How much do you pay for midwifery services? - Page 2

[Defenestrator]

Originally Posted by bryonyvaughn

The unproven pelvis discount sounded to me like another HB MW with serious doubts of women's ability to birth.

I know the midwife in question and I have to say that, while I understand how you could come to that conclusion given her non-standard fee structure, nothing could be further from the truth. She really is someone who trusts birth completely and is willing to go a lot further out on a limb for her clients than many midwives I know.

I think it is a case, instead, of a midwife who has been practicing for a few years who is still pretty heavily inspired/influenced by the habits of her preceptor. She trained with a midwife in Amish country in Pennsylvania and the midwife she trained with had this policy, though there were so few c-sections, and therefore, so few VBACs among her women that she basically had two prices, one for first-time moms, and one for second-time and above. Some of the women they were working with had 15 or 16 kids and the lower price helped encourage repeat business, but also those moms tended to know their bodies well and call only when the birth was near -- they used their husbands as primary support people, whereas primip women would call a lot earlier and need more support. I personally absolutely love working with women having their first VBAC, but if you added up the hours that I spend with them, they are probably the most-time-intensive of any of my clients, so I can see lumping them in with the primips if you were going to have two different fees.

I don't think that she understands the subtle implication that first-time mom labors are going to be long and difficult and I would guess that she will either drop this price structure or find a different way to talk about it in the near future.

To be fair, I have a somewhat similar policy -- I knock off $400 from the price of anyone who comes into my practice having their 4th baby and above. I started doing it because I thought that my sliding scale didn't reflect the economic reality of the family with 10 kids who makes $50k per year, but I realized as well that I really do usually do less work with these women, especially if they have had babies with me in the past. Their labors tend to be shorter than primips or even second-time moms and the prenatals are shorter, too, because they are usually pretty busy and don't have the time to devote to a 90 minute prenatal in their home.

[~Kristina~]

I wish I hadn't posted here... I've completely made my great mw look like a jerk and that couldn't be further from the truth.

[bryonyvaughn]

Originally Posted by ~Kristina~

I wish I hadn't posted here... I've completely made my great mw look like a jerk and that couldn't be further from the truth.

I don't think that all. I'd never heard of such a pricing structure and only after the *why* was explained to me, it made complete sense.

Based on my experience as a first-time mom with a HB MW (waited to show herself an unethical HCP during labor) I am *very* sensitive to how first-time moms are treated condescendingly, patronized and tolerated. Honestly I'd MUCH rather have a MW with two different price structures and be honest about it (and word it a bit more sensitively per my suggestion) than to charge the same price for all mother, resent the imposition posed by first time moms, and treat them shabbily when it comes down to the crunch time.

IMO you did *nothing* to besmirch your MW's reputation.

~BV

[bandgeek]

My midwife charges on a sliding scale. We are at the bottom of the scale (under $20,000) and only pay $1000 for all the visits, the birth, and pp care. The most she charges is $1800 and that's for people making over $70,000 a year. The only extras are the tub rental (optional) at $150 and the birth kit which is $25 (but you don't have to buy it from her).

She usually requires payment by the 38th week, but will work with you if things are really tight.

I have to say that what she charges seems like about as cheap as it gets, which is good for us, since we're broke. She says she doesn't really make a living at midwifery, it's more like a hobby.

[pamamidwife]

Originally Posted by bryonyvaughn

Wow. I've never heard of an "unproven pelvis" surcharge. That's a little creepy/unsettling to me.

While I don't think this is exactly a reflection of how the mw views birth, but it does really strike me as odd. Is it customary for the area you live in? I've never heard of this before - does it count for VBACs too?

[pamamidwife]

just read the post from Defenestrator. I think there is a huge assumption when people are used to working with "plain" clients vs "english" clients for sure.

that explains alot. still, it would be something that I would consider changing because of exactly what BV said.

[DreamsInDigital]

I've had two homebirths in the same area within 2 years, and for one I paid $2500 and I didn't even start seeing her until my 30th week of pregnancy and for the other I paid $1300. Oddly enough, the second one was the one that respected my wishes during labor the most, and is definitely the one I will call on again for any future babies if we decide not to UC.

[Snowdrift]

I paid $2000 for my first.

If I hdn't miscarried my most recent pregnancy, I would have paid what you are paying because I hired the same midwife.

[kim_nz]

I live in New Zealand and we pay nothing for a midwife, doesnt matter where or how we birth. Its all free apart from ultrasounds. If you go for a OB (not referred due to complications) i think you have to pay but its VERY rare for a woman to do that.

[Peacemamalove]

Luckily my insurance covers my midwife she charges $2400 out of that all I have to pay for is her gas mileage which is $12 a visit and then if I have to transfer to a hospital I have to pay $400 for her services ....

I also have to pay for her birth assistants( doulas and midwife assistants) ( I only have to pay for 1) $250 and I get to meet them a few times before the birth

but that is all I have to pay for ....

[FillingMyQuiver]

My MW charges a flat fee of $2000 for prenatals, birth, and I think 3 PP visits. This fee is for those that can afford it and she is VERY flexible when it comes to changing her fee, working on payment schedule, etc. She will also prorate her fee if you end up having to go to an OB (I know another client of hers whose baby was breech and she needed a c/s. She prorated the prenatal visits and didn't charge the whole fee.)

2yrs ago her fee was $1500.

The birth asst, any labs, birth kit and birth pool are not included in her fee. The birth asst was $300 2yrs ago (not sure if her fee has gone up), we don't do labs, and we have supplies left over from the last HB and our own birth pool.

When I had DD 2yrs ago, I started out w/ a MW team in another state and their fee worked out to be $5000 for prenatals, birth, and PP visits.

[Elsaraw]

Las Vegas: 2400 plus 50 birth kit and 90 blood test.