So have you interview these midwives in person? Most midwives I know will usually work out a payment plan. What I have seen though is a difference in values. Some people want a payment plan or a reduced fee just because they are like that with everything they buy, and some people do it because they haven't really evaluated their lives and decided maybe new furniture is less important than having a health care provider. There is a midwife south of where I live and she mostly provides care for migrant women who come up from Mexico, these women come with cash in hand-- for them the value is high, they may live in a house shared with 10 other people but they would not even think of asking for a reduced rate. Now I think that these people do need a reduced rate. But then there are others who have cable Tv, new computers, new cars and are planning a trip to Disney World- I don't think a cost reduction is in order. kwim, most midwives can see and are realistic about trades, fees and when someone can't afford something they often will stretch out the payments. I know one midwife who had a client set up a fund for people who could not afford services, also recently people in town just had a fundraiser to pay the midwife fees and any medical if it came up.So interview first before you decide you can't afford and really look over your lifestyle and spending choices, it may be true that you do need a reduced rate and in this economy many people are just lucky to have jobs, or maybe you need to trim a bit to come up with the payments, the bottom line find someone you really trust and like.