Midwife Jeannette
Things to Consider
So you want to have a homebirth! Good for you. Research indicates that it’s the safest and most sensible option for low risk moms and babies to deliver out of the hospital for the majority of women in most parts of the world.
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The #1 question I receive from prospective clients, after we discuss safety and routine care questions, is how much does a homebirth cost? I feel this question deserves an article of it’s own, and maybe I’ll tackle this subject first, bear with me as we dive in together.
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When you think of a homebirth, it’s often a fraction of what a hospital goes for and the quality of care, including the really valuable relationship with your care provider is incomparable. It’s like comparing night and day, two totally different models.
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We often think of costs associated with the hospital. To break it down for you, the average hospital birth usually goes for anywhere from $10,000–30,000, more if it’s a cesarean birth, if there are any complications, and if the baby or mom need extensive care, such as NICU stays. This care usually does not include things like prenatal care, postpartum care, well baby checks, newborn care outside the first 24 hours, which homebirth care does include in the global fee.
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For comparison, homebirth goes for an average of $5000, depending where you are in the country (US): for all your prenatal care, two midwives you know well at the birth, often a student midwife, maybe even a birth tub rental, on-call availability where we answer our phone 24/7 during the 37–42 week window and any questions answered in between visits, plus any extra care, such as referring a mom to get an ultrasound that day who may be spotting or bleeding.
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It includes immediate postpartum care of 3–6 hours following most births with multiple in-home visits the first week through the first 6–8 weeks post birth. It includes a newborn exam, where we check the baby head to toe, weigh and measure the baby, listen to his or her heart, check the lungs, check all the reflexes, and offer any ongoing support or recommendations, including referrals to higher level of care. It includes any supportive services you might need: extra breastfeeding support on day 2 after things were going well right after the birth. Sure, call your midwife! She will come over, talk you through or send her student or assistant if she is not able to come due to another birth or her other appointments.
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It includes extra counseling support for moms who had difficult births, cesarean births, or postpartum depression. It even sometimes includes some in-home support around the time of the birth, such as doing all your birth laundry and sometimes cooking you a nice meal following your triumph. There really is no other service like it!
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The average midwife spends about 30–60 hours per course of care with one family. This is average because everyone is different. Some people need more, some people have 2–3 day births, some people have a difficult time nursing, some people have another circumstance that is not foreseen prior to the birth that may need addressing. I’ve had families call me to ask any number of questions, not only prenatally but in labor and of course, postpartum. Even highly experienced moms with 5–6 other children rely greatly on this ongoing support system. We cater our services to everyone.
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The average phone call ranges from 15–20 minutes. I’ve timed these over the years. Even a simple question can take 5–10 mins of texting back and forth. I’ve been on the phone with some moms daily in their last weeks of pregnancy because they needed to walk through fears, ask me questions, or thought they were in labor. I’ve gone to their homes sometimes two or three times the week they do deliver.
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So just hourly if you’re going to break it down, make it $4,500 (which is my full fee), if I pay a back up midwife to come to your birth, because I have 2 birthing at the same time, that is around $1,500. including her assistant. My back up midwife travels some distance to get here. and say the average client needs 50 hours of care (usually more but let’s just say average) that’s not even $50/hour of face to face, not including the 3–5 weeks we are on-call which is already included in the global fee we discussed earlier.
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Out of this fee, the midwife must pay her overhead. Midwifery is a very expensive profession in comparison to many others; compared to a school teacher or an office assistant, per say. Midwives must have a space to meet (usually an office, their home, your home, or another neutral space), have a car that is maintained and ready to go, all the insurance, and take numerous classes annually that usually run $2–3,000 a year just to continue their trade. And don’t forget the cost of equipment & supplies.
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Add to this the time she is away from home and her husband. add to this time away from home and most likely eating out for a few meals (no matter how prepared you are, they always seem to call right when you just stepped out for 10 minutes on an empty stomach or right during dinner after you just sat down;). Maybe she even has to pay for extra services she is unable to do at home such as housekeeping because she is gone so much or overnight care for her kids, especially for us single moms.
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When I do my taxes each year, I can usually write off about half my income easily. I invest a lot into my education and into my practice. Medications expire. Supplies must be replaced or reordered periodically. Things can break. Birth tubs develop holes sometimes. Hey, it’s a messy business out there.
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So after all the expenses, she still has to pay taxes, her rent or mortgage, and think about her golden years/retirement …And the list goes on. Usually when people see the break down, they realize they are getting an amazing service!!
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A massage therapist usually charges $60–75/hr and can schedule her time, charges extra for transportation and often does not do house calls unless it’s extra. So it’s a very reasonable fee.
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Now that you know where your midwife spends her hard earned money, let’s discuss ways to fund your homebirth because that’s really the goal of this essay.
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Ways to Fund Your Homebirth
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Do you have a Flex Plan?
Flex plans are pre-tax dollars set aside each year to cover medical and childcare expenses. So if you are in the 30% tax bracket and you take out $5,000, you do not pay taxes on it and it’s more like $6500. You have to use it that calendar year, though, and there are limits as to how much can be set aside. The good news is midwifery care is almost always covered!!
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Christian Support
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Are you part of a Christian Sharing organization like Samaritan Ministries, Christian Healthcare Ministry or Christian Care Medishare? These organizations pay for midwives!!! Do you have insurance? Many PPOs do cover a portion of your homebirth. If not, don’t worry, most people pay at least a portion of their fee out of pocket. If you do have insurance, then your midwife can go over the plan with you and discuss billing services and when you might see a reimbursement. Most do charge their fee up front and the client is then paid back by insurance weeks or months later.
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Do you have savings?
Babies are pretty important. Now days fewer and fewer people have savings but a few years back, many of my clients did. If you do, even a modest amount can be taken out to help pay for your homebirth, or at least the deposit to start care while you work toward the rest.
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Do you have a tax refund coming or expecting a tax refund next year?
Many families will use a portion or their whole tax refund to help pay for their homebirth. Remember that homebirth is also tax deductible!!
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Do you have an IRA or any retirement plan?
While I don’t suggest pulling money out lightly, I do think that sometimes getting creative with where your money is stored is needed to help people actualize their plan.
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What is your friend and family network like?
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Many people can go beyond their immediate household to ask for help paying for their dream birth, whether it’s asking for help from their parents, their siblings, friends they’ve had for years, or other family who may be able to help. It’s not something everyone can count on but until you ask and check your resources, it’s hard to know how much might come your way.
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Do you have a special skill or service?
Can you put it out there that you are offering your skill or service NOW to help fund your homebirth. This may include someone who does haircuts or someone who is an artist or someone who is amazing at organizing homes or office supplies. Everyone is good at something! Think about what that is and put yourself out there a little instead of just asking your midwife for a discount.
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Does your midwife offer some trade or barter?
Some of my favorite partial trades included: having my house painted inside for half the fee, receiving fresh fruit, veggies, and raw milk from local organic farmers, having my daughter watched while I was working or needed a break (childcare is an amazing trade if you have that skill and that time, even when you have other kids, sometimes watching one or two more may not be that much effort). I’ve even received massage and dance class trades and a really nice jewelry trade for part of my fee. Definitely ask your midwife if there is anything she might need! Midwives are helpful people and like receiving help. Keep in mind that most midwives cannot do a full trade so you will have to be more creative. Treat your trade as an agreement. I’ve had some flaky trades over the years too and that just lowers the morale for everyone. If you say you’re going to do something, do it in a timely fashion like you are getting paid for it (which you are!! You’re paying for your homebirth). The worst are people who offer to do trade or barter and flake repeatedly. Don’t do that to your midwife. Birth is a ton of responsibility. What if your midwife did not take your trade seriously and flaked out on coming to your birth that same way? Not good!!! Plus midwives would never do that.
Can you get a part time job or a job if you are not already working?
If you already work full time, can you ask for a raise? Most people feel shy negotiating their wages yet when they realize it’s not for them, it’s for their family, many do feel a little better about asking for a 10–20% raise. It may not happen right away, but asking usually does pay off.
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Do you have a credit card or credit union you can get a loan through?
While you must be careful with credit, it is another resource. I do believe that when used wisely, especially to cover a portion, not the whole birth, it can really help people out. Get a low interest credit card of under 6%. You may need to go through a credit union or a bank to make this dream real. Think of it as investing in your child’s future. I do not recommend this for people who already have debt of over $10,000 (not including school debt, most have more than that), or who have bad credit or really high interest rates (over 10% is really high!). Again, be wise to build your credit and make sure you can pay more than the minimum.
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Payment plans are something most midwives offer.
If you start care at 8 weeks with me and put $1,000 down, you have 7 months to pay off the remaining $3,500, so about $500/month. Many people feel they can do that. Be sure you stay current with your payment plan and talk to your midwife if you are feeling stressed or like you are unable to keep up. She might be able to help you find other alternatives.
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Sliding scale is another thing many midwives offer.
For example, a midwife might charge $6.000 for her full fee but be able to go down to $5,000. Don’t ask her to do your birth for free because it’s actually asking her to pay to do your birth, which most midwives, unless they are already wealthy, have other sources of income, or a husband who is very generous and understanding cannot afford to do more than once a year, if that. Most midwives do take one pro-bono client a year, and it’s often a single mom, a teenager, or someone whose house just burned down, to give some examples. It’s usually not two-parent families who work full time and want a free birth so they can go to Disneyland that summer, sorry, it’s just not how it works for most of us.
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Instead of a baby shower, ask for a Money Tree.
Many people will give you baby stuff second hand, often for free. However, many people will also have lavish baby showers thrown in their third trimester. I’ve been to many, many over the years. Even moms who say “they can’t afford my services” end up with $4,000–5,000 worth of stuff, not always but usually. The average American spends $10,000 on just their nursery. I know that’s average but c’mon, do you really need that $800 stroller and that crib for $1000 that will be used to store clothes? It’s possibly excessive for many families, then you end up selling the items at half or quarter of the price barely used to your community instead of asking for what you really want and need: MONEY! Money is the currency that makes getting what you want possible. Ask for what you need. Some families have raised $2500–3500 in one day! It’s amazing. And unless you ask, you might just get 3 car seats and 4 baby bouncers. Money trees work because the whole family-community pitches in at the same time. It’s an age old tradition. Think about when a friend is getting married, many now days ask for money instead of gifts to help offset the cost of a wedding or their honeymoon or just getting started as a new household.
Online fundraising!
GoFund Me, Indiegogo, Care.com all offer options to fundraise. Be sure to set up a PayPal account so those who wish to donate can do so easily. Don’t have a PayPal account, it takes 10 minutes to set one up. Don’t have a bank account? You might want to get one! Don’t have an ID, well, I’m not sure I can help then) You probably need an ID to have a baby now days. Be sure to start these in your 2nd or early 3rd trimester to give your campaign enough time to grow over the months. I’ve seen people fund their whole homebirth, doula care, and their postpartum visits with online campaigns. Don’t be shy and ask people to share. Offer something in return, such as a handmade item, music you made, or even a cute baby photo that’s signed and mailed as a thank you. Never just ask for money online, especially from strangers without giving something back, even a sticker or tee-shirt is better than nothing. I’ve done these for many families and have seen the most successful. Share your story, why you want a homebirth, talk about your midwife, and talk about the care you are getting. You’d be surprised that even old classmates from high school might donate $25–50. People are really generous when you are having a baby.
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Do a community fundraiser to raise awareness about midwifery care or homebirth.
These are amazing!! We have done them in numerous locations and with different events in mind: a community picnic where you charge $10–15/person to eat a sandwich, a movie screening for $20–30, an art exhibit with some drinks, a neighborhood house party where you might have catered food or music and charge per person, a tee shirt selling venture that might have a cute logo or something about how the person is supporting midwifery care, a farm-to-table catered event with a raffle where you might charge way more per person, like $30–50, a local band that plays at the park, or?? The sky’s the limit. Get creative! And don’t feel weird putting yourself out there. Community loves to help out and people are way more generous when you feed them or give them entertainment than when you just ask, “can I have $10?”
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Is there a local organization that might have funds to help offset some of your care?
Often in certain areas there might be a non-profit or another kind of organization that would love to help you fund your dream birth. If not, why not start one while you fund your own birth then pass it on to another expectant family?
Do you go to church or are spiritually affiliated?
Often people in church and other spiritual communities gather their resources to pay it forward to help a new family out. Don’t be shy and maybe get help with this one from one of your friends or the pastor.
Can you sell some things of value to make it work?
I’m not talking about Auntie Alma’s heirloom vanity, unless you are truly ready to part ways with it. I’m talking about that extra motorcycle you barely use, that second or third flat screen TV you forgot about, or even going through your storage and doing a yard sale and putting the proceeds toward your birth. People have sold a 3rd car, have figured out how to sell other valuable things they don’t need, like that record collection you’ve had since high school, the art piece you don’t really like anyway, or some furniture cluttering up the spare room. If there really is nothing of value, then don’t worry, you have plenty of other options.
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Create value in the world.
This one is one of my favorite ways to pay for things. Is there something you can do or offer that you can sell at a good price? It goes with a lot of the other categories but this one really looks at what people need vs what you have or what skills you possess. So let’s say you know your midwife’s daughter needs a car to get to school and you are selling yours soon anyway, could you work something out with your midwife (or her neighbor), etc? Could you also figure out what people around you need and offer it as a service to help fund your birth? There really are so many needs and so many gifts.
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Do you have a spare room in your house?
Consider renting it out for a few months to help lower your overhead and use the money to help pay for your birth. I know most people may not have this option but some do! And if you do, you can charge money and have a sweet roommate for a few months. I know most people don’t want to live with roommates but you gotta be creative sometimes. Things like airbnb and short term rentals are also possible and do some kind of background check for you so you don’t have to spend all this time doing that yourself. Be sure to charge fair market prices and include things like utilities and internet in your fee. You probably won’t want to share your home after the baby is born but some make that work too…I’ve known several families who saved thousands by sharing their spare room, even for part of the year.
Can you consolidate your expenses?
Get rid of your Netflix if you only watch it once a month and rent that Redbox instead, stop going out to coffee or lunch several times a week and make it at home, consider what expenses you have that you can lower. Even $5–10 here and there adds up. For example, Some phone companies often have a deal that if you auto-pay, they take $5 or more off your phone bill. Some utilities have an option to pay less if you use less electricity or make less than a certain amount, like with CARE through PG&E. Some places even have reduced internet providers or deals on your insurance if you put two cars and a home under the same policy. What can you cut down on to save more money to actualize your dreams? The average American wastes a lot of money in things like overdraft fees, late fees (movies, even library), credit card fees with high interest, and many more. Even medical bills can be reduced when you negotiate with the company.
Can your midwife offer you a slight discount or work within your budget?
I always tell families that I find ways to work within their means. You should not be going without basics such as food, heat, or shelter to pay for your homebirth. No, you should not ask for a discount if you just went to 3 festivals this summer, sorry guys. But maybe you are working full time, already have done a fundraiser and a money tree and have offered being of value and even did a partial trade and are still coming up a few hundred short? This is the time to talk to your midwife about what she can do for you. Most midwives are reasonable people. They care about their clients. So please ask if you need more of a break. The worst thing, though, is saying you will pay her and getting really behind, then either stressing or having her stress because you told her $300 a month and now you owe $900 without progress made. Midwives have budgets too. Be honest and keep your word if you are already asking for a discount.
Here are other ideas:
1. You can borrow the money from United Medical Credit, your midwife may charge a little more for this service since they charge her, but sometimes it can be interest free sometimes for a whole year! Borrow money from a friend or family member that you pay back with or without interest (5% is fair, more than that can feel like a burden) over the next year or two.
2. Start a small business during your down time, either using your skills or figuring out what you can sell that already exists. Keep in mind all business does carry risk and not everyone is cut out to do business.
3. Write, make videos, and help people online while getting paid for it. Many people don’t have time to research or investigate info or products and you can sometimes find paid gigs online that are really easy and don’t take up much of your time. Some places even pay for you to use their products and write about them and you often get to keep the product too. This is something that is growing more over the years.
4. Now it’s time for your ideas? Please let me know if there is anything else to include on this list? What else worked for you in raising funds for your homebirth? How much did you generate? How long did it take? Was it worth it?
Thank you so much for reading and sharing with your friends and community. Please let me know if you have any more questions or if you’d like to set up a consultation.
Many warm blessings on your upcoming birth! Your investment is worth it. You’re worth it. Your baby is worth it.
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These were not my original ideas, just some I found to share!