overall costs we must pay out of our own pocket.  Average out of pocket costs for a birth covered by a health plan in the US are $2,854 according to KFF.

By comparison, the average natural vaginal birth attended by a licensed midwife in the US in 2021 was $4650.  In the North Bay area where I practice, that would be on the low end - the average price is closer to $6,500.  

Typically this is a flat fee, including all midwife services such as prenatal care, birth services and postpartum care / newborn care, including home visits and / or visits to a birthing center.

So clearly, an OOH birth for low-risk pregnancies in the US is, on average, less expensive than a hospital birth (prior to any insurance company reimbursement).

“But Paula” you may be thinking “my health insurance plan doesn’t pay for an OOH birth.  How can I possibly afford $4000-$6000 in out-of-pocket costs?”

Many of my clients wrestle with this question.  I share with them the ideas and information I’m about to share with you.  But I get it – it’s not a simple question.  The price of childbirth is significant.  And the type of birth you choose, matters.

Today’s reality is: at least in the United States, natural childbirth is not (yet) considered mainstream maternity care by most healthcare providers, There is relatively little consumer demand and underwriting data to support health insurance coverage. Many private insurance companies won’t pay for home births or birth centers.

But some will.  More on that in a moment.

How Much is a Midwife?
9 Ways to Pay for a Natural Birth

In the Introduction to this website, I shared my credentials as a Certified Professional Midwife, licensed by the Medical Board of California.  I have provided midwifery services for over 1500 mamas and babies over the last 25 years.

In my humble opinion, I have probably seen EVERYTHING when it comes to paying for a natural childbirth.   The number one thing I have learned is:  those mothers who really want a natural childbirth, find a way to have one.

Here are 6 ideas I personally share with all of my clients when I am asked "how much is a midwife?"  All references to ‘midwives’ are understood to mean fully licensed and experienced professional midwives, including nurse midwives:

1. First and by FAR the most important - know what you want from your pregnancy and childbirth experience:  The single most important question in your personal cost equation is: “What is it worth to ME?  How determined am I to have a natural childbirth?” Again, I have found that women who truly want a natural birth find a way to have one. They often use one of the methods below…
2. Ask about discounts:  Many midwives offer a discount if you pay upfront, pay by cash or check, or meet certain other conditions.  In my practice we offer a $1000 discount if the account is paid in full by the 28th week of pregnancy.  We also a military / public service discount.
3. Ask about a reduced fee:  Many licensed midwives offer ‘sliding scale’ pricing, based on ability to pay.  In my practice we offer a reduced rate to help manage the cost of a natural birth for those who qualify for MediCal coverage based on income. We also frequently reduce our fees for moms who are willing to come to our birth center vs having us visit them in their homes.
4. Ask about payment plans:  Many midwives will offer payment terms.  Some of my clients are in the midst of temporary financial hardship and just need the opportunity to spread the cost over time.  We offer 6, 12 and 18 month payment plans to make natural childbirth more accessible for these families.
5. Inquire about an in-network exception:  Some insurance plans will grant an in network exception if they do not have a contracted OB or hospital in your location. In my practice we have a billing specialist on staff who specializes in securing in-network exceptions for as many of our clients as possible.
6. Be willing to push for what you want:  This is SO important.  No insurance plan has rules to account for every individual client and their needs. Be persistent. If you have a good argument and patiently pursue it, you may be rewarded.  The billing professional on our team knows the ins and outs of negotiating with insurance plans and is hugely valuable to our clients. Many licensed midwives offer a similar service.  We also offer a packet of support material including examples and templates. 

In addition to these approaches, a few of my more creative and determined clients have elected to:

1. Barter: Some midwives will consider a barter arrangement... In my practice we once cared for the wife of a plumber who installed a separate birth tub in each room of our birth center in exchange for his wife’s midwifery care (she had a beautiful water birth).
2. Ask for financial help from family and friends in lieu of baby-shower gifts.  The total cost of a natural childbirth for the birth parents can be much more manageable if shared by a group – particularly a group of people who love you and want you to have your perfect childbirth experience.
3. Setting up a crowdfunding campaign such as GoFundMe to help cover home birth cost, the cost of a birth kit, or other specific parts of your medical care, is another good idea for realizing your dream of a natural birth.

Does one of these ideas appeal to you, Mama?  Do any of them raise additional questions?

Don’t hesitate to reach out using the ASK ME button.

In the meantime, here are the important questions for this section.

Questions for Part 2

Choose the statement that is MOST true for you at this point of our discussion on how much is a midwife (you can always change it later).  

CHOICE A: I’m comfortable with the cost of a natural birth.  If I do choose a natural childbirth, I will find a way to afford it.

CHOICE B: I still have questions or concerns about the cost of a natural birth.

Now get ready to hear me say: “there is no right answer.”

Ready? Here it comes …

There is no right answer :-).

Our goal here is to help you decide if natural childbirth is right for you and your baby – not to ‘push’ you in either direction.

So once again, please feel free to ask me ANY question that has occurred to you as you read this introduction. Simply tap the ASK ME button below.

Summary of Part 2

Now, to recap: today’s main questions were "How much does a natural birth cost?  Does insurance cover it?  How can I pay for it?"  Between this discussion and any thoughts you have chosen to share with me, I hope that I have answered these important questions for you.

In Part 3 we will focus on the questions "Does it hurt (natural childbirth) hurt more than a hospital birth?  How can I manage without pain medication?"

This topic is so important! I can’t wait to discuss it with you.

In the meantime, thank you for completing Part 2 of my introduction to natural childbirth. See you in Part 3!

Warmly –

Paula Grady LM, CPM

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