Midwife fee question

[VeganC]

I just moved back to California from England, and saw the midwife I'll be using for my homebirth for the first time today. I'm 28 weeks. Her usual fee is $4,000, which includes prenatal, birth, and postnatal. She does work on a sliding scale and can go down in price if we can't afford that. We all (my parents, my husband, and I, since I'm living with my parents and they're going to be helping us pay for it since they're so awesome : ) need to look at finances anyway to see what we can afford, but my question is this. Is it fair that we ask her to slice off some of the fee considering I got a fair portion of my prenatal care while still in England and only have about another 10-12 weeks (my daughter was born at just about 38 weeks, so I'm guessing here) of prenatal care to go? And how much of a reduction would be fair to ask of her?
Hopefully that made sense, I've got a wriggly toddler in my lap. TIA!

[70toes]

I would ask her what she's comfortable with. Something like, "Since I'm already so far along, how much will you be charging me?" That way she has the option of stating the full price or whatever price she's thinks is fair. I would think that she would be willing to reduce the price quite a bit. But then again, she still has a lot of work ahead of her. I'm sorry, I guess I'm riding the fence here and I'm not much help! But I don't think it's an unreasonable thing to ask for.

How wonderful to have such supportive parents, too, IMO!!

[RachaelsMommy]

My midwife's fee is half for prenatal care and half for the birth and pp. Going by this, I'd try to get her to knock $1000-$1500 off.

[AnnR33]

You could ask her what her standard prenatal visit fee is (she'll have one if she has to submit anything for insurance since they need to itemize) and just subtract however many visits you've missed -about 4-5?
I think my mw's fee is $250 per visit so that would be about $1000.

[deymm]

Where in CA are you? I had our first at home in the Los Angeles area.

I think it would be fair to ask her to reduce her rate.

[nkintzel]

Yeah, I think it would be fair to ask for a little off. I really can't say how much. It seems to me like a lot of the prenatal stuff really isn't anything substantial until closer to the end, but maybe that's just me. The birth is really the big thing and I guess the postnatals, too.

[lovetheheights]

a friend just transferred to midwives in NYC and since she was that far along, they charged less. I think it makes sense. good luck!

[MandyGail]

I asked my MW the same question since I started seeing her at 25 weeks (well next week is my first appt) - she said that she doesn't normally reduce the fee for that reason because it takes her 'more work' to get to know me & to deliver the amt/quality of care that she wants to in a shorter amount of time. I get that but....

So she gave me a $500 reducuction anyway because we're having a hard time coming up with that amt of money in such a short time. Hope you get the answer you want, but I dont think it hurts to ask.

[naturallyspeaking]

I started seeing my mw at 18 weeks and asked her if she would reduce the total cost since I haven't used her prior to 18 weeks. She said no because some/many people try to do that and it is not fair to her or something like that. I thought I understood then but now I'm thinking again, I wonder why... OH, she did say some people will do their own prenatal and want to use her for only birth and want to pay a lot less or something...

[mom2a4Rashelle]

I too live in California and I transfered care to a midwife at 27weeks she credited me $50 towards ea prenatal visit I had already had. Since I did not even know I was preggers till 9weeks I had only had 4 visits so she took $200 off her usual fee of $3900. Being my 1st homebirth with our 4th child I wish I would have known how wonderful homebirth was...it was definatly worth every single penny. Once I submitted the superbill to my insurance company I was only out-of pocket $1200.....

[mwherbs]

since she already said that she does a sliding fee scale, then use that to get your discount, and ask if she will give you a discount credit for getting care elsewhere. Now here is why I don't give discounts for people coming to me late , I may make exceptions, but besides the typical watching over what is going on in pregnancy is all the communication and education that is missed, and some things I will be working harder for to catch up I will have to go over odd records that may be missing bits of info I would have covered or labs that may need to be followed up on or even weird additional care that takes extra discussion/education to teach around/work with. In the far past and in places where midwives aren't licensed the clients may be getting complete parallel care that doesn't mean that the midwife has to do less work. there is a reason that insurances pay a"global" fee for prenatal and birth because it works out better to not break down the care I saw this years ago where people would try to wait until they were almost due and then want to switch to midwifery care hoping that it would only be 1/2 the regular fees or even less just the birth fee and not get any post care either. I would rather have negociated the fee in the beginning and do most of the care than to short cut on all the ground work before birth and walk away leaving something to happen I could have helped avoid or make a timely transfer.
so she may give additional discount or not and if she does bonus for you.

[robbins611]

I second mwherbs comments. Continuity of care offers some protection for the mother and midwife. Problems get caught earlier and relationships solidified. It is asking a lot to have a midwife take you on late because you are basically asking her to assume more risk and work much harder to get a clear picture of you, your baby, and all potential issues that could arise. It is also a relationship issue because you need to trust her and she needs to trust you and that comes only with time. I pray that you work this out and have time to develop a great relationship and have a beautiful birth.

[questionsall]

I started with my midwife at 22 weeks. Her fee was ~$3000 for all prenatal, the birth, and up to 6 wks post partum. The only discount was 10% for paying in full in advance. We asked if she gave additional breaks, and she said that the only times she would give a refund/price break was in very rare circumstances (late term loss perhaps). We didn't try to bargain with her because we did not want to make money the reason we did/didn't use her, nor did we want her to feel pressured. The price was the same if we had to go to the hospital (where she would continue to attend in the role of a doula), if the labor lasted 3 days, and so on. Personally, beyond asking about the sliding scale she already mentioned, I would not lean on her to give you more of a price break. Putting pressure on her over money is not the way to foster a good relationship.