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How much money midwives make - Page 2

post #21 of 35
Midwives in Ontario are reasonably well-paid, and get paid somewhere between a salaried family physician and a nurse. We also have to pay professional fees of about 4k/year. I would estimate that the average full-time midwife here earns about 75k (less experienced midwives with the same caseload make 55K and more experienced midwives about 90k. AMost midwives in Ontario have been practicing fewer than 5 years.

Most weeks I would estimate that I work 50-80 hours a week (not including on-call time, I am just counting actual work time), with a few 110+hrs/weeks a year, and a couple 30+ hour weeks a year. When our professional association did research into the average work of a full-time midwife vs. pay it was less than 4 bucks per hour. We got a raise, so now it is more like 5 bucks an hour, after 11 years of no raises. I am self-employed so I have expenses that are write-offs, and that helps my take home pay. I also take off 8 weeks a year vacation (unpaid) and 10 weekends a year. I look after 38-45 women a year as their main midwife, and another 40 as their second midwife. I go to about 2 births per week, and run a full-time clinic. There is a lot of non-clinical work that I do as a midwife (hospital comittees, volunteer programs, outreach, public education, business admin, and tons of paperwork and billing stuff. It adds about 10 hours a week to my clinical work mentioned above.

It was very hard to get a mortgage as a self-employed person. At 34 and 40 we just bought our first, and very modest, home. I live in a urban/semi-urban area and houses sell for 230k-400k. Everything is expensive and we watch our money very carefully.

I think that relative to other people, like those in the retail sector, I make great money. Compared to others who are primary care providers, we earn pennies. One OB I worked with pulled in over 500k a year, and had his office and admin paid for by the hospital that he worked in. he had a house in Bermuda, and lived in a mansion. I would guess that most OBs around here take home 200K+ after expenses.

In all, I have a roof over my head, can feed and clothe my kids, and eat out once in awhile. I am satisfied with that. We don't take vacations (ok, one big road trip in 10 years), purchase modest things, and need to watch our money very carefully. I feel like I earn every penny, and would feel better compensated with a higher income. I feel like my work deserves more, but when I think of people who are starving and working their tails off full-time or more, and can't feed their kids, I feel like a shcmuck for thinking I need more.

That is my perspective.
post #22 of 35
i know that where i live midwives are charging aroudn $2600 a birth. like the others said though, they are responsible for regisration, insurance as well as their office space etc etc. i know the one midwife working at the shared care community program makes $60/hr (i just saw an ad, they are looking for a new midwife) along with benefits, which actually is not too bad.

i think midwives are underpaid like carolynnmarilynn was saying. midwives are specialists in normal birth and any other medical "specialists" get paid a whole lot more than a midwife.

but ... midwives are not valued as highly as other specialists where i live. it seems their salary really depends on where you live.
post #23 of 35
The midwife I apprenticed with was very busy 8-12 births per month. But don't forget about all the fees that are associated which others have mentioned. Plus she usually has a student or two.

Plus continuing education, supplies, conferences, subscriptions, you want the midwife to be well-educated and up to date, right ?

I think someone else mentioned insurance for self-employed. We easily spent 10,000 on health insurance and costs for our family.

And the driving: As a midwife in this area, I travel many more miles than most people who have a "regular" commute. I might travel one hour one way, turn around come home, go 1/2 hour another way, back to the first one, back home, back to second. You get the idea. Both my husband and I put about 30-40000 miles on our cars per year (he also has a job that requires alot of driving). And many companies reimburse for mileage, wear and tear, etc.

If she is getting that many clients per month, then I would think that is a reasonable fee in her area. And considering the fact that with 5 clients per month, she is on-call 24/7, does all the prenatal/postpartum work, zillions of calls at all hours of the day/night, beepers going off constantly, inability to make any real plans or commitments, etc. then when you break it down by the hour, it isn't unreasonable at all.

Plus, one more thing, where did we get the idea that midwives should not be well paid? Or that if you want to make money and run your business like a good businesswoman that is a bad thing? I don't this for the money (right now I am making more teaching college part time) but I darn well need to be making enough to pay the bills, etc. And my husband expects me to contribute something if I am out there running around all the time.

Someday, I hope to be as successful. Maybe this midwife needs to do some conferences or articles on running a business successfully. Lots of midwives would benefit and quit burning themselves out!
post #24 of 35
Quote:
Originally Posted by janellesmommy View Post
Around here homebirth midwives charge around $4,000. So if they take 5 clients a month, that's $240,000 a year! I know they have some expenses, but still, that sounds like a lot of money!
I hope you're right and that they really do make that much! That would be great.
post #25 of 35
My MW takes 2 clients a month and her rate is 2000.00 a birth. Even though she will barter and work around what you can afford so she doesn't even get that at times. She is WELL worth that and WAY more IMO.. So she doesn't have a glamourous (sp) sallary, but this is what she loves and I'm assuming to her that is worth more then the money.
post #26 of 35
I SHOULD be paid $200,000 a year!

post #27 of 35
I would also imagine at least part of that $4K goes to supplies and whatnot? I mean, not that they cost THAT much but it's not as if she's taking your 4 g's and socking it all away.

I wish midwives made that much money. What's actually criminal is that my old OB was billing my insurance $250 an appointment (that lasted 15 minutes, tops). Do the math on a guy making $1000 an hour with god knows how many patients. Considering I had about 15 appointments with my midwife, most of which lasted over an hour, not even counting the birth she's coming up short.

I really don't like the implications here. If you don't feel like her services are worth what she's charging something is wrong and you should find someone else. My midwife was worth every penny and then some. If I were to have another baby I would happily pay whatever she wanted to charge.
post #28 of 35
Quote:
Originally Posted by pamamidwife View Post
I SHOULD be paid $200,000 a year!

Bah, you're only a $150k midwife, tops. :




post #29 of 35
Thread Starter 
Would everyone stop getting so hot and bothered about the "implications"?! I was just really surprised, because that seems like a lot of money to ME, and it is more than I would expect. I wish ALL midwives made $1,000,000+, then we'd have lot more midwives and fewer OB's.
post #30 of 35
I was shocked when I found out that while the midwife might *charge* $4000, the insurance company decides what is a reasonable fee and pays her accordingly.

For a state health care policy, I think this ends up being about $1000 per birth + minimal exam fees.
post #31 of 35
Quote:
Originally Posted by Arwyn View Post
Bah, you're only a $150k midwife, tops. :

well, fortunately that's all I'm charging you!
post #32 of 35
After my birth, I am conviced my mw doesn't charge enough. After all, she did the work that at least 10 seperate people do for a mainstream birth:

Paperwork -- OB office staffer
Scheduling -- Another OB office staffer
Phone calls -- Another OB office staffer
Urine/blood pressure/weight -- OB office nurse or tech
Prenatal checks -- OB
FHT checks during labor -- L&D nurse
Helped me during labor/birth (aka delivery) -- OB again, perhaps a different on-call OB
Initial baby check -- pediatrician or pediatric nurse
Cleanup after the birth -- housekeeping/maintanence
Helping w/ breastfeeding -- hospital staff lactation consulant
Help with my first post-birth potty -- post-natal nurse
Advice on perineal care post-birth -- post natal nurse

And more I'm probably forgetting.

So I figure she should add up the hourly wage for each of those people, and that's what she should be paid... which is way more than the $1800 she charged me.
post #33 of 35
I agree, midwives should charge whatever they believe their services are worth, and that is going to be different for every midwife. I wish we all we able to comfortably support our familes, but we're not. Far from it. That's why most aspiring midwives who train/apprentice never end up practicing.

I know of a few midwives who do 5+ birth a month, solo. It's on the upper end of manageable, but can be done with organization, strong community support, and solid childcare.

I agree, a midwife who charges $4000 x 5 births a month is NOT making $240,000.

I was a student MW in an area where midwives charged $4,000 for care, and NO ONE was grossing $4000 a birth. Not even close!

I'm guessing you live in a regulated state? If so, insurance and medicaid are likely to be covering a portion (if not most) of the clients. As other posters mentioned, third party insurance pays whatever the heck they want, often HALF of what the midwife charges. In my state they pay ~$1,800. Medicaid typically pays between $1000-$2000. In addition, neither or insurance or medicaid will reimburse in the case of transfer, so you have to factor those in as well.

If practicing in an un-regulated state, I think it's unlikely *most* folks are will pay $4000 out-of-pocket for an unlicensed provider. In unregulated states midwives typically charge lower fees in my experience (~$2000). And again, most cash paying clients are not going to pay the full fee.

Then like others mentioned, overhead, insurance, advertising, taxes, billing, car and travel costs, etc.
post #34 of 35
I can tell you FOR SURE....that she is not making money hand over fist...
Taking the number of births a midwife does and multiplying it by what she charges may seem like a huge amount - but you cannot do that. There are too many hidden costs and pitfalls...
I have been a midwife for 23 years. I make less than the OB nurses at the local hospital, am on call 24/7 and then some, buy my own health insurance for myself and my children, struggle with not being able to buy malpractice (not available to home birth midwives), etc, etc.
PLUS - the women with medicare expect to me accept $900 for complete care and delivery, when my fee is $3000. They know that a homebirth is premium care, they get to choose how they birth, who is with them, etc.....
This next year I will no longer be accepting medicare payments. This decision was not entirely because of the $$ - there have been times when I was the ONLY provider in our area who would take it for OB services. I am cutting back in other areas too....
In answer to the previous TAX question - there is not only self-employment tax, but State Tax too.....my taxes total 28% of my taxable income !!! That is almost a THIRD. Not to mention it took me 6 years to pay off my school loans.....
Carla
post #35 of 35
She works completley alone? She does all the prenatals, billing, driving, etc.? My MW has an apprentice and an assistant. She charges MUCH less than what yours does, and has from2-4 clients per months.
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