Starting with midwife at 20 weeks- ask for reduced rate or no?

[Lashlock]

I don't know if this is a normal question or if I am overstepping my boundaries by thinking this. We will be starting hopefully with a midwife group and most midwives I know do a global billing fee. Since I will be starting later in pregnancy and will require fewer visits than if we started at 8 weeks, should I ask for a lower rate?


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[JamieCatheryn]

It doesn't hurt to gently ask, but don't expect anything and let her know you understand if it's full price if you do mention it. That's only 2-3 less visits than normal, and besides they have to cover the same stuff in less time.

[JudiAU]

I did the same thing and two midwives wouldn't credit anything even for a very late transfer of care and the one I choose did. I believe it was $100/ per missed appointment up to X amount, maybe 1/4 of the fee.

[suzanne0706]

I just transferred late in pregnancy because we moved...I was 31 weeks and I have to pay full price.  Basically if you can possibly get 7 or more visits before the birth, I wouldn't expect a discounted rate.  Most of the support is given in labor and postpartum...not during the pregnancy.  So that is what they charge for.
 

[loveandgarbage]

I didn't even have my first appt with my midwife til 18 weeks and I think that's pretty common. Many midwives won't make appointments until you're over 12 wks (so it's different than at an OB's office). And I agree that most of what you're paying for is support during birth. But it wouldn't hurt to ask as long as you do so gently.

[Comtessa]

I transferred to a HB MW at about 32 weeks, and it was crazy for us and them.  I would not have dared ask for a price reduction after I had thrown her schedule for such a loop at such late notice.  It was generous of her even to take me on at that point.  I ended up being in labor for three days and my MW was there the whole time, barely slept or ate the entire time she was there.  If I calculated her hourly rate based on what I'd paid her and how much work she did on my behalf, it was... astonishingly minimal.  So keep that in mind when you ask for a price reduction; your MW might be making some absurdly low rate already based on the number of hours she works on your behalf.  

[stephbrownthinks]

With my first I switched to a midwife at 31 weeks (something like that) and asked for a reduced rate. She gave us a little off (we also offered to pay all cash upfront so that helped I'm sure), but honestly most of the visits happen towards the end of pregnancy when you start going every 2 weeks, then obviously most of the "work" the midwife does is for the labor, the birth, and the follow up visits. At this point you've really only missed 3 visits at most, and probably more like 1 or 2.

[homebrewer]

I agree with the previous posters. In the grand scheme of things the visits you missed are a very small part of the package of care and she'll need to spend some extra time getting up to date with your records and care so far. I only had an interview and 2 appointments prior to 20 weeks. At/after 20 weeks I'll have probably 10 visits plus the labor and a post partum visit, so the majority of my care. Also, many women start off with an ob/gyn and only later switch to a midwife, so what you're doing isn't that uncommon that it would warrant special treatment.  I wouldn't ask personally, but if it means a lot to you financially it wouldn't hurt as long you keep in the mind the answer will could well be no.