Join Date: Aug 2006
Location: Montana/New Mexico
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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.